Strategies to Improve Global Patient Adherence



Pharma IQ
05/12/2011

The figures relating to patient adherence, in particularly with regard to chronic diseases, sometimes make for grim reading.

Manish Gupta, chief executive officer of life sciences firm Indegene, cited figures recently claiming 70 per cent of patients with chronic diseases stop taking their medication after two to three months, not only impacting their health but also the drug sales of the provider.

"Patient adherence programmes help in keeping the patient on the drug, and also improving their lifestyle, leading to a win-win situation for both the pharma company and the patient," Gupta told Live Mint.

Although his comments were made in reference to the pharmaceutical market in India, it is truly a global issue for the pharmaceutical industry, and one which it is investing significant resources in addressing.

New technology

Part of the solution to improving patient adherence, as seen by many, is the increased use of new technology.

Indegene is among those in India helping to boost patient adherence through the use of call centres, which comply with the country's strict rules on the marketing of pharmaceutical products to patients.

Merck Sharp and Dohme India is among the companies to have seen a good return from such a strategy, Live Mint reported.

Called Sparsh and targeted at users of its diabetes drug Januvia, the facility offersadvice on lifestyle, diet and delivery and alerts for medication. The article claims that two years on, the drug is among its biggest sellers and similar results were said to have been seen for other Indegene clients.

Healthcare management company WellDoc is also harnessing technology to boost patient adherence for its clients, earning itself the Strategic Patient Adherence (SPA) Award for Innovation.

The solution offers United States customers real-time patient information and support, using feedback related to behaviour, motivation and clinical feedback, combined with platforms such as mobile phones.

"By focusing on the unique behavioural determinants of a particular disease and therapeutic class we are able to significantly impact drug adherence, which supports better patient outcomes," Robin Anthony Kouyate, PhD, MA, director, behavioural sciences at WellDoc, said.

Counselling

Dr. David Lorber, Wallgreens' vice president of clinical affairs, recently revealed a study which showed over a two year period, patients on multiple sclerosisdrugs who were adherent to medication could save a large national insurance payer $1.1 million(£0.67 million) for 801 patients, compared to those who were less adherent.

"Patient counsellingand education by trained pharmacists and nurses .... translates into fewer office visits as a result of improved adherence. Proactive patient monitoring also drives early recognition of, and response to, adverse drug reactions and side effects, resulting in improved outcomes," Lorber said.

This approach – providing targeted support to patients throughout their treatment – is also one which has been adopted by Pfizer, manufacturer of the stop smoking medication Champix, and pharmacy chain Numark in the UK.

When patients came in with a prescription for Champix they were initially offered counselling from the pharmacist about the medication.

From there, they were offered face-to-face support throughout the treatment cycle, which looked at the progress being made, along with any behavioural changes and the expectations of the patients.

Information from the pilot revealed increased adherence of 20 percent over the first four weeks and an increase in prescriptions of 50 percent.

Mimi Lau, Numark's director of professional services,said: "Crucially, the support programme is designed not only to measure adherence to medication, but also how this impacts on the health outcome for the patient, reasons for a patient discontinuing treatment and the associated NHS spend."

Lau added that in the past adherence schemes had been too difficult for pharmacies to deliver, describing them as "too complicated and manually driven" but both patients and pharmacists had expression satisfaction at the Pfizer scheme.

Some 84 percent of participants described the support as valuable or very valuable and a similar number said they would recommend it to a friend.

Shamir Patel, of North Meols Pharmacies Ltd, who participated in the pilot scheme, concluded: "I found this service an excellent way to engage with patients, support them with their treatment and build their loyalty to my pharmacy."