Patient compliance is a $30 billion complaint

Data from the Medicines Monitoring Unit (MEMO) at the indicates that only one third of patients are fully compliant with their drug prescriptions. A third are non-compliant while the remaining third are considered completely non-compliant.

On top of the over $30 billion annual cost to the pharmaceutical companies from prescriptions and repeat prescriptions never filled, patients also suffer in terms of loss of quality of life. Furthermore, national health services also incur costs due to the increased risk of hospitalization and additional healthcare interventions.

Unintentional compliance can easily be targeted through such simple solutions as electronic or telephone reminders to take medication or refill prescriptions, however intentional non-compliance is more difficult to address.

The results of Datamonitor's Patient Compliance Survey 2004 support the idea that tailored or personalized communication with patients is an important tool in compliance initiatives. In other words, the interaction with patients must not stop at direct to consumer advertising (DTCA) that raises awareness of products at product launch. Instead, direct to patient communication (DTPC) should be provided throughout the pharma-patient relationship to provide continual support to compliant behavior.

Novartis's recently launched patient recruitment program for Diovan is an example of a DTCA awareness initiative that is fully integrated with a patient education and support service. The 'Take Action for a Healthy BP' (blood pressure) promotion advertises access to the support program as a key incentive to seek treatment with Diovan.

Finding drivers of non-compliance

To develop a tailored patient communications strategy, companies must first understand the patient and the drivers of his or her non-compliance. This can be achieved through utilization of analytical customer relationship management (CRM). However Datamonitor's survey found that many companies are underutilizing CRM: of the 80% of respondents that used CRM, only 25% reported that this initiative was being used to address patient compliance through targeted marketing.

One of the biggest barriers hindering the return on investment of CRM programs where patient compliance is the aim is the fact that the very patients most in need of such intervention may be the hardest to reach. While patients with severe symptoms may appreciate the provision of patient support services such as a telephone helpline, Datamonitor's analysis indicates such patients are not at the greatest risk of non-compliance. Asymptomatic patients are more prone to low compliance due to the limited perceived benefit of a therapy.

Such patients are unlikely to be sufficiently motivated about their disorder to make use of telephone helplines or online educational content. Likewise, non-compliance in patients with a distrust of pharmaceuticals and the pharmaceutical industry will not be effectively addressed through the provision of company sponsored support programs and education.

Are the costs too high?

While personalized patient communications and support may be the most effective marketing strategy when the aim is to boost patient compliance, the cost of such a strategy is often seen as prohibitive.

However, while DTPC programs are more resource intensive than DTCA and branding, the smaller target audience can reduce the overall costs of this strategy. Also the increased access of the general public to electronic communications is further reducing the cost of DTPC campaigns, making it more applicable to a wider range of disorders.

When evaluating the cost effectiveness of patient compliance initiatives, companies should tailor their strategies and consider the per patient cost of the intervention. In large therapeutic indications, where the value of each patient to the pharmaceutical company is low, costly DTPC campaigns may not be appropriate.

In niche disorders however, where the value per patient is high, DTPC not only represents a more effective way of targeting compliance but may also represent a more cost-effective option than mass-market DTCA approaches.

Related research:

·          Addressing Patient Compliance: Targeted marketing driving a shift in focus from acquisition to retention

·          Improving Patient Compliance: Utilizing online and mobile compliance tools

·          eHealth Regulations in the US: Understanding the Evolving US Legislative Landscape