Beyond the scrip
By: Paul Harney | April 28, 2016
How comprehensive patient engagement efforts can help improve compliance.
For years, commercial success for a biopharma product was measured by prescriptions – the more providers wrote them, the more successful the product would be. At least that was the theory. But that theory doesn’t take into account all of the obstacles patients’ face between receiving that prescription and filling it on a regular basis.
Patients have many reasons for failing to fill or refill their prescriptions. They might be too expensive, or confusing to use, or have unpleasant side-effects. The patient may forget to take the drug, or begin to doubt its effect. Or in some cases the problem can be as simple as lack of transportation to the pharmacy. According to a 2014 study published in the Annals of Internal Medicine, nearly a third of patients fail to fill first-time prescriptions. Non-adherence was highest for expensive drugs and preventive therapies for chronic conditions, such as ischemic heart disease and depression. Patients that faced higher co-pays, experienced recent hospitalization and had more severe co-morbid conditions were at increased risk for non-adherence.
Regardless of the reason, the impact of this gap is significant. Biopharma companies are losing roughly a third of their sales to non-adherence, and as the market shifts to pay for clinical outcomes, the impact of this lack of compliance will only continue to grow. This gap underscores the problem with measuring prescriptions alone as a rate of commercial success and underscores the need for biopharma companies to think more strategically about comprehensive patient engagement as a means to drive bottom-line results.
A lifeline for MS patients
The problem of non-adherence can be addressed if pharma companies are willing to take a more relational approach to commercial marketing efforts, or activating the patient. Ensuring patients achieve better outcomes is evolving the measurement of success versus strictly measuring how many prescriptions providers write. And you can’t get the desired outcomes unless you activate each patient.
One key to obtaining better patient outcomes is positively affecting the patient experience by developing patient support programs that help increase adherence by providing early and ongoing support to patients as they become accustomed to their new treatment regimen. Pharma companies must engage patients at the outset (when the prescriptions are written) and then evaluate whether the patients need minimal intervention or more in-depth assistance to administer their medications, which increase adherence rates. These “triage” evaluations help to scale services as more patients are prescribed the medications. The true art of these programs is in the triage evaluation stage to balance the cost and appropriate interventions.
We have seen several examples in recent years of compliance levels rising dramatically as a result of patient adherence programs implemented by pharma companies. One example is a multiple sclerosis (MS) nurse educator program that addressed declining persistency rates among patients using a new injection product through comprehensive, quality training and education for caregivers and patients.
After the biopharma company’s injection product launched, patients began to drop off therapy within just three months due to side effects and lack of knowledge about how to manage them. In response, the company launched a new program that provided newly diagnosed MS patients and their caregivers with home visits by a licensed nurse specifically trained in MS and the injection treatment. These nurse educators were able to answer patient questions and review their self-injection techniques to make sure they were doing it correctly. The nurse then continued to visit the patient until they were well-maintained on their treatment and had the confidence to do it alone.
The result: The program recorded an astonishing 40 percent improvement in patient adherence rates in the first two years, compared to the launch baseline. The program is still in place, and recent assessments show ongoing positive impact even with an aging drug in a competitive market.
Improving better care delivery
The remarkable results of this program demonstrate the profound impact patient support programs can have on overall adherence and retention, and it represents an evolution in market dynamics that can benefit developers, patients, providers and payers. These programs improve outcomes and increase adherence, which results in more sales for developers, better quality of life for patients, and reduced overall healthcare costs. In the United States alone, the healthcare system spends an average of $290 billion a year on healthcare complications related to non-adherence trends, which is about 13 percent of total health care dollars spent.
The message is clear: if biopharma companies want to increase sales they need to look beyond the prescriber. They need patients to be actively onboard with the benefits of their treatment, and that requires more than a slip of paper or electronic prescription and a scheduled follow-up visit. Patients need support, knowledge, encouragement and reinforcement to make the treatment an important part of their routine.
Investing in such comprehensive engagement strategies may seem like an added expense, but it is the best way to drive adherence and improve bottom-line results. The way we see it, biopharma companies that have a more comprehensive approach to patient engagement with measurable outcomes that link patients and providers drives better care delivery.
Paul will be discussing the topic below in more detail at the upcoming eyeforpharma Philadelphia 2016 conference on May 3.