While it's not a new matter, adherence is a complex one to solve, with influences from society and the economy, the healthcare system, the disease and its treatment, the physician and caregivers and from the patient him - or herself. The most obvious impact of non-adherence is that on the patient. By not taking the drugs at the right times and in the right doses, patients may not get the full benefit of the treatment. Because of this, their symptoms may not get better, or their disease may progress. However, these poorer outcomes also have an impact on both the healthcare system in the following way:
- Not adhering to drug regimens means fewer prescriptions filled
- This might lead to reduced benefits from the drugs and poorer outcomes for patients, again resulting in higher costs for the healthcare system, and more pressure on healthcare professionals
By helping with the issue of adherence through support and education, patient programs could make a real difference in cost containment for healthcare providers, as well as improving outcomes for patients (and their families). These programs need to be designed around patients' needs, and tailored to the specific factors that have an impact on adherence.
Healthcare system infrastructure/stakeholder engagement
The healthcare system regulations differ across Europe and the US, and an increasing number of complex products such as biologics have regulatory criteria post-approval, such as surveillance studies, which means an increasing need for stakeholder engagement. Providing patient support programs is an important part of supporting both patients and healthcare professionals, but the regulatory landscape varies across Europe as to whether patient information is differentiated from direct-to-consumer (DTC) advertising. For example, Ireland and the Netherlands have strict laws differentiating between the two, whereas France doesn't differentiate,This information is important, as it is vital to understand how to link patient support into the healthcare system.
The patient support landscape in Europe: Focus on Germany
In Germany, the payer and provider landscape is fragmented, and the regulation of patient support is vague. The statutory health insurance funds (sick funds) offer disease management programs (DMPs) to help patients manage their chronic disease and maintain or improve their quality of life over the long term. These programs mainly cover asthma, chronic-obstructive pulmonary disease (COPD), breast cancer, coronary heart disease (CHD) and chronic heart failure (CHF), and type 1 and type 2 diabetes. Patients have regular appointments with their doctor, along with patient education sessions. In general, biopharma companies offer patient support programs, and there are a few multi-stakeholder programs, but these are rare. These programs also need to take federal and state laws into account where patient data protection and pharmaceutical regulations are concerned.
Because of the lack of guidelines and structure compared with countries like the UK, and the increasing number of stakeholders involved, biopharma companies that want to run patient support programs in Germany need to start to plan these early, with defined scope and program goals. This will help them to engage with all stakeholders, especially healthcare professionals, and have the maximum impact.
Optimising outcomes for all stakeholders
There various factors to take into account when creating patient support programs in Germany, but these could bring a lot of benefits to all stakeholders:
- Healthcare providers and patients
- Better patient outcomes
- Lower healthcare costs for treated vs untreated patients
- Real-world data and confirmation of efficacy
Improved differentiation in the marketplace, giving a competitive edge
Better reputation for the biopharma companies
Trigger for stakeholder engagement
To learn more about patient adherence strategies in Germany, you can view our on demand webinar recording
discussing this topic in more detail which includes Joanne Thiele, Project Manager Market Access at Quintiles and a representative from the IGES Institute for research and consulting in healthcare from Germany to provide valuable insight on this topical biopharma debate.
View the webinar recording here: http://bit.ly/1JC6pKE