However successful a drug is in clinical trials, one of the biggest challenges for treatment is once it reaches the patients' or caregivers' hands. The effectiveness of a treatment, and its safety, depends on patient adherence and persistence – taking the right dose in the right way at the right time, and continuing to do so, whilst storing the drug in the right conditions.
Non-adherence has a major impact on the healthcare economy, from patient outcomes and treatment costs to wasted drugs. By supporting patients through education and technology, and empowering them to make the right decisions, biopharma can help to improve adherence and ensure patients and the healthcare system get the full value of the treatment.
The importance of adherence: The financial and social impact
According to the National Institute for Health and Care Excellence (NICE), around £4 billion1
of medicines are not used correctly. The most obvious impact of poor adherence to treatment is on patient outcomes, because diseases are not treated effectively, or side effects are increased. This will increase the healthcare costs, as healthcare providers need to treat an increasingly severe disease and deal with higher levels of hospital admissions. This has a knock-on effect on society – patients with poor clinical outcomes will have more time off sick, so have lower productivity, and those with caring responsibilities may be less able to fulfil these. Death rates also rise unnecessarily, potentially leaving families without caregivers and breadwinners. At a time when the NHS is dealing with a drugs bill of £13.8 billion a year2
, budget cuts, an aging population, and increasing levels of lifestyle-related diseases such as cancer, metabolic disorders and cardiovascular disease, non-compliance is adding extra pressure.
Issues with adherence have an impact on biopharma – missed doses can lead to issues with efficacy and safety, which can damage the relationship between companies, patients and healthcare systems.
The role of biopharma in adherence intervention
Improving adherence requires the investment of time and resources. This ranges from decisions during drug development, through providing patient and physician support, to the collection of local and clinical trial data about medication adherence and outcomes. To be effective, these need to be tailored as much as possible to the target patient population, including adherence risks and behaviors, and treatment needs. This is where the biopharma industry can step in, by providing support to the NHS in three key areas:
- Regimens – simplify regimens where possible, including using controlled or extended release products, and integrate with patients' and carers daily routines.
- Formulation and packaging – masking unpleasant tastes and smells, making therapeutics easy to take and discrete to carry, and tailoring formulations to patient populations and ages, e.g. liquid, solid, tablet, powder.
- Education – make sure patients and carers understand why adherence is important.
- Training – help patients to manage complex drug regimens or use unfamiliar devices and delivery systems.
- Ongoing support interventions – provide oral and written instructions using easy to read language (with translations as required); follow-up phone calls; reminders to take drugs and attend appointments; symptom and/or drug diaries.
- Patient communities – create new communities or help existing communities to provide emotional and psychological support.
- Healthcare professionals will require training and support for the best use of the programs.
- Economic and clinical value data to support paper decisions, by tracking patient beliefs and behaviours, monitoring clinical outcomes, and measuring program success.
Technology can play an important role in improving adherence, through patient-centred communities, support and education apps, platforms and websites. These kinds of support strategies can help to support behavioral change in patients, thereby improving adherence, as well as empowering patients and improving relationships between companies, healthcare providers, carers and patients.
Medication adherence is vitally important for patient health, for the economics of the healthcare system, and for the wider economy. Biopharma can play an important role in improving adherence, through support, training, education and technology, and by providing important data that could influence future drug development. This should lead to better outcomes and cost savings, as well as improving and confirming the value of drugs on the market.
To find out more about how an improvement in patient adherence would positively impact the wider health economy and the outcomes of the ‘Triple Aim’ – download the Quintiles white paper "Influencing patient adherence in an outcomes focused era
1. World Health Organization. 2003. Adherence to Long-Term Therapies: Evidence for Action. Geneva, Switzerland: WHO.
2. Shaw, V., 2014. Clinical leaders: Pharma on the front line. Health Service Journal
. [Online] <http://www.hsj.co.uk/resource-centre/supplements/clinical-leaders-pharma-on-the-front-line/5072260.article#.VP2kWxjtmko
> [Accessed May 13th, 2015].