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Once again this month, we change our focus
to look at an issue of great importance and complexity: patient persistence,
or a patient’s continuing to take a medication until he or she
is told to stop by their health care provider. More specifically, we
examine why patient persistence, which is critical for a patient’s
health and safety, can be derailed by a number of factors that can vary
by treatment area and patient segment.
One roadblock affecting pharmaceutical marketing researchers’
ability to study the issues surrounding patient persistence is the “Don’t
ask, don’t tell” approach toward the handling of Adverse
Events (AEs) by some pharmaceutical companies that have developed internal
policies for employing marketing research methodologies and questions
that avoid causing a doctor or patient to report an AE.
While we do not want to have another detailed discussion about AEs here,
since we have covered the issue at length over the last few months,
this article examines the benefits of using open-ended, exploratory
techniques and lines of questioning to tap into the underlying issues
of patient persistence up against the risk that this form of
open dialogue might provide a respondent with the opportunity to report
an AE. We believe that if asking these types of open-ended questions
to better understand the issues of persistence might help keep millions
of patients on drugs they genuinely need, it far outweighs the “risk”
of having to report an AE encountered during research. Thus, we hope
that these new reporting requirements will not impede the pharmaceutical
industry’s willingness to study significant matters such as persistence.
Three factors directly related to patient persistence include:
- Motivation – Research
shows that physicians fail to thoroughly communicate to patients
the “value proposition” of persistence with a prescribed
medication. In addition to doing a better job of explaining the
importance of compliance, we must also understand the factors (and
misconceptions) that discourage patients from complying with therapy.
- Information – Pharmaceutical
companies seem to believe that the more information they layer upon
patients, the more likely they will comply with therapy. However,
patients report that too much information overwhelms, rather than
motivates them, and it is often totally ignored and/or discarded.
We must focus on providing patients with information that motivates
them to persist in taking their medications. Here, brief and concrete
statements of benefits that the patient is likely to receive from
taking such drugs are most valuable.
- Aggravation – Up to
one-third of prescriptions written by physicians wind up being “orphans,”
meaning they are never filled at the pharmacy. Looking at the “whys”
underlying this phenomenon and considering prescription-related
issues such as prior authorization, drug costs and co-pays and the
rules surrounding the refill process, it is clear to see why a sense
of aggravation can negatively impact persistence.
With the lack of appropriate motivation and information
available for patients, and the amount of aggravation they face in getting
the medications they need, it is hardly surprising that so many spontaneously
discontinue using chronic drugs for silent, but often deadly conditions.
When this happens, the patient loses out, physicians become frustrated
and the sales of chronic medications, on which most pharmaceutical companies
make most of their profits, are reduced significantly. To help improve
patient persistence, both physicians and patients need significant assistance
from those with core competencies resident within pharmaceutical companies
and the service organizations that assist them.
To download the complete February 2007 discussion on patient persistence,
adverse events and drug safety, including a recommendation for how pharmaceutical
companies might work toward resolving these issues, click the link on
the graphic image above.
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