Why Do People Think Adherence Is So Easy?

I think we all know that medication adherence is a big deal. The most common number quoted is the $290B waste number from NEHI. There are numerous studies that confirm the value of non-adherence even one that just came out.

The amount of money spent on trying to improve adherence is huge! Pharma has worked on. Retail pharmacies have worked on it. Providers have worked on it. Insurance companies have worked on it. Employers have worked on it… And all of these have happened across the world.

At the same time, you see people get so excited about things don’t make any sense to me.

Let me take an easy example. A few months ago, a company called MediSafe put out a press release around moving medication adherence on statins up to 84.25%. Nothing against the company, but I read the press release and reached out to them to say “this is great, but it’s only 2 months of data…most people drop therapy after the first few months so who care…call me back when you get some good 12 month data.”

But, a lot of people got all excited and there was numerous press about this – see list of articles about them.

Now, tonight, I see another technology getting similar excitement. Fast Company talks about the AdhereTech technology which integrates a cellular phone with a pill bottle. And, it costs $60 a month. In my experience, companies wouldn’t even spend $2 a month to promote adherence so $60 is just impractical. The argument is that this is good for high cost specialty drugs that are oral solids not injectables. But, this isn’t a new idea. Glowcaps already built this model with a very slick interface and workflow.

And, I don’t know about you, but I think this would be obnoxious. And, I love data and am part of the QuantifiedSelf movement. I’m not sure I understand the consumer research here. I would have to believe all of the following to buy into this model.

  • Non-adherence people are primarily not adherent due to no reminders to take their medication on a daily basis.
  • People with chronic conditions that require high cost specialty drugs are going to change behavior because some bottle sends them a text message.
  • Manufacturers or some other healthcare company is willing to pay $60 a month for this service.
  • There won’t be message fatigue after a few months (weeks) of messaging.
  • Pharmacies would be have to be willing to change their workflow to use these bottles.

Yes. Will this work for some people…sure. But, if it helps 10% of people, then my cost is really $600 per success.

Should we be working on better solutions to address adherence…of course.

But, let’s stop trying to figure out some gimmick to fix adherence. Let’s look at root cause.

For example:

  • People don’t know why they’ve been given a medication.
  • People don’t understand their disease.
  • People can’t afford their medication.
  • People don’t know what to expect in terms of side effects.
  • People don’t see value in improving adherence.
  • People don’t know they have to refill their medications.
  • People aren’t health literate.

We have a lot of problems.

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5 Responses to “Why Do People Think Adherence Is So Easy?”

  1. This is a smart solution – a mobile connected and monitored pill dispenser – Medimi from MedicPen in Sweden: http://medicpen.com/

  2. Hey Lady, is it me or does Mr. George Antwerp seem like he’s under the influence in this post?!?

    Kym S. Wambold | Senior Account Executive, Healthcare
    Varolii Corporation | Office (615) 368.3408 | Mobile 615.866.8635 | kym.wambold@varolii.com

  3. George, thanks for addressing this! I agree, patients need to be educated and motivated to participate in their pharmaceutical care. One point this involves is breaking the barriers to effective patient counseling. Patients definiately need to know why they need to take their med so they can buy into the concept. Patients need to be in a position to ask educated questions about their medication, because, as we know, after a pharmacist describes the medication and then asks, “are there any questions?”, they will wait about 2.5 seconds and then say, “OK, thanks, have a great day”.

    AudibleRx is all about helping folks understand what they do and don’t know about their medications so they may take educated questions back to their own pharmacist. OBRA 90 based Medication Specific Counseling Sessions in audio format. http://www.AudibleRx.com
    Thanks
    Steve

  4. Maria von Hildebrand Reply May 7, 2013 at 1:50 am

    Excellent article George, thank you. The questions you raise about people’s health literacy is key. It’s not that people don’t want the info imo. Engagement key for patient/people participation, adherence. Transparency re efficacy of drugs essential.

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