Patients control the success of drugs. No matter how much money pharma companies spend on patient acquisition, they will lose
market share when consumers decide to stop taking their products.
Dorothy L. Smith, PharmD
Improving patient compliance is fast becoming a priority for many pharma companies, given that patients' adherence to prescriptions
is declining. According to Ipsos PharmTrends, 14.5 percent of US households (16 million) failed to fill either a new prescription
or a refill in 2003, a 21 percent jump from 2002, when 12.3 percent didn't fill the physician-prescribed Rx.
Many product managers are aiming for the low-hanging fruit. They define success as getting patients to stay on therapy for
one more refill. That makes little sense for medications used to treat chronic conditions. Instead, pharma companies need
to develop a patient compliance strategy during clinical trials so that when the product is approved, adherence programs are
part of the launch package—and compliance messaging is integrated with all patient materials.
This article highlights how pharma marketers can develop successful patient retention programs. It discusses how a compliance
strategy must actually be a series of smaller strategies that patients' progress through as their relationship with the brand
deepens. The article also emphasizes the importance of developing an official patient package insert (PPI) and gives practical
advice for program execution through the use of direct-to-consumer (DTC) materials.
The Patient Retention Problem
A Message for Each Stage
As patients' attitudes and experiences evolve and change during the course of their therapy, so must pharma company programs.
Therefore, industry initiatives must be based on the transtheoretical model of change, which describes how people modify a
problem behavior or acquire a positive one. Simply handing out the same sheet of medication instructions at each refill is
a waste of money because patients need different kinds of information every step of the way.
Filling the initial script. Once patients receive a prescription from their doctor, they start asking questions and making decisions: "Shall I fill this
prescription?" "Do I really need this drug?" "How safe is it?"
Empathy for Patients
Indeed, many patients prescribed a drug don't even bother to get the script filled. Therefore, companies need to give patients
more than just the practical information about appropriate dosing and common side effects to accompany the initial script.
They must also motivate them to fill their prescription by demonstrating that the drug is necessary for their condition.
How and when to deliver these patient messages should be determined during the clinical trial phase. During those interactions
with patients, companies can find the most appropriate and effective methods to improve compliance based on the specific medical
condition, the drug, and the targeted populations.
Early refills. Two of the most common reasons patients drop out of therapy are adverse side effects and the feeling that the medication
isn't "helping." Getting patients past those hurdles goes far to keep patients as customers, yet companies currently devote
little time or effort to those issues.
For example, companies should not only tell patients about potential side effects, but should relate how patients can best
manage them. Instead of informing consumers that a drug can cause "dry mouth," marketing messages should instruct patients
that brushing their teeth and gums daily, sucking sugarless, sour hard candies, and sipping water helps alleviate that side
effect. Those simple instructions may make the difference between compliant patients and lost customers.
Companies also need to develop campaigns that help patients monitor their progress, possibly through creative programs that
use clinical markers of patient management. That should help decrease therapy dropout because patients can witness the drug's
efficacy for themselves.