On their own, DTC ads will never improve refill compliance. Because patients experience side effects and drug interactions,
the issue is far too complicated to be addressed by ads alone. But they can play a reinforcing role. The goal is to convince
patients with chronic conditions to develop habits that help them manage their medications correctly. Once patients have taken
their medications correctly for one year, their chances of being compliant thereafter are significantly increased. Thus, the
goal should be to get patients through the first year so they will remain on the medication for as long as necessary.
Staying the Course
An effective patient compliance strategy can take a DTC program to the next level and improve prescription refills. But to
do that, it is critical at the outset for companies to communicate with patients differently than they do with traditional
medical communications and continuing medical education (CME) programs. The reason so many patients drop out of therapy is
that they are simply being given information-much of which they cannot understand. Companies must create programs that teach
patients to modify their behavior-and convey information in language that patients can understand. (See "Voices of Experience.")
The DTC ad can become a very effective first step to winning the person's trust and helping the physician and pharmacist persuade
the patient that the medication has value.
But patient retention programs must go far beyond DTC advertising and address the problems patients face as they try to make
treatment decisions. What are the side effects and are they manageable? Does the medication change the effectiveness of other
prescriptions they are currently taking? Is the medication easy to take on a regular schedule? Anyone who has counseled patients
in clinical settings knows that when patients make mistakes, it is usually not their fault. They just didn't have the information
they needed to make a better decision.
Programs will work only if the content
- provides patients with information they need to manage the medication safely and wisely
- helps build confidence and trust in the medication
- is provided in language the average consumer can understand
- is reinforced with an effective design based on health literacy principles.
To create an effective patient retention program, companies must develop materials in the following order:
1. Patient Compliance Strategy. Before developing content or design, it is essential for companies to:
- Identify-through research on the disease, its therapies, and the target population-all the other potential compliance programs
patients may encounter.
- Identify the barriers that health professionals are most likely to encounter when answering patients' questions about a company's
DTC campaign or patient compliance tools.
- Determine which patient counseling techniques and programs are successful in overcoming each patient compliance barrier. Sometimes
that means patients must keep personal progress journals so they can self-monitor and remain motivated. At other times, a
clinic and pharmacy reminder program will help.
- Apply behavior modification models that work with different types of information at each stage of patients' decision making
pro-cess: the DTC campaign, initial prescriptions, and refill prescriptions. That will help drug makers connect with patients
at an emotional level and deal with their fear, anger, denial, concern about side effects and worry about the therapy's cost
as well as its impact on their family and lifestyle.
- Identify behavior modification techniques tailored to the medical condition and product. Patients with obsessive-compulsive
disorders require different approaches than patients taking long-term antihypertensives. Identify self-monitoring and interactive
tools that will help patients follow their own progress so they are motivated to continue taking the medication.
2. Content. Once a patient compliance strategy has been developed, pharma companies must incorporate it into all DTC materials, on websites,
and in health screening tools, patient pamphlets, patient videos, product launch kits, starter packs, and health professional
The foundation of a strong patient compliance program and strong DTC promotion is the FDA-approved PPI, which replaces the
brief summary on the back of DTC print ads and helps ensure that consumers understand the medication's benefits and risks.