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AstraZeneca Digs Into the Cause of Non-adherence


Pharmaceutical Executive

Pharmaceutical ExecutivePharmaceutical Executive-10-15-2008
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AZ interviewed physicians to determine why patients fail to take their medicine as prescribed. Unsurprisingly, affordability and patient apathy tied for top excuses. Pharm Exec talked to AZ to find out what the company is doing to boost compliance.

Each year, industry loses billions of dollars in prescriptions and healthcare costs due to patient non-adherence. And each year, questions mount about why this is happening, and how to plug the holes in the system. On Monday, AstraZeneca released data from a study conducted with 200 physicians, the goal of which was to find out why patients are skipping their treatments.

Though the rank of result has been different in the past, the actual data aren’t exactly shocking. Tied for top among the reasons for non-adherence are drug costs and apprehension over starting treatment. Far lower in the study (though perhaps not surprisingly in a survey of physicians) were lack of information about the disease state, treatment, and medication; ignorance about condition; and conflict of information between physicians.

The top 10 reasons for non-adherence:

  • Affordability of medicine (20 percent)

  • Patient does not feel he or she needs the medicine (20 percent)

  • Side-effects of medication (17 percent)

  • Forgetfulness (16 percent)

  • Lack of concern over condition (5 percent)

  • Lack of information on disease or treatment (5 percent)

  • Lack of information on the drug prescribed (5 percent)

  • Lack of family/social support (5 percent)

  • Low satisfaction with the drug they are prescribed (3 percent)

  • Poor relationship with myself or another physician (2 percent)

“This survey gives us four very clear prongs that should be addressed,” said Karen Smith, vice president of external medical relations at AstraZeneca.

Smith explained to Pharm Exec on Monday that the company is using the data to tweak existing programs such as its AZ&Me prescription savings program and to launch new campaigns to encourage people to stay on their medication.

To curb forgetfulness, drug companies are reaching out to tech vendors for a number of reminder tools. AZ is working with WellDoc to implement a software solution that sends a text message via cell phone to remind patients to take their medication. The service also provides important information for asthmatics such as weather and pollen counts.

Another option is an e-prescribing technology that sends a reminder to refill a prescription directly from doctor to patient. Because the message comes from the physician rather than a pharma company, patients are more encouraged to open the email, and do what’s asked of them.

This however, doesn’t change the fact that some people just don’t want to take their medication.

“Patients who feel as if they don’t need the medication are a big issue,” Smith said. “As a physician, I’ve sat down with patients and asked them why they feel that way; oftentimes it’s in relation to a chronic disease where they don’t necessarily feel sick, and they don’t see symptoms, such as the case in hypertension or high blood pressure. So it’s really about the physician taking the time to explain what the medication will do in terms of giving them a better quality of life and how ultimately it will mitigate further progression of the disease.”

In recent weeks, new studies have been released suggesting that one reason some patients can’t afford their treatments is the use of free samples of branded drugs for low-income patients. According to one survey in the Southern Medical Journal, the use of free samples (associated with a lower rate of prescribing generic drugs) could ultimately lead to a cycle of non-compliance.

“At the end of the day, I think generics play an important option for patients and doctors to consider,” Smith said. “That’s something for the doctor and the patient to agree on, in terms of what is the best treatment. To get the most out of the medication, it’s about taking the medication as prescribed.”

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