In the efforts for better patient engagement, the pharma industry trends are moving towards patient reported outcomes, clinical trial data for targeted therapies and multitudes of patient support programs. Interaction between pharma companies and patients may be limited, but the industry appears eager to take action. Such limited engagement challenge can be attributed to medication distribution channels—other 3rd party stakeholders, such as healthcare professionals (doctors, pharmacists) and group purchasing organizations—who procure medicines on behalf of healthcare institutions. The pharma industry also interacts with or through drug distributors who supply the retail and hospital pharmacies. In all, there is limited, direct interaction with the patients because of significant regulatory hurdles. Patients want, and need, as much resources as possible to achieve better health and drug manufacturers can do more to support this.
Drug’s research and development is important as the initial action of servicing the patients, but if pharma can contribute to helping these patients take the right medicine at the right time, they should take the opportunity to. As Dr. C. Everett Kopp, US Surgeon General once said, “Drugs don’t work in patients who don’t take them”. Bridging the challenge of patient engagement with the hurdle of medication adherence seems like a logical void to fill. Approximately, 50% of patients do not take their medication as prescribed1, costing over $100 billion2, resulting in 125,000 preventable deaths in the US annually3. Many programs currently exist to support patient’s compliance: including pharmacy alerts, medication Apps, and even patient subscription to receive text messages. However, there might be more practical and simpler solutions that require “thinking within the box”.
The Hurdles
The patient engagement value proposition for pharma companies’ internal stakeholders—
senior management & cross functional teams— might be more challenging to external ones— patients, physicians, pharmacist and payers. Externally, pharma’s quest for patient engagement is obvious. The ultimate perception of the message is it is for a greater good: helping patients. However, some will wonder “what’s in it for them (pharma)?” There is competitive advantage to the company that offers patient engagement solutions first as a standard in their category of products or therapeutic area. It can also be about enhancing corporate and industry image, there are just other intrinsic benefits that come with that over time. Moreover, this could decrease the discontinuation curve that has been plaguing specialty pharma with lost revenues. Although internal value proposition is apparent, there are hurdles that remain for pursuing patient centricity.
The forthcoming example is from Europe, a region of the world where DTC (direct–to-consumer) advertising is forbidden because patient engagement is perceived as an oxymoron. Other regulatory hurdle might require medical justification or in some instances, ask to defend patient engagement solutions are not just gimmicks drawing an unnecessary attention to known issues. This external challenge pales in comparison to other internal challenges (manufacturing, supply, finance) who still think R&D is the only way pharma can help patients. Pharma companies’ internal stakeholders require a paradigm shift to appreciate the value of patient centricity. This is because the “patient first” mindset needs to established within the organization. There are more ways pharma can help patients beyond the pills. Other ROI metrics and KPIs might not be readily available at the onset but a path — from if to engage patients to how is set.
Complex Problems Needs Multidimensional Solutions
Integrated adherence platforms for multidimensional solutions at times are brushed aside because they have “not been done before” and the hurdles on doing something beyond the standard is far too great for some that are skeptical. As history has proven time and again, what has not been done before does not necessarily imply that it is something unattainable. For instance, the technological advancements in the past decade has been something out of a futuristic movie that people initially couldn’t fathom to ever become a reality— This is the same case for pharma. Leveraging technology solutions is gradually becoming accepted in the pharma industry, and it is a way to think of a more robust answer than simple packaging strategies to the complex non-adherence problem.
With chronic diseases, taking medications daily for the rest of one’s life can become a mundane and routine activity. A calendarized blister with the seven weeks days is becoming standard for most pharmaceutical compliance packaging. Patients cultivate a habit of when to take their pills, reducing wastage and make a routine, somewhat interactive to patients. Taking a second to think about if “I’m taking the Tuesday pill on a Tuesday” might not be enough to engage the patient to adhere to their medication. Leveraging multidimensional adherence technology solutions to add layers of patient engagement appears to be the logical improvement to just a simple packaging. New and improved features have been incorporated to the standard medication package to help make a difference in patients’ lives. Part of the solutions should include a wireless connected pillbox/cap with a visual and sound reminder, which also tracks and record the patient opening/closing the container that assumes the medication being taken. Another feature that the technology solutions should include is a provider/patient portal that provides the data of what the smart pillbox records. By having a portal, pharma’s designated support system can have visibility if patients are taking their medication as prescribed or not. Having visibility of patient’s adherence data is only helpful if the support system has a way to engage the patient by reaching out via phone call, text, or email. This will ensure a timely and proper intervention for the patients to get them back on track if they are not adhering to their dosing regimens.
Device-enabled technology solution is an approach in the right direction for taking patient engagement into the level that pharma needs to see the internal value proposition. In the era of technology and big data, utilizing a methodology that incorporates both is scratching the surface of the standard’s ceiling. The regulatory hurdles to get “patient-centric” innovations approved still exist. However, integrated technological solutions can spur innovative ideas and increase pharma-patient engagement.
References
- Brown, MT et al., Mayo Clin Proc. April 2011, 86(4):304-314.
- National Council on Patient Information and Education. Accelerating Progress in Prescription Medicine Adherence: The Adherence Action Agenda. A National Action Plan to Address America’s “Other Drug Problem.” October 2013.
- Iuga, A. O., & McGuire, M. J. (2014). Adherence and health care costs. Risk Management and Healthcare Policy, 7, 35–44.
