The following guest post — part of our Drug Adherence series — is by Elizabeth Sozanski, who is currently Senior Director, Global Brand Strategy, and is the former Adherence Leader for AstraZeneca. In that role, she was responsible for building the adherence strategy and initiatives in support of 5 largest brands; had a leading role in developing adherence-related partnerships with multiple healthcare partners; and served as the main interface to the organization for adherence best practices aimed at improving appropriate care and healthcare outcomes.

In the many years that I’ve been with the pharmaceutical industry, few issues have been both as divisive and unifying the way medication adherence has, all at the same time. It’s divisive because various stakeholders in the healthcare space each own a different—and often seemingly conflicting—component of this common yet complex problem. It’s unifying because not a single one of those stakeholders can solve the issue on their own. The unique opportunity this situation creates is that, to address this costly and serious challenge with the price tag of $100 billion each year, we all have to come together and work across our boundaries and individual interests.

When I talk about healthcare stakeholders, I certainly include the manufacturers, but also a whole host of other key players in the healthcare space: starting with patients, doctors and nurses, and including managed care organizations, insurance companies, employers, public health organizations, policy-makers and regulatory bodies such as the FDA or EMEA.

As manufacturers, our hope is that patients who use our medicines benefit from their full value by using them appropriately. As an industry, we put so much effort into discovering and developing new medicines for patients—the therapeutic benefit of these medicines is clearly compromised unless an appropriate doctor-prescribed regimen is adhered to.

There are as many theories as they are people as to why patients deviate from their doctors’ guidance, and choose to “prescribe” their own treatment regimen instead. I won’t go into them because they have been very well covered already in this debate.

So what can a manufacturer do to address the issue? While no pharmaceutical company can single-handedly remove all of the underlying issues which drive patient adherence (in fact, none of the other healthcare stakeholders can either), there are many things we can do as an industry, and even more we can do if we partner with others in this challenging mission.

There are three key areas where we can bring particular value to this challenging issue:

1. First and foremost, we have both the ability and the obligation to understand the needs of our patients—as individuals—and not as “numbers” or a “disease.” We can, and should be, helping patients in ways that are relevant to them. Through many years of research, we found that patients tend to follow certain adherence behavior patterns depending on their “healthcare personality.” This personality guides their actions, and tends to hold true regardless of the type of medicine or condition it treats. There are many excellent patient support programs offered by AstraZeneca, and by our industry peers. These programs (such as In Your Corner TM or Healthy Horizons TM), which usually offer the patient a combination of personalized reminders, education and information combined with some simple rewards, help keep adherence top-of-mind. Patients who participate in these programs typically stay more adherent to their prescribed treatment, especially if the offerings are relevant and tailored to their unique “healthcare personality.”
2. Second, as an industry with long-standing and important relationships with physicians, it is our job is to support them in clearly communicating the importance of therapy adherence. While the healthcare and adherence dialogue clearly belongs to the physician and their patient, there are tools that we can provide to make that interaction as strong as it can be. For example, during the starting phase (the first 4 prescriptions, or approximately 120 days), adherence drop-off is especially dramatic. A simple tool, such as SERVTM, which has been designed to work within the reality of a busy practice, can help the physician encourage their patients’ adherence, starting from the first prescription.
3. Third, we need to play an active role in addressing non-adherence in the broader context of public health, through coalition-type partnerships, public education, and policy forums. Because non-adherence has a profound impact on all healthcare stakeholders, it can be a well-recognized rallying point for all of us. Here again, there are many great examples of various parties coming together for this important common cause: a pharmaceutical company and a health plan building and testing a voice-activated reminder technology together; a national pharmacy chain and a manufacturer building a customized in-pharmacy counseling program for patients; a health literacy initiative between a pharmaceutical company and the American Academy of Family Physicians; a state working together with Medicaid and a manufacturer (Florida: A Healthy State program) on a broad health-improvement initiative including adherence.

With these examples to build on, there is no reason why we shouldn’t be able to rise above our individual interests and boundaries to address non-adherence. As manufacturers, we clearly own a component of the issue—as well as of the solution. But to really make a difference in this complex challenge, we must work together across the healthcare spectrum. With that approach, as the patients benefit, so will all of us.

This entry was posted on Wednesday, October 28th, 2009 at 9:10 am and is filed under Drug Adherence. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.