Consumers of healthcare are people who desire to be well, not people who are sick. They are continually making choices,very often the wrong ones. Some choose to ignore medical advice or not adhere to it; others choose to let underlying diseases go undetected; many choose to visit a healthcare practitioner only when the symptoms become acute or unbearable.
It is very evident that there needs to be a reorientation - from selling sickness to selling wellness.
Let us examine the effects of non-adherence.
Non-adherence is responsible for increased hospitalization and an estimated annual cost of $ 2 billion.
According to the WHO,only half of the 1.8 billion prescriptions dispensed every year are taken correctly. This is just considering adherence to medication. If we take into account adherence to treatment- which includes lifestyle modification, physical activity and good nutrition - the numbers will bemuch lower.
How does it affect the pharmaceutical industry?
According to a study conducted by Cap Gemini in the US, the average loss in revenue for all drugs due to non-adherence is 59%.When estimated in terms of value,this loss is an enormous $118 billion.
What are pharmaceutical companies doing to improve treatment adherence?
Traditionally, pharmaceutical companies have been sales focused. Sales growth and increased prescription support by doctors are the only indicators of success. Accountability for patient outcomes has yet to find a place in the performance metrics.
Patient centricity is a stated part of every pharmaceutical company’s mission, but in most cases the scope of such action is limited to the Return on Investments made; a very myopic approach indeed.
Leading FMHG companies have recognized the importance of consumer-centricity. They have long given up being sales oriented and have embraced aconsumer empowering approach. Harpic claiming that just a few drops ensures complete toilet hygiene, or Kelloggs saying that the ubiquitous idli-sambar is the healthiest breakfast option, seems contrary to increased product sales. But they are in the interest of consumers and leads to long-term brand loyalty.
Pharmaceutical companies have however continued to focus mainly on educating doctors about the efficacy of their drugs. Empowering patients and helping them live better seems to be a neglected area. This is evident from the fact that most pharmaceutical companies spend only about 3% of their marketing budget on Patient Programs.
There are many reasons for this negligence
Brand managers are unsure whether their programs to improve awareness and behavior will end up benefitting them or their competitors.
While the industry has expertise in reaching out to scientists and healthcare providers, communicating to patients who have low health literacy is still alien territory.
Emphasis is on treatment, not on prevention and wellness.
There is institutional neglect because incentives are built on sales and not patient outcomes.
Regulatory caps on direct to patient communication makes the industry very cautious while designing adherence programs.
This brings us to a pertinent question. Who is the customer of the pharmaceutical company - the doctor or the patient?
We asked this question to several people in the pharmaceutical industry. No prizes for guessing here – of course it is the doctor! Notwithstanding the fact that it is the patient who pays for the medicine, or that the patient does not take the medicine as advised or the patient is unaware of problems associated with non-adherence to treatment.
While companies regularly dish out adherence programs and other patient oriented initiatives, it is still the doctor who has the lion’s share of their attention. And then, there are regulatory trappings. ‘We are not allowed to promote our drugs to patients, so a lot of effort taken to educate patients will not benefit us’.
Unfortunately, adherence programs have remained as programs that incentivize patients to take the ‘particular brand of medicine’ as advised;they are not focused on getting people back to good health. This focus on selling medicines is in complete disharmony with the stated purpose of many pharmaceutical companies.
What could be the way forward?
Pharmaceutical companies should seriously consider increasing investment on patients. While doing so, they should realign the goals towards boosting Revenue, Reputation and Goodwill.
They should build effective approaches that improve both treatment adherence as well as access to medicine. These approaches should have scope for including patients who can’t adhere because of affordability issues. Effective measuring and tracking tools should be an integral part of these programs to ensure money is wisely spent.
They should develop partnerships and communication strategies with the purpose of influencing people to adopt healthy behaviors.
They should utilize engaging interactive technology and social networks to improve awareness, detection and treatment adherence.
They should reinvest benefits to address challenges of access to medicine.
As a result, outcomes will improve both for patients, and for companies that wish to achieve sustained category leadership. Companies who successfully deliver value to patients will be the ones that will gain their trust and everlasting loyalty of doctors.
Are CEOs ready for this change?