Adherence Arena: Why isnt non-adherence big news?

*A catchier name than medication non-compliance would help* If you believe the numbers, medication non-adherence is a bigger problem for the US than obesity.

A catchier name than medication non-compliance would help

If you believe the numbers, medication non-adherence is a bigger problem for the US than obesity.

A 2009 CDC study estimated that the direct and indirect costs of obesity total about $157 billion annually in the US.

According to the 2009 "Thinking Outside the Pillbox" report from the New England Healthcare Institute, medication non-adherence is the cause of $290 billion in otherwise avoidable medical spending per year in the US.

Putting aside the fact that these sorts of estimates are difficult to do, and one could probably find cause to pick at their accuracy, these numbers do reveal that obesity and medication non-adherence are at least equally large threats to the health and well being of Americans.

So why is obesity in the news every day, attracting luminaries such as Michelle Obama and Dr. Toby Cosgrove, CEO of the Cleveland Clinic, to press for change, whereas medication non-adherence garners relatively little press and has attracted no equally influential spokespeople?

I have a few thoughts on this, and I'd love to hear yours.

For one, obesity is in your face' and obvious. Medication non-adherence is not.

I can take one look at a person and diagnose obesity, and this doesn't take an MD degree.

In contrast, I can't tell if a person is non-adherent with their critical prescription medications unless I ask them or examine their refill data.

Another reason is that the connection between obesity and poor health is easier to understand, at least for the lay public.

Sure, not every obese person is unhealthy, per se, but when an obese person suffers a heart attack it is easy for an onlooker to conclude, They should have lost some weight.'

It's less likely that the same onlooker will jump to, I wonder if they were compliant with their blood pressure pill, or with their statin?' even though compliance with these medications is arguably more critical to preventing a heart attack.

I also think that language is important here.

"Obesity" is a single word that works well in a headline, one that can attract quick attention.

Compare "obesity" to "prescription non-adherence" or "medication noncompliance."

These are mouthfuls that don't pack a punch and, at worst, are even confusing.

Any smart newspaper editor would strike them from a headline.

So what can be done to raise awareness of the problem of medication non-adherence, a problem arguably on par with obesity in terms of importance to the health of the population as well as to the national budget?

At HealthPrize, one of our New Year's resolutions for 2011 is to help raise awareness.

If you have any suggestions as to catchier names for the problemone more likely to make headlinesI'm all ears.


Katrina S. Firlik, MD, is co-founder and chief medical officer of HealthPrize Technologies, LLC ( Prior to HealthPrize, she was a practicing neurosurgeon in Connecticut. She is also the author of Another Day in the Frontal Lobe: A Brain Surgeon Exposes Life on the Inside.