The economics of patient compliance
Americans somewhat jokingly refer to unpleasant, unchanging, recurring situations as living Groundhog Day, a reference to a 1993 film in which a TV weatherman relives a particular Groundhog Day and all of its bad weather annoyances over and over and over again.
Economic news of late feels like it own kind of Groundhog Day. Falling revenues, bankruptcies, layoffs - and although the company names change from day to day, the storys the same again and again.
Its certainly not news that hard times are hitting every geography, every industry, and every pay grade and job type. So it should come as no surprise that patients, many of whom were already staggering under the costs of prescription drugs, are feeling the pinch more than perhaps ever before.
According to the US group the Center for Studying Health System Change, one in seven Americans under age 65 went without prescription medicines in 2007, up from one in ten in 2003, because they couldnt afford their prescribed medication.
The finding is particularly worrisome, the group says, because those people least able to afford medicine were often those who needed it the most uninsured, working-age adults suffering from at least one chronic medical condition. Almost two-thirds of this group reported when surveyed that they had gone without filling a prescription.
But the trend isnt exclusive to those without insurance, the group says. Even among patients with employer-provided, private insurance, one in ten said they went without a prescription medication in 2007, up from 8.7% in 2003.
And while the economy is a big consideration, according to the group, it isnt the only culprit. The study researchers say rising drug prices, the tendency of physicians to prescribe drugs more frequently, the introduction of expensive specialty medications and skimpier drug coverage that shifts a greater share of cost onto patients are all key factors.
When looking at reasons for patient non-compliance and non-adherence, however, pharma now must add widespread economic hardship to the top of the list. Despite all we may accomplish through adherence and disease management programs, it may prove to be the biggest deterrent to our patient compliance efforts yet. And it certainly promises to be one of the most difficult to address and solve given the magnitude of the crisis.
As always, we love to hear your thoughts. How might pharma help patients break out of the vicious Groundhog Day loop and keep economics from fueling non-compliance?