Why Pharma Reps Should Sell Adherence

For the pharmaceutical rep, is the goal of patient retention in conflict with the more traditional goal of patient acquisition? Patient acquisition primarily demands a focus on the prescribing physician, whereas patient retention demands a focus on the patient. Is there even time for both?



Pharmaceutical companies are interested not only in selling pills, but in selling pills that actually work. Given that drug efficacy and, therefore, clinical outcomes are critically dependent upon (1) the patient actually filling—and refilling—the prescription and (2) the patient actually taking the medication as prescribed, promoting adherence needs to be a top priority in the quest to sell effective products. Increasingly, pharmaceutical brands recognize this.

We know that, given decreased access to and limited time with physicians, many pharma reps chose to focus primarily on the copay card. Copay cards are a commonplace and familiar method of overcoming the “first fill” barrier—but not necessarily the “next fill” barrier—and one that physicians quickly appreciate at face value and look favorably upon.

However, many physicians have become jaded about the problem, figuring it is simply not possible for them to detect, and then to adequately counsel, the non-adherent patient who is at risk of poor outcomes.

I would argue that selling adherence—whatever solution a brand has “wrapped around the pill”—is a very worthy additional sell, even to a time-strapped physician. Why? Doctors intuitively understand the critical role that adherence plays in clinical outcomes. They know that medication adherence is a key “healthy behavior” along with diet, exercise, and smoking cessation. All too frequently, they witness the downstream and otherwise preventable complications of non-adherence, and it’s quite demoralizing (as I can say from first-hand experience; see here).

However, many physicians have become jaded about the problem, figuring that in their harried fifteen minutes with a patient, it is simply not possible for them to detect, and then to adequately counsel, the non-adherent patient who is at risk of poor outcomes.

Further, I would argue that the time constraint of the typical office visit is not the only challenge when it comes to physicians having a sufficient motivational influence on their patients. There are a host of additional limitations. Consider frequency of messaging. How often does a patient see a physician? Once a year? Twice, maybe? There simply isn’t enough frequency of adherence messaging for it to stick when delivered in the doctor’s office. Add to that the fact that some physicians simply aren’t motivational dynamos, and the challenge is compounded.

So, a pharma rep that comes bearing not only copay cards or samples, but also a novel approach to one of healthcare’s most intractable problems will be most welcome by most physicians.

A medication adherence solution, whether online, mobile, or otherwise becomes a valuable physician-extender in a sense. And arguably, the best solutions will nicely serve the dual purpose of patient retention and acquisition. Particularly in crowded therapeutic categories, more favorable long-term adherence to a product should prove to be the most important clinical differentiator of all.

Physicians care deeply about medication adherence. It should be an easy, and welcome, sell.

A few years ago my company decided to test the potential differentiating power of an adherence solution and commissioned an online survey of one hundred physicians who treat patients with diabetes. We introduced these physicians to a new adherence solution via a screen shot and a brief description, then asked them how their prescribing decisions might be affected if the solution were added to Brand A vs. Brand B, and then vice versa.

The two brands we chose were, at the time, the only two medications in their class of oral diabetes agents, and felt by many physicians to be “me-too” competitors. The addition of a new adherence solution “wrapped around the pill” was compelling enough to sway prescribing preferences by more than 30 percentage points. Although this was a survey and not real-world prescribing data, what it shows—clearly—is that physicians care deeply about medication adherence. It should be an easy, and welcome, sell.


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