From Formulation to Drug Delivery to Specialty Packaging: A Comprehensive Approach to Patient Adherence

Pharmaceutical companies have long understood that patient adherence to their prescriptions is an addressable barrier that can help lead to better and more costeffective treatments for patients. Patient non-adherence to medications is heavily dependent on the individual needs of specific patient demographics. Even though the action and goal is easily identifiable, the solutions are often complex and multilayered. Patient non-compliance in America is a major medical problem, with an estimated cost in excess of $290 billion a year, according to a report from the New England Healthcare Institute. The increased cost of non-compliance, combined with payor systems implementing “pay-for-performance” reimbursement models, leads to the need for additional approaches to tackle the issue of patient non-compliance. Understanding the root causes and underlying drivers of patient non-adherence is critical to developing solutions. In a survey of 10,000 patients conducted by Harris Interactive and BCG (Figure 1), they cited a high level of forgetfulness to using or refilling the medication (24%) and also not wanting to experience side-effects (20%) as main reasons for noncompliance. Additional studies show dosing regimens have dramatic effects on adherence. In a study conducted by Claxton and Cramer, the rate of adherence varied inversely with the number of doses needed throughout the day. For example, in the study, once-daily dosing had a higher adherence rate than three-timesdaily dosing. Illustrated in Figure 2, these results suggest that a reduction in the number of the dosages can have positive effects on adherence. While researchers have identified improved patient education about disease management and medications, pharmacist and physician assistance, and simplified drug regimens as means for improving compliance, many in the pharmaceutical community are recognising that drug delivery and specialty packaging may also be influential factors. Figure 3 illustrates solutions that can be implemented to improve patient adherence at any stage of drug development, launch, and life-cycle management.