Healthy Skepticism Library item: 16203

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Electronic Source

Launch target
PM Live 2009 Aug 05
http://www.pmlive.com/find_an_article/allarticles/categories/pr_and_med_ed/2009/august/features/launch_target

Full text:

New products are launched on a wave of educational materials and meetings aimed at healthcare professionals (HCPs). This ensures HCPs’ awareness of new products and can change prescribing habits. However, in the months and years that follow the launch, patient non-adherence frequently becomes a problem and can prompt HCPs to switch their patients to other products. The pharmaceutical marketer’s reaction to this is to implement an education programme aimed at the patient to improve adherence. So, why wait until non-adherence becomes a problem? Why not target the patient at launch?

Non-adherence to prescribed medication is common across most therapeutic areas (See Hidden blockbuster? in PM June 2009). Using an understanding of the factors that cause poor adherence to medicines, patient education to increase adherence can be integrated into a launch plan. This can prevent non-adherence becoming a problem, resulting in better patient outcomes, increased brand loyalty and, ultimately, increased sales revenues.

A widespread problem
It is estimated that a third to half of all medicines prescribed for long-term conditions are not taken as recommended. Adherence rates as low as 50 per cent have been reported in a diverse range of diseases and conditions, including hypertension, schizophrenia and even HIV.

Non-adherence not only represents a loss of potential revenue worth millions to pharmaceutical manufacturers, it also has a profound effect on the NHS and the patients themselves. Non-adherent patients are more likely to experience symptoms and disease deterioration. Worryingly, in diseases such as hypertension, which can lack obvious symptoms, the first sign of non-adherence could be a heart attack or stroke.

This increase in symptoms and in costly hospitalisations places an increased burden on the NHS. From the standpoint of a pharmaceutical marketer, this can lead to the frustrating situation where doctors are switching patients to other products despite the fact that the originally prescribed product is effective if taken properly. Moreover, if patients are frequently non-adherent to certain products, HCPs may simply regard these products as less effective.

Reasons for non-adherence
Non-adherence to medicines is attributed to several factors, which can be grouped into patient-related, HCP-related and medication-related factors. Patient-related factors can include complex psychological issues such as disease denial and fears associated with taking medication. A low level of understanding of either diagnosis or treatments can also play a part. Other patient-related factors include simple reasons such as people forgetting to take their pills.

HCP-related factors include whether the HCP informs the patient about possible side-effects and fully explains the consequences of non-adherence. Medication-related factors include the side-effects of the drug, which can be quite debilitating, as well as factors relating to the dosing of the drug, for example, the route of administration and the ‘pill burden’ (how many pills the patient is required to take per day).

For any one product, there will be a unique mix of factors contributing to non-adherence. It is perhaps confusion around these issues that prevents companies from tackling non-adherence.

However, many of the reasons for non-adherence should already be known before the product is launched. It is intuitive that some patients will be annoyed at having to take pills four times a day, or that an absence of symptoms can lead to patients thinking they no longer have to take medication. Indeed, unless the product is licensed in a completely new therapy area, many of the patient- and HCP-related factors causing non-adherence will already be known.

A new approach
Currently, HCPs are seen as the most important target audience at launch – after all, they are the people who prescribe the medication. However, when non-adherence becomes a problem, the patient swiftly becomes a target. A new approach that is already proving successful with some brands is the integration of patient education at launch. Making the patient as important as HCPs at launch addresses the issue of non-adherence from the start, ensuring that patients have the support they need to make informed health decisions. Acting early will reduce non-adherence and prolong sales growth.