• by Tanya Gazdik , August 21, 2007

On average, half of patients with chronic illnesses skip doses or otherwise mess up their medication, says a report from the nonprofit National Council on Patient Information and Education.

The federal government is planning outreach programs to combat patients who don't take the medications prescribed to them, skip pills or otherwise don't take them correctly. However, the pharmaceutical industry is already one step ahead with programs of its own to boost compliance.

Bedminster, New Jersey-based Cegedim Dendrite is a leader in the patient compliance area, with programs involving more than 40 brands. These programs primarily involve "loyalty" cards that the pharmaceutical industry provides to physicians, who in turn provide then to patients when the initial prescription is written. The cards provide a financial incentive for patients to fill the initial prescription and any subsequent refills. There are associated Web sites and patient information newsletters that consumers can receive on an opt-in basis.

Currently, Cegedim Dendrite has more than 30 million cards in circulation via 50 different programs and is working with nine of the top 10 pharmaceutical companies, says Harvey Brofman, vice president and general manager of Cegedim Dendrite's Opus division and chairman, American Pharmacy.

Although Cegedim Dendrite can't reveal its clients due to confidentiality agreements, the company was willing to share a blind case study. In this case, the pharmaceutical company was facing an unsettling situation with one of its biggest sellers. Managed care formulary restrictions were resulting in fewer new patient starts through prescribing physicians and higher co-pays for patients.

Cegedim Dendrite developed a brand loyalty and persistence program consisting of peer-to-peer telecommunications outreach to 3,600 physicians and distribution of a persistence card kit via sales reps to physicians. The card kit educated patients about the therapy and provided patients with up to $30 off their co-pay for six months (a total value of up to $180).

Of the 6,000 patients enrolled into the program, more than 75% used the card two or more times, with 62% using the card three or more times. A persistence analysis conducted four months post-program indicated that new patients increased their refill ratio by an average of one additional refill month per patient. The six-month pilot program encouraged redeeming physicians to prescribe an additional two New Brand Starts (NBS) per month per physician.

Of total prescriptions generated by this program, 63% were new patients to the brand. The program increased the propensity to stay on therapy into the fourth month and beyond, raising the percentage of patients who were persistent by an average of 21% versus control. Among redeeming physicians, NBS share increased an average of four points versus control. The program ultimately generated an ROI of more than 3:1.

One opportunity is for pharmacists to get more involved with patient compliance. Of all health-care providers, pharmacists have more "touchpoints" with patients, and potentially can have the largest impact on patients complying with their medication regimens.

"For every one visit to the doctor, patients visit the pharmacist three or four times," Brofman says. "There are more opportunities for intervention. It's a more natural fit."