Compliance, Math, and Marketers

I spent the day yesterday at eyeforpharma's 3rd Annual Patient Compliance and Adherence Congress in Philadelphia. I went mainly because I was "commissioned" by the conference organizers to be a roundtable moderator on the subject of Direct-to-Patient compliance campaigns. The round table participants discussed new ways to implement a successful direct-to-patient campaign to increase compliance. More on that in a bit.

While there, I also sat in on a few presentations and learned a thing or two. I'll just give a 50,000 foot overview here and will have a more in-depth review published in an upcoming issue of Pharma Marketing News (see the Pharma Marketing News Editorial Calendar).

Definitions
Compliance concerns following the dosing regime of a drug. You can measure it as the percent of doses of a drug taken as prescribed while the patient is actively taking drug.

Adherence, on the other hand, concerns refilling the prescription. As time goes on, patients refill less and less often and many drop the medication altogether. It has been estimated that in developed countries only 50% of patients who suffer from chronic diseases adhere to treatment recommendations. This is measured with "persistence" curves.

One thing I learned was that to understand compliance and adherence problems, you need a lot of data and analysis -- math, in other words.

Many of the presenters were vendors or solution providers and some presented data tables and plots, which I saw sailing right over the heads of many pharma marketers in the room.

Aversion to math is just one problem about assigning the compliance problem to marketers. The other is that compliance is a long-term problem and marketers -- especially pharmaceutical marketers -- are short-term thinkers. How can they be otherwise? After 2 years, product managers move on to another product or department. Compliance is the next guy's problem.

So what ideas, solutions or insights did participants in my direct-to-patient roundtable discussion come up with?

IMHO, the best idea we came up with is the one I championed: social networking. I have already blogged on the topic of social networking for compliance; see "Chantix: Opportunity for Social Marketing Lost?"

The idea started when someone suggested using celebrities to help get the message out that patients on drug X should remember to get their prescription refilled, etc.

We've seen celebrities used in traditional DTC ads urging people to ask their doctor about drug X. These ads, however, are designed to recruit NEW patients, not keep the ones already prescribed the product.

Instead of celebrities, what about people more like the typical patient?

At that point, I threw in the idea of "Consumer Opinion Leader", which is a term coined by Jack Barrette at Yahoo! (see "The Girl from Google"). "Patient Opinion Leader" (POL) would be more appropriate here to confine our attention to consumers already on medication.

POLs already exist on the Internet in patient chat rooms and bulletin boards and social networks where they upload content for other patients, give advice, and are rated on how helpful they are.

Take Marketers Out of the Equation
Getting marketers involved in social networking, however, is a touchy subject, especially in the pharmaceutical industry. In fact, every solution we came up with would be a problem for pharmaceutical marketers who don't understand patients' needs very well.

Whatever the compliance solution is, I propose that marketers be taken out of the equation. They are neither equipped nor motivated to solve the problem. What's needed are people who are patient advocates within the pharmaceutical company akin to Medical Science Liaisons (MSLs) who manage relations with physician Key opinion Leaders (KOLs).

Just as MSLs and physician education programs are now separate from marketing with their own budgets, patient advocates and patient education programs (ie, compliance-focused campaigns) must be separate from marketing and have their own budgets as well. Only then will pharma companies be equipped to deal with the long-term issues of compliance and adherence and perhaps solve them, IMHO.