Wednesday, April 30, 2008

Invasive Compliance: A Bitter Pill to Swallow

A World Health Organization (WHO) report—"Adherence to Long-Term Therapies"—estimates that between 30 and 50% of medicines prescribed for long-term illness are not taken as directed. "It is undeniable," says the WHO report, "that many patients experience difficulty in following treatment recommendations."

No doubt this lack of Compliance and Adherence represents lost income to pharmaceutical companies. Yet, the industry spends very little marketing effort to capture this income by improving compliance and adherence. There are, of course, some exceptions. See the Pharma Marketing News article "Accomplishing Adherence," which chronicles Shire's effort to boost adherence in the attention deficit hyperactivity disorder (ADHD) market. [Also see this article: "Effective Pharma Adherence Programs Start With The Patient" and this post to Pharma Marketing Blog: "Accomplishing Adherence: Highlights from a Conference."]

NOTE: Shire's drug Vyvanse--the follow-up to its ADHD drug Adderall--was just approved for use in adults. Right on the heels of that news, Shire announced that 2008 sales of Vyvanse would be at the lower end of its expectations.

As Shire's experience demonstrates, it's not easy to get a good return on investment from a compliance/adherence marketing/patient education campaign. That's why the vast majority of pharmaceutical marketers continue to focus on the "low-hanging fruit," ie, new prescriptions (new patients).

That doesn't stop academic researchers, entrepreneurs and communications experts from coming up with new ideas and gimmicks to improve compliance and adherence. The latest effort comes from researchers at the Georgia Institute of Technology (GIT) who have developed a sensor necklace (see prototype photo on left) that can record when its wearer has swallowed pills, and send reminders if necessary (see "The Necklace that Nags").

Of course, someone will have to come up with a MUCH BETTER looking necklace before I would ever wear such a device!

But that is not why I think this gadget will never make it out of academia: it relies on tiny magnets being placed within pills! As the magnetized pill slides down your gullet, the senors on the necklace detect it and identify the medication. Then it sends the info wirelessly to some database for confirmation.

As pointed out in the Newsweek article, pharmaceutical companies will have to be convinced to insert magnets into their pills. Yeah, that will happen! As I pointed out above, pharma marketers cannot even be convinced to do non-invasive compliance programs to increase their bottom lines. I just cannot see them going gaga over this necklace-magnet-in-the-pill "invasive compliance" thing.

Why not? Well, there are several reasons. Perhaps the most important is this: in an era when there is great concern about the foreign ingredients in our medications (see, for example, "Eighty Percent of Drug Safety Problems Originate Overseas"), inserting tiny magnets made in China into pills certainly is not a good idea.

Also, did I mention the ungainly necklace? Even if it were re-designed, I can't imagine me ever wearing a necklace. My sons tried earrings for a while, but not even they ever wore a necklace! Maybe if it were a religious necklace, like a Saint Christopher on a gold rope, I might wear one. But, again, too weird for pharma.

Sorry, GIT, my advice is nice try, but "git" back to the drawing board!


  1. You mention medicines prescribed for long-term illness are not taken as directed. I can relate to this but in my case it is not that I choose to ignore the suggested dose, it is all about forgetfulness.

  2. Anonymous8:37 AM

    I am concerned about the new launch of CVS' answer to this problem. CVS will be contacting patients by phone to remind them to refill perscriptions or let them know that it is past time to refill etc. I work for CVS pharmacy and wonder if this will be offensive to the customers. I know that customers need to take their medications as directed and some can be harmful if you take them sporadically or suddenly quit taking them. But the invasion into ones home via telephone by your local pharmacy seems to be a less than optimal answer to the problem. What are others thoughts on that?

  3. Anonymous9:24 AM

    when the pharma company befriends the patients and give them quality ongoing communication (instead of, say, sales) this will remind, entice and encourage patients to continue their medication. that communication will need to be both warm, welcomed and informative so the CVD patient understands why the zetia is working even when he doesn't notice a difference. we're not far away from that! those entrepreneurs you mention aren't just lab rats. there are some good ones behind the curtain of marketing.


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