Medication adherence is a major concern in chronic disease management, especially within complex drug regimens. Only 80% of new prescriptions are filled, half of which will be taken incorrectly. While this can be attributed to several factors (including socio-economic barriers), the route and potency of drug administration can largely affect adherence rate. Independently of the why, lacking medication compliance is associated with poor patient health outcomes while simultaneously contributing to high healthcare costs.
How Can Pharma Be a Part of the Patient-Centric Movement?
Historically, Pharma have had to balance their opposing objectives of developing innovative medicines which safe and effective medicines and producing strong investment returns.
Patient adherence is directly correlated to both of those objectives, as better adherence leads to better health outcomes, and ultimately enhanced revenue. With these milestones in mind, it is of interest of Pharma to adopt principles of patient-centricity to the earliest stages of drug development.
Engaging patients in R&D can be beneficial at multiple stages of the early drug development process, including identifying unmet patient needs early on and enabling better informed decision-making. This can be especially beneficial for lead compound development as RoA, and formulaic modifications can be tailored to help maximize future adherence. For instance, manufacturers could develop extended release or easy-to-swallow oral formulations. Not only would this secure “buy-in” from patients but could also save the need for costly reformulation initiatives and confer competitive advantage.
How do “Patient-Centric” Drugs Perform in the Market?
Emerging evidence supports the value associated with patient-centricity in early drug development. A key aspect of this is ensuring that drug formulations are fit-for-purpose for the end-user. For example, Takeda/Shire’s extended-release Adderall formulation (XR) for patients with ADHD can be taken once daily in comparison to its immediate-release (IR) version, which needs to be taken multiple times per day. In HIV, adherence-leader Biktarvy combines three agents into the same fixed-dose combination, eliminating the need for patients to manage separate prescriptions.
Another aspect involves assessing chronic and acute disease states, which include oral, self-injected, and hospital-administered products. We must consider if patients are more likely to adhere to medications which have more convenient dosing schedules than other comparable options in the market.
What does it mean for Pharma and for Patients?
Unfortunately, medication non-adherence takes a significant toll on patients, their caregivers, providers, and the health system at large. In the US, ~50% of patients don’t take their chronic long-term therapy medications as prescribed, which contributes to >$500B in avoidable healthcare costs and more than 125,000 potentially preventable deaths.
Patient-centred care requires a greater understanding of the daily decisions patients make to manage their complex medication regimen. Thus, a more patient-focused approach to medication development can better ensure that medications are working for patients – not the other way around.
Incorporating patient insights early in the drug development process ultimately serves to improve target product profile and adherence, which will ultimately yield better therapeutic outcomes and improved quality of life. All of these downstream effects make patient-centric care a key differentiator amongst Pharma companies.