Compliance Through Mobile Applications
Compliance Through Mobile Applications
Oren Salomon
Compliance – What it is and Why it Matters
Patient compliance (also known as adherence or persistence) with doctors’ prescriptions is essential to treating medical conditions. Many patients choose to ignore doctors’ orders for any number of reasons, but the result are the same: lost sales to pharma companies and increased healthcare costs for healthcare providers as the entire system has to absorb the consequences of letting medical conditions spiral out of control. This cost can be forwarded onto consumers in the form of worsening their quality of life, possibly even through death in extreme cases. In financial terms, hospital stays are expensive and avoiding them through compliance is a much more economical solution. Bacteria can mutate and evolve into a bigger problem for those who do not fully comply with anti-biotic prescriptions.
According to a McKesson report, the leading cause of non-compliance is simply forgetting to take one’s medication. Nearly 80% of respondents of a study of those who did not fully comply with doctors orders cited this as a reason for non-compliance, followed by running out of medication (19%), too costly (9%), perceived lack of need (9%), side effects (7%), and the very rare no improvement seen (3%). All of these are causes that need to be addressed as non-compliance is one of the most costly problems facing the pharmaceutical and healthcare industries today.
Compliance Hurting the Healthy of the Industry: Costs to Pharma and Healthcare
The primary cost to pharmaceutical companies is the lost revenue from unfilled prescriptions. Conservative estimates indicate that only 60% of prescriptions actually get filled and while 100% compliance is an unrealistic goal, some of the $70 billion in revenue lost annually from non-compliance could reasonably be captured if pharmaceutical companies find a way to merely increase compliance rates. Essentially this means for every percent rise in compliance, the pharmaceutical industry as a whole stands to gain nearly $2 billion in sales. Rather than targeting new potential customers, which is very costly and involves pushing doctors to write more prescriptions (and leads to charges of “disease mongering”), pharmaceutical companies can raise revenues in a more cost effective manner by converting more existing prescriptions into sales. As will be discussed in the next section, this can be achieved by better managing relationships with existing patients using new mobile technologies.
Non-compliance is not only an issue in the lost revenue from the marketplace for drugs, but can also tamper with research and clinical trials. One of the key problems with non-compliance is that patients and especially paid test subject patients do not always freely admit when they are not complying with doctors’ instructions with regards to prescriptions. This creates problems in research models as some test patients will effectively place themselves in a placebo category by not taking the medication given to them without telling those running the trial. This can conflate variables in research and also lead test results for drugs to represent less effectiveness than actually achieved. Controlling for non-compliance is difficult when testing for it is expensive and researchers like doctors rely on honesty from their patients for effective treatment. Doctors and researchers are simply too busy to conduct a lie detector test on their patients to guarantee compliance. There must be a better means that doesn’t waste doctors’ time, researchers’ time, or patients’ time. Convenient and effective ways to increase compliance can be achieved through mobile technologies.
Lastly there is the myriad of costs for the healthcare industry as a whole. Medical problems do not simply go away and if allowed to fester the patient’s condition can deteriorate and treatments for worsening conditions become progressively more expensive. Often times, if the condition leads to extensive hospital stays, the medical bill can spiral into six or seven figures, a medical debt many patients cannot afford, leaving taxpayers and the healthcare industry as a whole the burden of paying for their mistakes. Fulfilling prescriptions immediately and taking medication as prescribed is an effective form of preventative healthcare that can keep healthcare costs down for our society. Healthcare costs for our nation are spiraling out of control and growing faster than any significant section of our national GDP. More so than Social Security, Healthcare costs represent the biggest budget challenge for the federal government. New mobile technologies promise to raise compliance and therefore hopefully mitigate the challenges that growing healthcare costs present to our society.
Pharma’s New Swiss Army Knife: Mobile tools to combat non-compliance
A popular mobile tool for raising compliance to date has been SMS, commonly referred to as text messages. An SMS reminder sent to the patient when they need to take their medication or refill their prescription can be an effective tool, but there are significant limitations. First and foremost, there is the 160 character limitation of any SMS message. Second, text messages, like email, can be considered invasive and even intrusive. Creating an opt-in feature can help keep this from being viewed as annoying, but the SMS is a 1 way communication tool that cannot easily adjust for the customer’s individual pill schedule or refill schedule. There is no room for the creation of rich content explaining the benefits, side-effects , and implementation instructions of the medication. Additionally, depending on carrier infrastructure, SMS messages can be delivered late or not at all – resulting in non-compliance. Generally, SMS messages serve best for campaigns that send an undifferentiated non-personalized message to a wide reaching audience. Serving an individual patient through SMS is therefore generally ineffective when compared other, more sophisticated tools.
Branded mobile applications behave much like programs on a computer in their high functionality, but reside on an individuals’ most personal electronic device, their cell phone. Much more secure from both hackers and other physical users, cell phones are a personal item that are generally not shared and therefore provide a digital safe haven for storing this kind of personal medical information. Because they are always opt-in (the user has to willfully choose to download an application to a cell phone), being perceived as invasive is almost never an issue for mobile applications. The power of mobile applications to increase compliance lie in their ability as a powerful communication tool, not only to remind the user to both take and refill their medication when appropriate. Mobile applications can feature as much content as most websites and display them in similarly easily accessible and navigable formats. The patient can become educated on the benefits, side effects, and implementation instructions (particularly useful for inhalers) on their own time, sparing doctors and pharmacist’s time and efforts. Unlike pamphlets with this information that are quickly discarded, mobile applications (until deleted) follow the patient everywhere they go. Additionally as a digital format, mobile applications offer the ability to animate instructions, which can often be more helpful than static illustrations.
In sum, mobile applications offer many improvements over existing approaches to combating non-compliance without suffering many drawbacks. While mobile applications require an upfront start up cost, their maintenance is often low cost and does not require many human hours. A mobile application, much like a website, works overtime and is available to the consumer 24-7 for confidential disclosure of information. A mobile application, unlike an SMS can be outfitted to include full disclosure (fair balance) on side effects and drawbacks of medication and therefore comply with legal regulations much easier and still leave plenty of room to express benefits. Therefore mobile applications represent pharmaceutical companies’ best tool yet to combat non-compliance.
Oren Salomon
Compliance – What it is and Why it Matters
Patient compliance (also known as adherence or persistence) with doctors’ prescriptions is essential to treating medical conditions. Many patients choose to ignore doctors’ orders for any number of reasons, but the result are the same: lost sales to pharma companies and increased healthcare costs for healthcare providers as the entire system has to absorb the consequences of letting medical conditions spiral out of control. This cost can be forwarded onto consumers in the form of worsening their quality of life, possibly even through death in extreme cases. In financial terms, hospital stays are expensive and avoiding them through compliance is a much more economical solution. Bacteria can mutate and evolve into a bigger problem for those who do not fully comply with anti-biotic prescriptions.
According to a McKesson report, the leading cause of non-compliance is simply forgetting to take one’s medication. Nearly 80% of respondents of a study of those who did not fully comply with doctors orders cited this as a reason for non-compliance, followed by running out of medication (19%), too costly (9%), perceived lack of need (9%), side effects (7%), and the very rare no improvement seen (3%). All of these are causes that need to be addressed as non-compliance is one of the most costly problems facing the pharmaceutical and healthcare industries today.
Compliance Hurting the Healthy of the Industry: Costs to Pharma and Healthcare
The primary cost to pharmaceutical companies is the lost revenue from unfilled prescriptions. Conservative estimates indicate that only 60% of prescriptions actually get filled and while 100% compliance is an unrealistic goal, some of the $70 billion in revenue lost annually from non-compliance could reasonably be captured if pharmaceutical companies find a way to merely increase compliance rates. Essentially this means for every percent rise in compliance, the pharmaceutical industry as a whole stands to gain nearly $2 billion in sales. Rather than targeting new potential customers, which is very costly and involves pushing doctors to write more prescriptions (and leads to charges of “disease mongering”), pharmaceutical companies can raise revenues in a more cost effective manner by converting more existing prescriptions into sales. As will be discussed in the next section, this can be achieved by better managing relationships with existing patients using new mobile technologies.
Non-compliance is not only an issue in the lost revenue from the marketplace for drugs, but can also tamper with research and clinical trials. One of the key problems with non-compliance is that patients and especially paid test subject patients do not always freely admit when they are not complying with doctors’ instructions with regards to prescriptions. This creates problems in research models as some test patients will effectively place themselves in a placebo category by not taking the medication given to them without telling those running the trial. This can conflate variables in research and also lead test results for drugs to represent less effectiveness than actually achieved. Controlling for non-compliance is difficult when testing for it is expensive and researchers like doctors rely on honesty from their patients for effective treatment. Doctors and researchers are simply too busy to conduct a lie detector test on their patients to guarantee compliance. There must be a better means that doesn’t waste doctors’ time, researchers’ time, or patients’ time. Convenient and effective ways to increase compliance can be achieved through mobile technologies.
Lastly there is the myriad of costs for the healthcare industry as a whole. Medical problems do not simply go away and if allowed to fester the patient’s condition can deteriorate and treatments for worsening conditions become progressively more expensive. Often times, if the condition leads to extensive hospital stays, the medical bill can spiral into six or seven figures, a medical debt many patients cannot afford, leaving taxpayers and the healthcare industry as a whole the burden of paying for their mistakes. Fulfilling prescriptions immediately and taking medication as prescribed is an effective form of preventative healthcare that can keep healthcare costs down for our society. Healthcare costs for our nation are spiraling out of control and growing faster than any significant section of our national GDP. More so than Social Security, Healthcare costs represent the biggest budget challenge for the federal government. New mobile technologies promise to raise compliance and therefore hopefully mitigate the challenges that growing healthcare costs present to our society.
Pharma’s New Swiss Army Knife: Mobile tools to combat non-compliance
A popular mobile tool for raising compliance to date has been SMS, commonly referred to as text messages. An SMS reminder sent to the patient when they need to take their medication or refill their prescription can be an effective tool, but there are significant limitations. First and foremost, there is the 160 character limitation of any SMS message. Second, text messages, like email, can be considered invasive and even intrusive. Creating an opt-in feature can help keep this from being viewed as annoying, but the SMS is a 1 way communication tool that cannot easily adjust for the customer’s individual pill schedule or refill schedule. There is no room for the creation of rich content explaining the benefits, side-effects , and implementation instructions of the medication. Additionally, depending on carrier infrastructure, SMS messages can be delivered late or not at all – resulting in non-compliance. Generally, SMS messages serve best for campaigns that send an undifferentiated non-personalized message to a wide reaching audience. Serving an individual patient through SMS is therefore generally ineffective when compared other, more sophisticated tools.
Branded mobile applications behave much like programs on a computer in their high functionality, but reside on an individuals’ most personal electronic device, their cell phone. Much more secure from both hackers and other physical users, cell phones are a personal item that are generally not shared and therefore provide a digital safe haven for storing this kind of personal medical information. Because they are always opt-in (the user has to willfully choose to download an application to a cell phone), being perceived as invasive is almost never an issue for mobile applications. The power of mobile applications to increase compliance lie in their ability as a powerful communication tool, not only to remind the user to both take and refill their medication when appropriate. Mobile applications can feature as much content as most websites and display them in similarly easily accessible and navigable formats. The patient can become educated on the benefits, side effects, and implementation instructions (particularly useful for inhalers) on their own time, sparing doctors and pharmacist’s time and efforts. Unlike pamphlets with this information that are quickly discarded, mobile applications (until deleted) follow the patient everywhere they go. Additionally as a digital format, mobile applications offer the ability to animate instructions, which can often be more helpful than static illustrations.
In sum, mobile applications offer many improvements over existing approaches to combating non-compliance without suffering many drawbacks. While mobile applications require an upfront start up cost, their maintenance is often low cost and does not require many human hours. A mobile application, much like a website, works overtime and is available to the consumer 24-7 for confidential disclosure of information. A mobile application, unlike an SMS can be outfitted to include full disclosure (fair balance) on side effects and drawbacks of medication and therefore comply with legal regulations much easier and still leave plenty of room to express benefits. Therefore mobile applications represent pharmaceutical companies’ best tool yet to combat non-compliance.
Labels: applications, branded mobile applications, compliance, healthcare, mobile marketing, non-compliance, prescriptions