Medical Non-Adherence: One of the Biggest Challenges in Pharma
* Medical Adherence = taking the right dose at the right time. Medical Non-Adherence is the opposite of that.
Jesper Hassel, CEO of Mevia, explained in this episode of Data, Pharma & Fika that according to studies, if adherence is increased by 1%, say going from 60 to 61%, then 13 fewer patients are needed in a clinical study, where each patient costs thousands of dollars.
We all know that medicines will not work if you do not take them. Yet according to the World Health Organization, only 50% of patients suffering from chronic diseases take their medicines as prescribed. There are numerous reasons to why people do not follow their treatment plan. It can be economical (i.e., you can’t afford to buy the necessary medicines), forgetfulness (i.e., lack of routine), and it can be something as meek as not wanting to be reminded of being sick. However, non- adherence has a severe negative impact on pharma companies and is one of the field’s biggest challenges today.
In order for a potential medicine to get to market, it must first go through several clinical trials and be approved in the countries where it is launching. Each clinical trial can take several years and cost millions of dollars. Hence, poor data quality and incorrect results, due to test subjects not following their treatment plan, will have very worrying and costly consequences:
Scenario 1: terminating a medicine which possibly could have been effective, a loss for both the patients and the pharma company.
Scenario 2: deciding to go to the next phase when the medicine actuality isn’t effective enough, and realizing this too late after enormous investments were made.
Scenario 3: needing to recruit more patients to ensure better data quality, leading to prolonged clinical trial, more expenses and hence, a more expensive medicine.
The consequences of non-adherence can also be seen on a societal and individual patient’s level. It is in fact not just a pharma problem. According to the National Center for Biotechnology Information, non-adherence is estimated to cause 125,000 avoidable deaths each year and $100 billion annually in preventable health care costs. Furthermore, a patient’s health deteriorating negatively affects not only the patient but also his/her family and friends, especially if the cause is not taking the medication or not having the medication available due to prolonged clinical trials.
Adherence is therefore vital, and it can be increased in many ways. Mevia has developed one solution, a package with a device that measures if, when and which pill is taken, helping clinical studies get more accurate data on adherence so that they can act accordingly. Mevia also has an application that sends out reminding messages to the patient, a relative and/or a care giver.
The surge of COVID-19 this past year posed new obstacles to tackling the issue of non-adherence. Many drug development projects grinded to a halt and clinical trials were paused due to quarantine and difficulty to conduct safe treatments. Many are now exploring ways for patients enrolled in clinical studies to a larger extent take medication at home to ensure that these studies can continue. That however means that there is a greater responsibility put on the patients to follow the treatment plan. Therefore, pharma is now forced to use more tools and methods to increase adherence and just as importantly measure it. There are many uncertainties in pharma, and adding non-adherence makes it even more challenging. Time will tell which methods will be adopted.
It is exciting to follow along this journey in pharma where there are ongoing changes to produce better quality data and to reduce non-adherence, which in turn will allow decision makers to become more confident in their strategies and discover connections in new and undiscovered ways.
How are you working with non-adherence? What challenges are you facing in drug development?
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