Medication Adherence: A Win-Win for Patients and the Pharmaceutical Industry

Written by Nihar Patel, DPT ’22, MBA ‘23
Published on October 24, 2018

When an individual takes driver’s education, they are told to abide by the posted speed limits. They are trusted to follow the rules of the road yet, 27% of car fatalities are a result of speeding. In the pharmaceutical industry, similar to drivers not abiding by the posted speed limits, patients are not taking their medications as prescribed and in some cases they are not even taking the initiative to fill the prescriptions. This is called medication non-adherence. According to the World Health Organization, medication adherence is defined as “the degree to which the person’s behavior corresponds with the agreed recommendations from a health care provider”. In layman's terms, medication adherence is the act of obtaining medications and consuming them precisely as they are prescribed. Medication adherence is not only limited to taking medications on time but taking them according to  the prescriber’s instructions consistently throughout the entire course of treatment. As simple as taking medications sounds, in the US, a  third of prescriptions are not filled and half of patients do not adhere to medication instructions in one form or another. Medication non-adherence is an estimated $3.6 billion issue facing the pharmaceutical industry. Similar to how speeding not only affects the driver but other drivers on the road, medication non-adherence has a significant effect on patient outcomes and on the pharmaceutical industry.

There are three types of patient non-adherence categories, the first category is primary non-adherence or non-fulfillment adherence. This is the least adherent category since a patient in this category does not fill the prescription they have received from their physician and takes no further action to obtain the medication. The second category of non-adherence is labeled non-persistence; a patient in this category does not complete their full course of medications. They start their course of treatment as instructed but abruptly stop taking the medications without consulting with a medical provider. Non-persistence commonly occurs because the patient misunderstood the prescriber’s instructions, it is not usually intentional. The third category is non-conforming. In this category the patient is taking the medication but is not adhering the specific instructions such as the doses and the time of day the medications should be consumed. The patient might consume too much or too little of the medication. Most of the time, a patient does not fall into just one category but may resemble traits from multiple categories. 

Both the patients and the pharmaceutical companies suffer from non-adherence of medications. Patients have a direct negative impact by experiencing poor health outcomes and sometimes an accumulation of more health related issues over time. Pharmaceutical companies are impacted by adherence  negatively skewing the sales of a drug when consumers decide not to fill their prescriptions or are choosing a competitor’s drug because of the better therapeutic outcomes. Medication adherence is an issue the pharmaceutical industry faces and with so many factors that result in patient non-adherence to medications, the industry is investing more and more money to halt patient error with a goal to optimize patient medication adherence.

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