Patient compliance programs: Learnings from the trenches



At eyeforpharmas recent Patient Compliance Europe 2008 conference, Chris Venn, European brand manager at Pfizer, shared some hard-won advice on tackling patient compliance challenges in his presentation Insights derived from real-life failures and successes.

The most central and basic question to address head-on, Venn says, is whether patient programs are worth the effort.

There is evidence, he says, that disease awareness and health campaigns work, but companies must ensure that the campaigns are aligned with the expectations for physicians and dont unduly influence the worried well to simply find new conditions to go talk to their doctors about. As an industry, we must be aware of and sensitive to this concern, Venn says.

For those that actually register and participate in outreach compliance programs, adherence is improved, he reports, but there are concerns that self-selection and low registrations yield limited results. We must do more work to be sure were registering the right patients and not just ones that would be compliant anyway, Venn says. If so, our ROI will be hugely negative.

Making noise vs. making a difference
Calculating the value of program can be challenging, he says. You have to ask yourself whether a program really made a difference and to how many people, Venn suggests. Its also important to consider whether patients registering are better off than those that dont.

Designing an effective program relies not only on providing information but on motivating and influencing patients, he says. Patients very quickly forget how bad they felt at the onset of managing their condition, so motivating and influencing them is an important aspect of any program, Venn says.

He believes the industry is too focused on taking pills rather than on patient outcomes. The real goal is improve outcomes for patients, regardless of how many pills they take, Venn says. So, we need to think much more broadly about our campaigns and activities.

When asking doctors to enroll patients in a program, he says, pharmas must be sure physicians see the value for their patients, he says. A lot of healthcare professionals are wary of industry programs because they tend to end with the current brand manager, Venn says. Buy in from healthcare professionals requires that its all about patient outcomes.

Because there is a lot of noise in patients lives, with advice from various people and a lot of information floating around, Venn says it is important for pharmas to choose the right method to deliver information to patients.

You may need to use multiple approaches to deliver information, so that patients can choose the one thats right for them, he says. And by using multiple approaches, companies can increase the likelihood of action by more than 50%, Venn says.

An advert in and of itself is not likely to generate activity, he says. But a series of activities and getting that communication in the right place will hone the message to where an individual takes action, he explains.

Placing and honing the message
Venn says getting the message in just the right place and honing it is what Pfizers LifeREWARDS program is all about. The program, which focuses on patient outcomes and is now available in 20 countries in Europe, is an online support program for smokers attempting to quit by using Pfizers Champix that uses web-based tools to interact with participants. It includes a booklet for those without web access or 112 days of content via email, SMS and a web site.

Venn says Pfizer has included LifeREWARDS as part of its brand awareness and usage research and is measuring the impact it has on physicians and patients. We know it has a direct impact on adherence, he says, but only in patients, obviously, that register.

To increase registration, a major hurdle for such compliance programs, Venn says companies must make sure that physicians recognize the program as useful. To improve registration rates, Pfizer includes information about LifeREWARDS in sales aids, makes easy for reps to explain, keeps it simple for doctors to register patients and makes it easy for patients to sign themselves up, Venn says. It is also working with other stakeholders, such as pharmacists and smoking cessation advisors, to support registration.

We need about 25% of patients registered to see an impact on our bottom line, he says.

Along the way, Venn says Pfizer has learned that campaigns must push the envelope and launch with the most powerful mechanisms. He suggests that pharmas try to work with a big idea not just a big project. Communication needs to make it through the noise, he says.

He advises using segmentation to find similarities and identify the best ways to communicate. He also urges pharmas to keep implementation simple, especially when working in a European structure.

Last but not least, he stresses the importance of engaging physicians in order to build a reciprocating relationship with campaigns. Dont be afraid to try different channels and approaches, including things employed by other industries, like viral campaigns, social networking sites and online peer forums, Venn says. But you have to keep working to keep them effective.

To learn more about patient compliance programs, make plans to attend eyeforpharmas Patient Adherence USA conference in Boston, October 23 -24. For more information and to register, visit www.eyeforpharma.com/pcusa08/

Author: Lisa Roner, editor, eyeforpharma