Specialized article
The information technologies and the improvements in the compliance with the prescription

Compliance on the part of the patient with his medical prescription can lead to problems for him or her, for society and for the pharmaceutical laboratories. The laboratories should incorporate compliance programmes in their marketing plans, for there are many benefits which can be lost. Furthermore, the image of their products can be severely damaged when they turn out to be ineffective, because the medical treatment was not correctly complied with. Information technologies, through the sending of SMS messages, can make it possible to remind the patient of the precise moment when he or she has to take the medication.

Compliance with the medical prescription on the part of the patients is a problem which has existed for many years and it has increased considerably as time goes by. Approximately one third of the patients complete their medication (more than 80%); another third only finish between 50% and 80%, while approximately the remaining one-third do not even complete 50 % of their prescription. This last group does not receive even the slightest benefit from its medication; in fact, in the case of the statins, only those patients who complete more than 80% of their treatment have a significantly lower risk of suffering a heart problem.

The main causes for the failure to fully comply with the treatment are the following: forgetting to take the medication, concern for the adverse effects and doubts about the effectiveness of the product, when notable improvements in the disease are not appreciated. In addition, other less frequent factors are an improvement in the symptoms, a financial savings, pains and interference of the medication with the exercising of other activities.

There are several negative consequences involved in the failure to comply fully with the pharmacological treatment:

• The patient’s health does not improve as the treatment prescribed with the medication has not been correctly completed. This could lead to more serious complications in the future and more severe medical processes.
• Society can also be negatively affected in several ways. Failure to comply with the treatment can lead to a immunity to the drugs, an unnecessary waste of health resources and a greater expense for the health services, as the end result could lead to more complicated and expensive treatments.
• The pharmaceutical laboratory will obtain less benefits, as there will be fewer units sold. The doctor and patient’s perception of the effectiveness of the overall product will be diminished if the patient does not comply with the treatment and does not improve.

Up until now, no member of the health sector has really paid sufficient attention to this problem. The pharmaceutical laboratories, responsible to a great extent for the general health of society, have not considered this matter as a priority in their business plans and in their marketing actions, and they often deal with the problem in an occasional and isolated manner as a critical process in the life of the product.

The information technologies, the key tool for resolving the problem

There are several tools or methods for dealing with this situation and which will allow for a substantial improvement in the compliance with the prescription. An initial analysis of the cause of the problem leads us to conclude that an improvement in the information available to the patient in regard to his treatment is fundamental in order to avoid its abandonment as a result of a lack of knowledge of the effectiveness of the product or a lack of confidence in its secondary effects. Furthermore, helping the patient to remember the guidelines for the prescription will allow us to deal to a great extent with the leading factors related to a lack of compliance with a particular pharmacological treatment.

As regards this last point, marketing actions should be adopted aimed at reminding the patient about taking the corresponding doses of his or her treatment. In order to do so, a special communications channel is required which is commonly used by the patients, which would consist of an immediate and ubiquitous form of communication, so that the patients can receive the reminder to take their medicine in an immediate manner. The cell phone, through SMS messages, has allowed for the development of this type of project.

The patient, either directly or through his doctor, could sign up for a system through an SMS message, through the WEB or any other written form. In any event, what is fundamental is to respect the confidential nature of the data and obtain the patient’s informed consent to form a part of this initiative. As of that moment, the user will receive, via his cell phone, an SMS message at the exact moment when the medication should be taken.

In order to have these programmes, so-called “compliance improvement” programmes or e-compliance, prove successful, several factors will be required in relation with the type of the disease and the way the medication is administered:

• The effectiveness of the programme increases with those medications whose prescription guidelines are suitably spaced in terms of time (for example, vaccinations) or those which require a change in the doses in regard to time.
• For those pathologies associated with incapacitating diseases, the receipt of the message should be the person in charge of the regular care of the patient.
• It is important not to saturate the user with messages in order to prevent the patient from becoming indifferent and ignoring these reminders. If the prescription is a daily one, it is possible to send a reminder of the treatment in a not very frequent manner, for example, once a week.

The return on the investment from these programmes is quite high. The increase in the units issued by the laboratories will increase significantly if the programme has been correctly executed and if the product has a high rate of abandonment due to the patient forgetting to take his or her medication. Prior experiences have achieved an increase of 13% in the sales for products which fulfil both conditions.

Rafael Palomino Rodríguez
Consultancy and Marketing Manager
QUODEM CONSULTORES

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