There seems to be a never-ending stream of new tools designed to boost medication adherence. From information/support systems to physical reminders to phone apps using artificial intelligence, the list goes on and on. But before committing to any of these programs, a product manager would do well to examine the strength of the data supporting them. Better yet, back up one additional step and check the published literature showing which adherence barriers are actually the most common, and start your adherence-boosting efforts there. Let’s see what the research shows.
In Annals of Internal Medicine, Shrank and colleagues from Harvard and CVS Caremark reported on what may be the first study to comprehensively evaluate the phenomenon of prescriptions abandoned at the pharmacy.1 The study examined more than 10 million scripts in an exhaustive range of drug classes from antipsychotics to antihypertensives to antidepressants. Compared with scripts with no co-pay, scripts with co-pays of $40 to $50 had a 3.40 times greater probability of being abandoned, and those costing more than $50 had a 4.68 times greater probability of being abandoned. In the end, the authors concluded that patient co-pays “were the strongest predictors of abandonment, suggesting that patients experience ‘sticker-shock’ at the pharmacy and choose not to fill those prescriptions.”