Medication nonadherence has long been a problem in the healthcare industry, but that issue may only be exacerbated by the COVID-19 pandemic. Patients may be out of work with no insurance, afraid to visit a doctor or pharmacy, feeling stressed and overwhelmed, or dealing with other issues that lead them to forget to take their meds or are just unable to do so. But companies are always looking for ways to help increase adherence—no matter the situation. Here are just 10 of the latest to come out within the past couple of years.
Vice President of Marketing
Scalable, Regulated Digital Health Platform
Digital health is ushering in an exciting time for medicine with digital therapeutics offering new approaches to treating chronic conditions, rare diseases, and everything in between. For example, biopharma and medtech companies are adding digital service wrappers around current treatments to improve adherence instead of adding more options to a flooded market.
However, maintaining a homegrown infrastructure to support these new digital health products that fits the necessary technology, privacy, security, and regulatory requirements demands significant investment. Building everything in-house is a competitive disadvantage as the heavy lift involved in creating a properly secured platform distracts biopharma and medtech companies from developing transformational digital health products, devices, and therapies.
BrightInsight developed a leading regulated digital health platform for biopharma and medtech to help optimize these breakthroughs and support the complexities of a highly regulated industry. The scalable, medical-grade platform accelerates regulated digital health innovation for biopharma and medtech customers, including AstraZeneca, Novo Nordisk, Roche, and CSL Behring. Whether connecting a medical device or combination product, developing a companion app or deploying a smart algorithm, this platform simplifies digital transformation while accelerating time to market, minimizing risk, and future-proofing digital solutions.
The BrightInsight Platform features real-time insights around patient engagement, medication or device adherence, and operations. It can also help track patient demographics, revenue trends, and commercial KPIs for product launches.
COVID-19 Adherence Solution
Product Marketing Manager
AdhereHealth’s COVID-19 Adherence Solution is an innovative program that combines predictive analytics and tech-enabled consumer outreach with private couriered pharmacy to support high-risk patients. The solution helps improve health outcomes by enabling health plans to identify consumers who are at higher risk of medication non-adherence. Leveraging real-time data and a team of nationwide employed licensed clinicians, AdhereHealth provides direct omni-channel consumer and provider engagement to discuss health status, identify resources, coordinate care, and ensure consumers have access to their medication.
The program uses data-driven outreach to resolve social determinants of health (SDOH) issues in the context of COVID-19 using health plan benefits and community resources to ensure consumers are able to safely access food and other necessities. For high-acuity consumers with social distancing and mobility issues, the program also offers private-couriered medication delivery services, and includes monthly comprehensive medication reviews (CMRs) and drug utilization reviews (DURs) at no additional costs.
COVID-19 has exacerbated existing SDOH issues and medication adherence challenges for underserved populations. Statistics show almost 90% of those who are hospitalized with the virus have underlying conditions, and a majority are over the age of 50. By proactively targeting at-risk consumers, providers can promote adherence, keep consumers healthy, and help reduce the risk of becoming seriously ill from the virus.
AdhereHealth is a healthcare technology company supporting health plans, self-insured employers, and other risk-bearing entities for medication adherence insights and improved healthcare outcomes. The company’s closed-door retail pharmacy, AdhereRx, supports patients nationwide with high-risk chronic conditions and SDOH issues.
Senior Vice President, Head of Patient Services Operations
Delivering value in the era of empowered patients renders the one-size-fit-all patient services program obsolete. Not every treatment journey is consistently linear within a disease state because patients take different paths to adherence. For example, one patient may be compliant when prompted by a smartphone notification while another uses a calendar to keep track of daily medication.
Three main issues with current adherence programs are: 1) Patients Have Fundamentally Different Adherent Issues; 2) Not Every Patient Needs an App; and 3) Metrics Ignore Patient Subgroups. Patients demand more personalized services, yet current offers fail to meet their expectations set by standards from other industries. If consumers can track real-time pizza deliveries, shouldn’t they be able to do the same with the status of their medications?
Earlier this year, EVERSANA elevated its next-generation patient services with predictive analytics that inform “the next best action” along the patient journey. Predictive analytics enables existing resources to be fully optimized: The physician predicts outcomes, the pharmacy predicts cost of care, and the advocacy group predicts adverse events. By identifying where the patient is in his treatment journey, this enables EVERSANA to predict probability of nonadherence, provide effective corrective actions, and measure the size of the potential impact.
Manufacturers can achieve greater adherence by focusing on the unique needs of each patient. EVERSANA’s new adherence solution also offers one-on-one interactions; timely communication and resolution of access and affordability; and at-home product delivery and nursing care. This one ecosystem of integrated services not only keeps patients informed but generates positive outcomes to demonstrate therapeutic success.
LUminate Support App
Chief Strategic Officer
Beacon Healthcare Communications
Patients who have opioid dependence or opioid use disorder often want to discontinue their opioid use but either fear the symptoms associated with opioid withdrawal or have experienced the symptoms and revert to the opioids to mitigate the symptoms. Lucemyra, which launched in 2018, is a non-opioid prescription medicine used in adults to help with the symptoms of opioid withdrawal that may occur when stopping opioids suddenly.
Research indicated patients needed active—but anonymous—adherence support. Beacon and US WorldMeds developed the LUminate support app, an easy-to-use app patients can download on their smartphones. With customizable dose tracking, timely medication reminders, and daily messages of encouragement, the LUminate app is designed to support patients during each day of treatment with Lucemyra.
The app pushes notifications to remind users to take their medication as prescribed and offers tips based on the day of treatment. Supportive messages with dosing reminders are sent out four times a day, every day of treatment based on the reminder times set by the patient. Personal adherence tracking rewards the user by counting days in a row to encourage repeat use.
Education information is available that explains what the patient may be feeling and how to manage the symptoms. A meditation timer feature is included to encourage mindfulness while managing withdrawal symptoms. To help ensure privacy to the patient, the application is self-contained and does not need to connect to the internet for basic functionality.
Since the app is self-contained, direct results are not available; however, LUminate support app is the most visited section of the Lucemyra website and has more than 1,200 downloads.
Intelligent Devices SEZC Inc. (IDI)
Smart packaging adherence solutions that offer electronic timestamps for dose removal and bottle openings provide researchers with objective data that demonstrates a drug’s effectiveness or lack thereof. Data shows that patients in clinical trials are 25% to 35% non-adherent and this drops off at the rate of about 1.5% per month. Non-adherence during clinical trials leads to inaccurate data, and often results in incorrect dosing; abandoned trials; or unnecessary, lengthy, and expensive research.
Information Mediary Corporation’s (IMC) Med-ic technology is invisible to the naked eye and offers the patient an effortless experience. Designed with low to zero technology burden for the patient, the Med-ic embedded electronics give the patient options as to the level of technology engagement they want to embrace. Med-ic adherence data can be viewed during the return visit to the clinic site or technology-engaged patients can use Med-ic’s companion mobile app, CertiScan, at their leisure.
Research from HIV and HCV trials shows that poor adherence is associated with reduced antiviral effectiveness, leading to potentially harmful drug-resistant microbes; something that is entirely plausible to also occur with upcoming COVID-19 treatments. Irregular dosing may also increase the virus’ virulence, making the problem worse.
But it is possible to measure medication adherence simply and accurately. The adherence data can then be used to increase the accuracy and improve the effectiveness of the treatment, which can aid in the prevention of the spread of the COVID-19 virus once treatments have hit the market.
Multidisciplinary Behavioral Framework
EVP, Patient Solutions
Cello Health Communications
Many people diagnosed with chronic disease face a lifetime of illness management challenges, including treatment adherence. Whether it’s an asymptomatic condition such as dyslipidemia, a life-threatening rare disease, or cancer diagnosis, living with a health condition requires practical and emotional support. In order to provide support that’s meaningful to an individual, we must understand not only how a person behaves but also why they think and behave a certain way.
Though behavioral science is based in age-old theory, current published research highlights the necessity to look beyond behavioral science and motivation to thoroughly understand individuals and populations. That’s why Cello Health uses theories and models from several disciplines, including behavioral economics, sociology, anthropology, psychology, health psychology, and medicine. Their proprietary, evidence-based, multidisciplinary behavioral framework combines factors from theories of behavior (linear) and factors from theories of change (dynamic). This allows them to explore and understand the fluid nature of managing illness and treatment to better support adherence at an individual level.
Since each discipline they draw from looks at health and behavior from a different perspective, they can layer factors from these disciplines to unveil a more holistic and unique portrait of individuals. Their framework creates a dimensional picture of the why behind health behavior that cannot be created by any one discipline, theory, or set of factors alone. Cello’s unique methodology allows them to gather foundational evidence, interpret insights through a systematic and theory-based structure, and lend a valid and objective understanding to a subjective patient experience. This ultimately underpins their creation of strategies and tactics that lead to behavior change for patients and caregivers.
Sprout Behaviour Change
Pharminder is a fully integrated pharmacy-based system to improve persistence by sending two-way SMS reminders to patients when their prescription refills are due. Co-created with pharmacists and behavioral psychologists and using human-centered design principles, it increases the value to a patient of a reminder by enabling them to message the pharmacist directly, for example, so that their refill is ready when they come to pick it up. For pharmacists, it provides the opportunity to broaden their relationship with the patient beyond the pharmacy, and build customer loyalty.
Since 2019, Pharminder has been rolled out to more than 300 pharmacies in New Zealand. More than 250,000 patients have been onboarded within 12 months (growing at >5% per month) and these patients account for more than 60% of all medication dispensed.
Patient engagement has been excellent. There is a >50% response rate to messages, and 10% of messages become conversations, with opt-out from the service at only 6%. Pharmacists are happy to use Pharminder because it is fully integrated with pharmacy systems to reduce hassle and save them time, and the system itself requires no training to use.
This simple intervention has increased persistence by 13% (from 72% to 85%) for first refills and 15% (from 59% to 73%) for second refills. Overall, the pharmacy group saw refill volume increase by >5% during one of the toughest years of competition in decades.
Developed by Artilect, an innovative health technology company, Pharminder is currently available in New Zealand and in alliance with Sprout Behaviour Change can be compatible with pharmacy operations in any country.
RxMx’s Chameleon Platform
Global Marketing Manager
RxMx North America
RxMx’s technology helps pharma companies launch specialty medicines while improving patient adherence. The combination of a backend portal and apps for patients, HCPs, and field representatives allows RxMx to monitor treatments, engage patients, and achieve high adherence rates. One of its most successful programs in the U.S. has an average patient compliance rate of 90%.
Built on its Chameleon platform, the products are customizable based on the unique needs of each drug or treatment. In a recent project, RxMx built a patient app to allow patients to confirm their next treatment date, view the clinic location, and access critical product information. Patients can contact a nurse and access educational materials to learn about their treatment via the app. The app feeds data into a portal, which provides the information to their healthcare team.
One differentiator is that RxMx products don’t add to the administrative burden of doctors and nurses. RxMx apps, combined with the backend portal to manage treatments and keep patients engaged, is especially helpful when an HCP team is managing thousands of patients. The patient app provides automated reminders that would otherwise be handled by the support team.
Algorithm-based automation tools allow nurses to focus on patients most in need of their care. Nurses can more accurately track and view a patient’s journey in one platform, providing greater insight into the patient experience. The patient support team also has visibility into the patient’s schedule to support treatment adherence and keep them in the best possible health.
TrialCard’s Mango Health Solution
Chief Sales Officer
Over the past two decades, pharma manufacturers have tried a wide array of adherence solutions. Unfortunately, most of these attempts have failed to deliver meaningful ROI at scale for three reasons: 1) lack of patient scale; 2) narrow focus on one particular driver of non-adherence; 3) high cost of people-based programs such as nurse-led call centers.
TrialCard’s Mango Health solution addresses all three of these shortcomings by leveraging the scale of patient support programs to enroll patients into Mango Health, a low-cost, digital platform that enables patients to better self-manage their entire medicine cabinet and integrates all aspects of patient support into the digital experience.
By combining health management, affordability, and education, Mango Health addresses multiple causes of non-adherence including behavioral, financial, and clinical drivers. By leveraging patient support programs to enroll patients, Mango Health generates sufficient scale to impact a brand’s P&L.
Mango Health has been deployed in various settings (including IDNs, pharmacies, payers, and manufacturers) and therapeutic areas. In all these deployments, Mango Health demonstrated meaningful adherence lift ranging from 10% to 40%. Furthermore, initial evidence shows Mango Health can even improve fill rates for patients in copay programs that are normally predisposed to higher adherence. For example, TrialCard was able to identify more than 200 patients across two brands who had participated in both the brand copay programs as well as Mango Health. Patients enrolled in both copay and Mango Health had significantly higher fill rates relative to copay participation alone.
A digital, patient-centric approach deployed at scale can generate meaningful impact for brands and better outcomes for patients, providers, and payers.
Founder & CEO
Medication non-adherence is a major problem in U.S. with 51% of prescriptions taken incorrectly and only 15% of prescriptions are refilled. One third of hospital admissions among seniors are due to medication non-adherence, costing the U.S. economy $290B.
WatchRx offers a smartwatch-based medication adherence solution for seniors who are challenged by complex medication regimens, poor vision, and cognitive limitations. The patent-pending solution provides audio/visual/haptic medication reminders with medication name, dosage, and image with voice instructions. The WatchRx smartwatch features a phone, as well as WiFi, Bluetooth, and cellular connectivity for phone calls and text messaging. The smartwatch supports heart rate monitoring and can collect vitals such as blood glucose, blood pressure, or blood oxygen levels via Bluetooth while accelerometers and a gyroscope can collect motor symptoms coupled with medication timings. Medication regimens are downloaded onto the watch automatically. The smartwatch generates alerts to family/professional caregivers when medication is missed or when emergency or threshold crossing events for vitals occur via WatchRx’s caregiver app.
The WatchRx platform supports remote patient monitoring services for physicians to monitor chronic illnesses and can also be used to record self-reported adverse events (such as nausea or diarrhea) in real-time as well as deliver personalized, disease specific instructions. The solution can be used for hospital applications for inpatient medication management and medication reconciliation and is also well suited for electronically recording drug administration in home settings or during clinical trials. Preliminary data on Parkinson’s and diabetic patients has shown 20% to 30% improvement in medication adherence.