Patient Compliance: Converging Toward a Common Goal

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Patient Compliance Converging Toward a Common
Goal

• Verispans Strategic Study Series
• Prepared for PBIRGs 2006 General Meeting
• Research Excellence Series
• May 23, 2006

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Who Is Verispan?

• A full service primary and secondary market
  research company with products that cover market
  research, managed markets, and sales targeting
  functions for the pharmaceutical industry.
• The leading provider of de-identified
  longitudinal metrics to the healthcare industry.
• Privately held jointly owned by Quintiles
  Transnational and McKesson formed in 2002.
• 550 information professionals based in Yardley,
  PA

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Agenda

• Objectives
• Introduction/Methodology
• Key Findings
• Depression/Anxiety Focus
• Industry Interaction
• Summary

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Objectives

• To provide an understanding of how an integrated
  primary and secondary approach can help to better
  understand attitudes and behaviors
• To illustrate how a comprehensive approach can
  help to define gaps in perception, therefore,
  providing focus for compliance enhancement
  initiatives

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Introduction/Methodology
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Introduction

• The Strategic Study Series (est. 1984)
• A biannual series of studies supported by
  Verispans Marketing Research department
• Surveys key healthcare audiences
• Integrates data from secondary market research
  audits and patient centric data base
• Patient Compliance Objectives
• To provide a qualitative understanding of
  patients compliance attitudes and behaviors and
  how they correlate with healthcare professionals
  perspectives
• To provide the pharmaceutical industry with an
  understanding of how to best combat noncompliance
  in the investigated markets

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Methodology
Market Specific Foundation

• Arthritis
• Benign Prostatic Hyperplacia
• Depression/Anxiety
• Diabetes
• Estrogen/Hormone Replacement
• Gastroesophgeal Reflux Disorder
• Hypertension

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Panel Composition

• Consumers completed a 30-minute online survey
  qualifying questions
• Specialists completed a 25-minute survey via
  paper-based administration or an identical
  on-line version
• Primary care physicians completed one of two
  25-minute online surveys

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Comprehensive Approach
Patient Data
Consumer
Managed Care
COMPLIANCE
Primary
Secondary
Pharmacist
Physician Spec. PCP
Prescription Audited Data
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Table of Contents

• Introduction
• Methodology
• Executive Summary
• Seven Market Specific Chapters
• The Physician Perspective
• The Pharmacist Perspective
• The Managed Care Perspective
• Appendix

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Market Specific Contents

• Market Background
• Consumer Background
• Patient Persistency
• Compliance Attitudes Behaviors
• Physician Interaction
• Pharmacist Interaction
• Most Helpful Compliance Enhancements
• Pharmaceutical Company Interaction

PATIENT COMPLIANCE
Pharma. Companies
Physician Interaction
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Key Findings

• Depression/Anxiety Focus

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Market Consumer Background

• Market Background
• Number of patient visits
• Key Transactions by type Continuing, New,
  Switch/Add
• Supplemental unique patient counts by product
• Persistency measures for selected products
• Consumer Background
• Products prescribed by physicians and taken by
  patients
• Methods used to obtain and pay for prescriptions
• Co-pays for branded and generic medications
• Level of distress associated with condition
• Physicians seen to treat condition

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Market Background

• Key Transactions by Type

• Utilizing longitudinal patient-centric data
  offers direction in tailoring compliance programs
  for different patient types.

Verispans Patient Compliance Converging Toward
a Common Goal Depression/Anxiety Source
Verispans TPM from VONA
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Patient Persistency

• Depression/Anxiety Persistency Curve Zoloft N
  69,477

• Measuring brand persistency against competitors
  is also an important variable in developing
  compliance intervention.

Source Verispans Patient Parameters?
Persistency
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Compliance Attitudes and Behaviors

• Compliance Classifications and Distributions
• Five compliance behaviors when a dose of
  medication is missed or prescription is
  completed consumers vs. physicians
• Five compliance Factors Trust in the Medical
  System, Financial Stressors, Belief Systems,
  Quality of Life and Information Seeking
• Consumer Verbatims - Quality of life, Reasons
  for Intentionally Skipping a dose Medication and
  Compliance Motivation

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Compliance Attitudes Behaviors
Consumer Compliance Classifications and
Distributions

• On average, 94 of consumers said they take their
  medication as directed.
• Compliance classifications do not mirror this.
• Compliance classifications are correlated with
  numerous variables.

Verispans Patient Compliance Converging Toward
a Common Goal Depression/Anxiety
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Compliance Attitudes Behaviors

• When you miss a dose of your medication, do you

• Zero patients reported contacting their physician
  or pharmacist when they missed a dose of
  medication this differs significantly from
  healthcare professionals perception.

Verispans Patient Compliance Converging Toward
a Common Goal Depression/Anxiety
19
Physician Interaction
Frequency of Compliance Discussions

• Patients who report that their physician
  discusses compliance at every visit are
  significantly less likely to intentionally skip a
  dose of their medication (13) than patients who
  report that their physician never discusses
  adherence with them (24).

Verispans Patient Compliance Converging Toward
a Common Goal Depression/Anxiety
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Compliance Enhancement
Most Helpful Compliance Enhancements
Verispans Patient Compliance Converging Toward
a Common Goal Depression/Anxiety
21

Compliance Enhancement

• Provision of Compliance Enhancements

67

• PCPs and specialists tout the free literature and
  website information that they regularly give out
  however, patient perception is that they rarely
  get compliance material.

Verispans Patient Compliance Converging Toward a
Common Goal
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Industry Interaction
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Pharmaceutical Company Interaction

• Percentage of Reps who Discuss Compliance

• The percentage of reps whom specialists report
  are discussing compliance with them positively
  correlates with the frequency with which these
  physicians discuss adherence with their patients.

Verispans Patient Compliance Converging Toward a
Common Goal Depression/Anxiety
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Compliance Enhancement Rankings
Top Three Companies for Compliance Enhancement

• Pfizer was ranked first by seven out of the 10
  healthcare professional groups surveyed.

Verispans Patient Compliance Converging Toward a
Common Goal
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Top Companies for Compliance Enhancement
Psychiatrists Ranking

• Psychiatrists ranked Pfizer first for compliance
  enhancement however, these specialists were more
  likely to indicate implementing Johnson
  Johnsons strategies and that the companys
  strategies influenced their prescribing.

Verispans Patient Compliance Converging Toward a
Common Goal Depression/Anxiety
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Summary

• Physicians who said the reps they see discuss
  compliance with them are significantly more
  likely to, in turn, discuss the importance of
  adherence with their patients at every visit.
• Patients whose physicians never discuss
  compliance with them are less conscious of taking
  their medication as directed.
• Healthcare professionals perceptions of the most
  helpful compliance enhancements are not in line
  with consumers opinions.
• Consumers across all markets ranked provision of
  pharmaceutical company literature as the most
  helpful compliance enhancement however,
  healthcare professionals tend to underestimate
  the importance of this enhancement.
• Pharmaceutical reps can influence the frequency
  of physician/patient compliance discussions which
  can directly impact compliance therefore, they
  should be aware of gaps in perception and market
  specific variables.

Verispans Patient Compliance Converging Toward
a Common Goal
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Thank You!
Tara Hamm Associate Director, Product
Management tara.hamm_at_verispan.com 267.685.4300