whitepaper memotext summary

7/29/2019 Whitepaper Memotext Summary

1/7

MEMOTEXT

Personalized Adherence Interventions

Toll Free: 1877.636-6898 Tel: 647.430.8233 Fax: 416.946-1088

www.memotext.com

White pa pe r: Im prov ing Pa tie n t A dhe re nc e b y C om bining

M e d ic a l Ed u c a tio n a n d Te le c o m m u n ic a tio n Te c h n o lo g ie s

A nove l a nd t im e ly a pp roa ch to im prov ing hea lth ou tc om es .

The Problem: 2The Root Causes: 2The Economics of Patient Adherence: 3Overcoming Barriers 4What to look for in a Solution: 4

MEMOTEXT personalized adherence interventions in practice 5

Summary: 6EndNotes 7

By Am os H. Adle r M.Sc .MEMOTEXT Corporation


2/7

MEMOTEXT


Toll Free: 1877.636-6898 Tel: 647.430.8233 Fax: 416.946-1088

www.memotext.com

The Problem:M ed ica tion non-c om pl ianc e costs Nor th Am er ica m ore than 100billion

do lla rs a nd 125,000 l ives eve ry ye a r.i

Non- c om pl i a nc e : A fa ilure o r refusal to ad ap t o ne s ac tions to presc ribedtreatm ent regimens and lifestyle c hang es.

This prob lem costs entire healthc are system s, employe rs and nume roushea lth related industries tens of billions of d ollars ea c h yea r.

Non-compliance (aka non-adherence) impacts all levels of healthmanagement, from treatment effectiveness to unnecessaryhospitalizations. In addition, high expenses and lost revenues for payers,pha rma c eutica l com pa nies, pharmac ies and emp loyers have a ma terialeffect on the healthcare system, payers, the insurance industry and theec onom y itself.

Figures outlining the losses to pharmaceutical sales alone due to unfilled

prescriptions range from $25bn to $30bn annually.ii

It is also e stima ted thatalmost six percent of all hospital admissions are due to failed patientadherence. iii

Resea rc h indica tes tha t 70% of a ll p resc riptions a re never consume d a nd20% of all new d rug p resc riptions are never filled the first t ime. iv For somedisease sta te s, ad herence rates are as low as 10-20%.v

The Root Causes:Patient adherence has been a topic of research for decades. Althoughno root cause is shared by all patients, scientists have uncovered anumb er of fac tors that c ontribute to no n-c om plianc e, including:

Low Perceived Benefit

Ignoranc e (co ndition and purpose of the treatme nt or therapy)

Sta keholde r Comm unica tion Barriers

Ad ve rse Side Effec ts

Failure to Rem em be r

Financ ial Constraints

Cog nitive Imp airme nt

Lac k of Motivation

As suc h, multifac eted but highly pe rsona lized ap proac hes w ork be st t oovercome non-c omp lianc e. Individual preference , ag e, knowledge level,disease state and motivating stimuli should be considered when designing

a solution. Rather than approaching adherence as an authoritarian orDirec t-To-Consume r (DTC) m arketing initiative , it is important to ap proa c hpatients as partners in their health care, raise awareness, education,inform, encourage and reward them according to their individualc irc umsta nce s.

Using media andeducation relevantto t he patient,solutions using theoptimal mix of

patientinvolvement,education andtechnological

support are nowpossible.


3/7

MEMOTEXT


Toll Free: 1877.636-6898 Tel: 647.430.8233 Fax: 416.946-1088

www.memotext.com

PreventiveTreatmentRevenues

SystemicCosts

Economics of Adherence

The Economics of Patient Adherence:

The ec onom ics of ad herence are c om pr ised of three ma in e lem ents.

1. Healthc are System Burden2. Produc tivity Costs3. Lost Revenues

1. Hea lthca re System Burde nAchievable savings and cost efficiencies derived by improving patientadherence levels include the costs associated with preventable hospitalinpatient admissions, emergency room visits along with the preventableinsuranc e a nd p aye r co sts all mad e a vailable by low c ost tec hnologies.

Non-adherence is ve ry c ostly as third pa rty p aye rs reimburse p at ients forunused med ication and then p ay a ga in to help p atients w ho did not ta ketheir medication. Preventive treatment is far less expensive thanhospitalization. The t ota l co st o f d iabe tes alone ha s be en e stimated at

$132 Billion per year. I t is est imated that per capi tal medical expendituresfor individua ls with diabe te s alone we re $13,242 an nual ly.vi

Telephone based intervent ion programs for pat ients wi th cardiovasculardisea se ha ve show n redu c tions in inpa t ien t ad m issions by 40% a s wel l a sred uc t ions in e m e rge nc y d ep artm e nt visits by 73%.vii

The c ost o f non-ad herence rep resents almo st tw o pe rce nt o f UShospitalization costs and accounts for approximately six percent of allhospitalizations.viii The p otential savings ma de ava ilab le by imp rovedad herence are in the ma gnitude of $80bn in the US alone. ix

2. Productivity CostsThe soc ial c osts of ad herenc e inc lude resource w astag e, lost p rod uctivity,

absenteeism in the workplace, and the burden on the economy ofdisability and other indirec t co sts. Bene fits availab le throug h imp rove dadherence are linked to savings achieved by reducing absenteeism,reduced travel times and maintaining productivity. C ost e stim a tes forpa yers rang e from $290 for hype rtensive em ployee s, $631 per em ployeefor hear t d isease, and $1458 per employee managing d iabetes . x InCanada in 1998 nine billion dollars in prescription non-adherence costsw ere ge nerate d by lo sses in w ork resource s.xi

3. Lost Re ve nue sIncreased revenues for pharmaceutical companies and pharmacies aremade possible by the improved adherence and requirement fortreatment refills. For a $1bn product, a five percent increase in patientad herence c an reap $30 to $40 million in revenue .xii The m edian rep orted

improvements in adherence rates from theory-based (education),disease-based (skill-based) and behaviour-based (interventions) rangefrom 4% to 40% w ith a m ed ian imp roveme nt of 20%.xiii

yste mic c ost sa vings g ene rate dy improved adherence are

ogica lly coupled w ith anncrementa l inc rease in

reventative treatme nt


4/7

MEMOTEXT


Toll Free: 1877.636-6898 Tel: 647.430.8233 Fax: 416.946-1088

www.memotext.com

Each patientsegment requiresan appropriate mixof educat ion andbehavioralint ervention using

the most discretebut effective set of

technologies.

Improved return on investment (ROI) is attr ibuted not only to adherence

program s, but a lso to tec hnologies tha t prov ide a cost-be nef it ad vantag e . For examp le, resea rc h on a teleme dicine p rog ram for Type1 Diabetespat ients show ed levels of meta bo lic c ont rol similar to t raditiona l skill-ba sed

programs (manually teaching patients) but were provided at asignifica ntly lower co st. O ne stud y show ed a c ost savings of USD $800 perpa tient pe r yea r by using tec hnology ba sed ad herence solutions.xiv

Overcoming Barriers

Barriers to ad herence ca n be overc ome w ith a pa tient-ce ntric a pp roac hthat w orks w ith t he sta keholder organization t o:

1. Gather requirements to determine what the barriers are for aspecific patient population and how best to communicate withthem.

2. Provide the right set of patient-centric solutions that meet theneeds of the patient community and the requirements of thesta keholde r orga nizat ion in a w ay t hat ma ximizes ROI.

3. Provide a solution to me asurab ly imp rove t he q uality of life of thepatient.

What to look for in a Solution:

There is no universally op timalsolution, but through patient-centered communication,ed uca tion and the p recise m ix

of technologies appropriate to

the patients knowledge level,w e ca n now provide a level ofsupp ort and intervention thatis ta ilored to the ne ed s ofindividual patients.

The pe rvasiveness of voic e/ da ta , wireless, wire-line, Internet and (ma ssscale-customizable) paper-based communications media now allow foran experience that is as immersed or removed from technology as thepat ient desires.

Successful program development requires people, processes andtechnology for real success. As a prelude, accurate assessment ofindividual requirements must occur. Following this, service provided mustcombine planning, communications and relationships with stakeholderorganizations to complement the use of technology, processes andeducation.

The results of Data mo nitor's Pat ient Com plianc e Survey 2004 sugg est tha tpersonalized communication with patients is an important tool inc om plianc e initiatives. Direct -to-Pat ient communica tion (DTP) should b e


5/7

MEMOTEXT


Toll Free: 1877.636-6898 Tel: 647.430.8233 Fax: 416.946-1088

www.memotext.com

provided throughout the treatment relationship to provide continualsupport to compliant behavior.

The m ost ef fe c t ive solutions which a lso ha pp e ne d to provide

the gre a test RO I po sse ss the fol low ing c ha ra c teristic s:

easy-to-use omnipresent highly ac cessible feedb ac k loop of qualitative and q uantitative da ta c ap tivates interesting a nd informative to pa tient disc reet not o verwhelming or irritating the p at ient flexible ad ap ts to the need s of the p atient c om prehe nsive aligns interests of pa tients and sta kehold ers scalable c ost effec tive

MEMOTEXT personalized adherence interventions in practice

SM S C ontrac ep tive Rem inde r Prog ramAimed at sexually ac tive yo ung w om en, MEMO TEXT provide spharmaceutical industry client with a solution that consists of sendingsubscribe rs SMS/ Text Messag e and p re-recorde d voice c all reminde rs tohelp them ma intain a regular contrac eptive regimen.

This solution t ailored spec ific ally for c ont rac ep tive users allows thesubscribe r to c usto mize repea ted m essag es in order to ensure maxima ldisc retion. As per the client requirement, the sec ond da ily reminder isprovided within three hours of the initial message. No branding isrequested by the pharmaceutical company (though this option isavailable).

Sub sc ribe rs a re directed to enroll online by their physician. The p hysicia ncommunity in-turn was informed and educated by the pharmaceuticalsales force . This p rog ram c ontinues to ac hieve daily g row th andmeasurable, significant improvements in both compliance and brandawareness.

Educ a tion and Fol low- M e C om m unica t ions for Diab e te s C a re A blood glucose device manufacturer is embarking on an aggressivestrateg y to imp rove ad herence for pa tients w ith Type 1 diab etes mellitus.The educat ional intervention w ill use a n Internet a nd o fflinecommunications strategy along with a full voice and text messagereminder system . Throug h the diab ete s ed uca to r co mm unity, pa tients w illrec eive up t o 4 d aily SMS or Voice reminders to any c onta ct telep hone

numb er req uested .

Once co ntac ted on a da ily ba sis, patients will enter their glucose scoreinto the p hone via IVR. The results w ill be availab le to the p at ient o nline viaa sec ure w eb-pa ge. The p atient w ill be ab le to share results withc areg ivers and ed ucators. The da ily interac tions also serve as a d e-identified measure of increased adherence and improved ROI to thepha rma c eutica l manufacturer.


6/7

MEMOTEXT


Toll Free: 1877.636-6898 Tel: 647.430.8233 Fax: 416.946-1088

www.memotext.com

Summary:

Non-com pliance /ad herenc e is one of the mo st c ritica l issues threa teningall leve ls of he alth manag em ent. Trea tm ent ineffec tiveness, unnec essaryhospitalizations and lost revenues for pharmaceutical companies,pharmacies and employers, have had a significant impact on healthcaresystem s, third pa rty paye rs, a nd the insurance ind ustry.

Personalized and localized solutions that transcend social, cultural,language, literacy, and economic forces using a omnipresent approachto p atient ad herence has bee n proven effective.

MEMO TEXT offers turnkey telec ommunica tion-ba sed ad herenc e solutionsthat a re highly ad ap ta ble, quickly sc alab le, and c ost effec tive. Onave rag e, M EMOTEXT pa tients are significa ntly and me asurab ly mo recompliant than those acting alone. Ultimately this leads to better health

outcomes, reduced healthcare costs, and greater profits forpharmaceutical manufacturers and pharmacists.


7/7

MEMOTEXT


Toll Free: 1877.636-6898 Tel: 647.430.8233 Fax: 416.946-1088

www.memotext.com

Doc um e nt Ve rsion Log

Ve rsion Da te De script ion C ha nge d by

1.0 Dec . 14, 2005 Release Draft 1.0 Amos Ad ler M.Sc .

1.1 Dec . 31, 2005 Edite d Jay Keystone MD, FRCPC, M.Sc . (CTM),2.0 Jan. 4, 2005 Edited Danielle Keysto ne Ad ler LLB

3.0 Feb 2, 2006 Update d Amos Ad ler M.Sc .

4.0 Ma y 20, 2006 Update d Devin Shelley

5.0 Jan 7, 2009 Upd ate d Elisha Zavier B.A.

EndNotes

i Understanding patients needs is key to medication compliance, Walker, T., Ma nag edHealthc are Exec utive, 2001ii Patient-Cente red Ca re for Bette r Patient Ad herence, Low es, Robert, AAFP, 1998

iiiUnderstanding patient non-compliance, Rone r, Lisa , eye forpha rma Briefing - June,28,2005ivImp roving Patient Compliance: Utilizing online a nd m obile c ompliance too ls, Datamonitor,July 16, 2003v Supra, note iii.vi The Case fo r Diabe tes Disea se Ma nag em ent, Landis, Darryl, King, allen, Cua , Pat rick,Walker, David, Health and Productivity Management Vol. 2, No. 3vii Ca rdiovasc ular Risk Red uc tion a t United Healthcare of No rth Ca rolina: The first 12 Months,Land is, Darryl, Geo rgiu, Archelle, MD, Ap p le, Joa nna , MPH, RN a nd Durand , Jennifer, RN.,JCOM, Ap ril 2000viiim -Healthc are Initiatives for Imp roving Outp atient Ad herence : Op po rtunities and Barriers,Co c osila, M. and N. Arc her, Mc Ma ste r Unive rsity eBusiness Researc h Ce ntre (MeRc ), June2005.ix Assessing the dam ag e: Estima ting t he Ec onomic Burden o f Presc ription Drug Non-

Adherence in Canada, Iskedjian, M. Ca nad ian Healthca re Mana ge rxA review of the literature on the ec onomics of nonc omp lianc e. Room for methodologicalimprovement. Cleem put, I., K. Kestelot ., The Lance t, 2002 in m-Healthc are Initiatives forImproving Outp at ient Ad herenc e: Op po rtunities and Barriers, Sup ra no te vi.xi The ec onomics of c omp lianc e: manag ing com pliance is one w ay to co ntain climb inghealthcare costs. Coambs, R. Canadian Healthcare Manager, 2002 in m-HealthcareInitiatives for Improving Outpatient Adherence: Opportunities and Barriers, Supra note vi.xii Supra, not e iii

xiiiThe Pharma c ist s Role in Treatm ent Ad herenc e Part 4: Do Ad herenc e Interventions Rea llyHave An Imp ac t?, Krueg er, K.P, Felkey , B.G., Berge r, B.A, US Pha rmac ist: Vol. No: 30:05xivDiab etes and telemedicine, Klonoff, D., Diabetes Care, 2003 in m-Healthcare Initiatives forImp roving O utpa tient Ad herence : Op po rtunities and Barriers, Sup ra, note vi.

whitepaper memotext summary

Documents