By Kiril Tasseff

Medication & treatment non-adherence is an acute issue which barely raises an eyebrow outside of the healthcare ecosystem. Even within healthcare, many don’t quite realize the extent of the problem which seems to be progressing toward disastrous levels. Can technology help solve this crisis?

How big is the issue of medication non-adherence?

It’s having a seismic impact on healthcare worldwide. Medication or treatment non-adherence is a scenario where patients do not follow healthcare protocols. This includes skipping doses, incorrect timing, or prematurely stopping therapy. Data reveals that more than 50% ⁽¹⁾ of individuals are guilty of such practices, creating a significant burden on the global healthcare system.

Non-adherence worsens a patient's health status, accelerates the progression of the disease and results in extended hospital stays. This, in turn, causes healthcare costs to skyrocket. A 2012 study highlighted an alarming revelation: non-adherence contributes to an estimated annual cost of $100–$289 billion to the already overburdened US healthcare system ⁽²⁾. A more recent, 2018 study suggests an even steeper cost—over $500 billion—when considering all factors related to non-optimized medication use, not just non-adherence ⁽³⁾. These figures are staggering, indicating a crisis at both the human and economic level.

The pharmaceutical industry is also grappling with this. A 2016 report by Capgemini and HealthPrize unveiled an estimated $637 billion in annual losses linked to medication non-adherence for chronic conditions ⁽⁴⁾. These daunting numbers, combined with actual healthcare costs, clearly indicate that we are facing a trillion-dollar crisis.

What are the drivers behind this?

Numerous elements fuel this crisis. Predominant among these are high out-of-pocket prescription costs, fears over side effects and underestimation of their risk versus the dangerous consequences of non-adherence. Psychological barriers also play a critical role, with “present bias” leading patients to prefer immediate convenience or savings over long-term health benefits ⁽⁵⁾. This mindset is particularly prevalent in managing asymptomatic conditions, where the absence of immediate pain or discomfort shadows the long-term risks of non-adherence. Sadly, there are no widely accepted, effective or compelling ways for patients to clearly visualize the benefits of taking a particular drug as prescribed. Or, to fully comprehend the risks associated with non-adherence.

Who is trying to fix it?

Thankfully, all hope is not lost. Multiple tech companies are attempting to address the issue of non-adherence. Companies like DrFirst have integrated their solutions with top EHR providers, using patient engagement as a tool to combat non-adherence. Platforms such as Sidekick Health are pioneering comprehensive patient management approaches, especially for individuals dealing with multiple chronic conditions and comorbidities.

Many other startups are also hard at work on this issue. Innovations range from smart pill bottles (Popit, Pillsy), personalized health management and tracker tools (HelloHeart), platforms harnessing behavioral science and AI (Sweetch, PerxHealth, Thrive Global) and good old fashioned financial incentives offered by platforms like Sempre Health.

These endeavors promise progress in the fight against non-adherence. While it's too early to quantify their impact definitively, I feel optimistic that these solutions are a step toward a healthcare system that is more compliant and efficient. Still, there is more to be done and this is part of our mission at AIBODY and one of the reasons why we are hard at work to build practical digital twinning solutions for healthcare and leverage those to improve patient engagement and education. Innovation in this area can help uncover new strategies and complementary methods which will reshape the global approach to treatment adherence. Among many other applications, clinical grade digital twins can personalize treatment protocols to match individual patient profiles, minimizing side effects and enhancing patient adherence by providing clear, accurate forecasts of treatment outcomes. This tailored approach demystifies the treatment process, empowering patients with a clear vision of the positive impacts, thereby tackling key factors of non-adherence head-on. Despite sounding like science fiction, this type of technology is very much possible and closer to becoming a reality than we think.

References

1. Sabaté E, ed. Adherence to Long-Term Therapies: Evidence for Action. Geneva, Switzerland: World Health Organization; 2003.

2. Meera Viswanathan, PhD, Carol E. Golin, MD, Christine D. Jones, MD, MS, Mahima Ashok, PhD, Susan J. Blalock, MPH, PhD, Roberta C.M. Wines, MPH, Emmanuel J.L. Coker-Schwimmer, MPH, David L. Rosen, MD, PhD, Priyanka Sista, BA, and Kathleen N. Lohr, PhD. Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States, Annals of Internal Medicine, 4 December 2012. Volume 157, Issue 11, Page: 785-795

3. Watanabe JH, McInnis T, Hirsch JD. Cost of Prescription Drug-Related Morbidity and Mortality. Ann Pharmacother. 2018 Sep;52(9):829-837. doi: 10.1177/1060028018765159. Epub 2018 Mar 26. PMID: 29577766.

4. Thomas Forissier, Katrina Firlik, Estimated Annual Pharmaceutical Revenue Loss Due to Medication Non-Adherence, 2016, available here: Estimated Annual Pharmaceutical Revenue Loss Due to Medication Non-Adherence

5. Lee, Soah & Hyun, Myoung-Ho. (2021). The Effect of Present Bias and Belief about Medicines on the Medication Non-adherence of Patients with Chronic Disease. 26. 165-179.