As I See It: The battle for better compliance

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Peter Pitts
Peter Pitts

Zig Ziggler once said, “If what you're doing isn't working, try something else. If what you're doing is working, try anything else.” While there are successes in the battle for better adherence/compliance, we're losing the war. It's time to reconsider what we're doing.

There are six linked issues we want to impact:

1. Sub-optimal patient outcomes (the Big Kahuna).

2. Sub-optimal physician pay-for-performance metrics. (More important today than ever.)

3. Lower healthcare costs for payers. The big private payers are all in the adherence/compliance game.

4. Sub-optimal profits for pharmaceutical companies. (The sale doesn't end once the script is written.)

5. Impact on safe-use. For drugs to be “safer,” they must be used appropriately. Safe use begins with adherence/compliance.

6. Lower healthcare costs for society. (This issue has been in the news quite a lot.)

Should FDA insist that new drugs have adherence/compliance plans that can be monitored and improved? Should reps (or MSLs) “detail” adherence/compliance programs and share validated tools for adherence/compliance “triage?”

Trying to “regulate” adherence/compliance is a slippery slope. To make a difference, we need solutions that impact social conditioning and address patient responsibility. That means using innovative platforms such as social media and apps that educate and assist patients in their quest for better health. Apps are at the nexus of safe use, treatment outcomes, and patient satisfaction. And it's not science fiction.

As Walter O'Malley (the man who moved the Dodgers from Brooklyn to Los Angeles) opined, “The future is just one damn thing after another.”


Peter J. Pitts is a former FDA Associate Commissioner and President of the Center for Medicine in the Public Interest.

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