Pill color may not be the first thing that comes to mind when discussing a patient’s willingness to take a drug.  Nor that a patient may dismiss a medication because it is a pill as opposed to a shot or liquid, which they may perceive as being a more potent form of medicine.

Yet a recent study shows that these barriers frequently come between patients and consistent medication levels due to what multicultural marketing firm Global Advertising Strategies calls “cultural incompetence.”

More than half of the 3.2 to 3.8 billion prescriptions that are distributed in the US each year are not taken correctly, triggering around 125,000 deaths. Culture-clash is a major contributor, said the shop.

The study says the lack of cultural understanding across all levels of the healthcare chain severely affects minority populations, and found that 20% of Hispanics and African Americans – who top the charts in chronic diseases like diabetes and heart disease – don’t comply with their drug regimens.

Pharma has good reason to pay attention to these numbers. Global estimates that a greater adherence rate among minority populations would garner an additional $1 billion to $3 billion in sales every year. The report also suggests that investing in more culturally effective communications would also shore up a brand’s equity because “more so than the general population, ethnic minority patients tend to perceive brand medications to be better than generic options.”

And yet, the study notes that less than 5% of consumer advertising budgets are devoted to what amounts to 40% of the population.

The agency said it is critical to understand how healthcare fits into the community narrative, such as whether care is decided by the patient and doctor, or if a culture considers treatment part of the larger family narrative. The study also addresses how physicians come into the picture, noting that some communities defer to crowdsourced health information and consider the conventional medical community a resource of last resort.

The 22-page report outlines a multi-pronged approach that can begin to fix the communication gap. The plan falls into four broad categories which include establishing cultural profiles, educating healthcare providers with the culturally-relevant information, reaching patients through as many touchpoints as possible (e-mail, text) and establishing regular follow-up.