Change you can believe in

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James Chase
James Chase

Pharma marketers have always been reasonably slick at finding target audiences and grabbing their attention. But, like any other industry, it's the call-to-action that poses more of a challenge. And if you're talking about a treatment regimen for, say, a chronic condition, then getting a new script into a patient's hand is often no more of an achievement than… well, reaching first base (in the truest baseball sense, of course).

The really tricky part is getting the patient to stay on the damn things. Adherence to treatment is the holy grail for pharma, and the bane of its product managers, especially those running brands in chronic and asymptomatic disease categories like hypercholesterolemia, where the drop-off rates can be staggering.

Over the years, pharma has invested repeatedly in trying to crack the compliance code, but outcomes have too often proved underwhelming. In some cases, the needle has barely flickered, and it seems all the CRM programs, patient tools, reminder texts and smart pill bottles in the world won't change that.

I don't know that anyone seriously believes it's possible to achieve 100% adherence for any course of treatment in any therapeutic category. I guarantee it's not. Not even close. Not 90%, not even 80%. And as for all those large, adherent-averse, CV patient populations… well, they are destined to remain just that.

The trouble is, we can't help but apply logic and wisdom to the attitudes and behavior of other humans. We tend to tar every patient with the brush of reason. We keep making assumptions about why people do what they do, based on what we think they should do.

Why do some patients adhere fully to treatment regimens, and yet others fail so spectacularly? For some, it might be a straightforward answer, like financial barriers, side effects or good old-fashioned forgetfulness. But human behavior is a complex, illogical beast and, more often than not, I guarantee that non-compliance has nothing to do with the severity of a patient's condition or potential danger of discontinuing treatment. If we always acted out of fear for our health, there'd be no cigarette smokers. And adherence rates in oncology would be perfect. Well, they're not.

Behavioral scientists, of course, have a strong understanding of what drives individuals to make certain decisions, and are able to predict attitudes and behavior with a decent degree of accuracy; that's not the issue. To improve adherence, however, you need to actually change behavior, not just predict it. Many have tried and failed. But if you keep approaching the same problem in the same way, you will keep getting the same results.

What might be a different way, then? The answer is video games, or rather gamification, which is the application of game mechanics—rules, points, challenges, levels, rewards, countdown clocks, leaderboards—to a non-game environment in order to instigate behavior change.

It works because, for whatever reason, games turn people into highly productive, willing, relentless, focused, optimistic, socially dominant versions of themselves. We are really, really good at them.

Gamification is getting a lot of play right now. If you are familiar, you'll know there is a mounting body of the evidence to suggest that, not only can it successfully change human behavior and improve health outcomes, it might even be capable of changing the world. Now there's a thought.
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