Key areas for action include simplifying treatments, developing digital tools and raising awareness.
INSIGHT
According to the World Health Organization (WHO), nearly 50% of patients suffering from chronic conditions do not follow their treatment plan properly1, to the detriment of their health, sometimes to the point of endangering their lives. However, the severity of this problem is still underestimated by public authorities, despite the considerable impact it has on health systems. Patients, their friends and family, public authorities and manufacturers are becoming increasingly aware of the issue.
The many challenges facing patients who do not stick to their treatment
Adherence to treatment refers to the degree to which patients apply the recommendations of their health care provider. A patient is considered not to adhere if they follow less than 80% of their treatment plan. Chronic conditions are a particular concern (37% for diabetes, 40% for hypertension, 44% for hypercholesterolemia) with potentially serious consequences. Indeed, the WHO estimates that if everyone diagnosed with a chronic disease followed their treatment plan to the letter, 12,000 deaths in France and 200,000 in Europe could be avoided each year2. In addition to the impact on patient health, failure to adhere to treatment costs health systems heavily every year, estimated to represent €9.3 billion in France and between €80 and €125 billion in Europe3.
These costs are incurred through hospitalizations and avoidable premature deaths (cost of treatment and care, mobilization of health care professionals), as well as the waste involved in unused prescribed medicines. Increasing adherence to treatment would bring about two primary benefits: • Improve patients’ length and quality of life • Reduce spending on health by raising awareness among public authorities about this major global issue
Leveraging pharmacists as a key link with patients – In Australia, patients see pharmacists as one of the top 3 reliable health care providers. This gives them a central role in educating the public about medicines and raising their awareness about the importance of sticking to their treatment.
Understanding why people struggle to adhere to their treatment
To effectively combat this problem, we must first identify the cause. However, there are many reasons why people struggle to adhere to their treatment4 : • Socio-economic and cultural grounds (high cost of medicine, education, etc.) • Relationship between patients and health care professionals • The relative complexity of treatment plans (pills needing to be taken several times a day and/or at specific times, side effects, etc.) • Patient-specific issues (young or old-age, forgetfulness, fear of side effects, feeling of being cured, weariness, anxiety, depression, cognitive disorders, etc.) • The health system (complex process, partial reimbursements, access to treatments and consultations, etc.) Failure to adhere to treatment occurs as a result of one or several of these factors, and therefore requires a comprehensive response that engages patients, health care professionals, the pharmaceutical industry and public authorities.
Ways to increase adherence to treatment
By adopting a wholly patient-centered approach, certain pharmaceutical companies (including laboratories, start-ups and health care professionals) are becoming increasingly aware of the importance of boosting adherence to treatment. They are leveraging three highly promising potential solutions.
Single Pill Combinations
Single Pill Combinations (SPC) combine several molecules in one pill to simplify treatment plans and therefore the daily lives of patients. A study into hypertension patients demonstrated that an SPC improved adherence by between 27% and 60% over a year5 while also reducing the risk of death.
Digital innovation – Beyond the pill
Beyond the actual pills themselves, digital apps can really boost adherence to treatment by acting as “digital companions” to patient health.
Educating patients about their treatment
This empowers patients and helps them better understand their treatment plan through patient organizations. For instance, this may include patients joining psychological support groups or groups to discuss their lived experience, or rolling out screening campaigns.
Raising awareness among public authorities
As adherence to treatment is crucial to patient health, public authorities need to see the issue as a key source of progress. Already, the initiatives put in place by many in the pharmaceutical industry have helped make significant strides forward.
Professional and scientific organizations are also working to achieve the broadest possible consensus on the need for patients to stick to their treatment. For example, in September 2024, the European Federation of Pharmaceutical Industries and Associations (EFPIA) worked to ensure adherence to treatment was included in the EU Council conclusions on cardiovascular health in order to better orient European policy on the matter. The European Society of Cardiology (ESC) was one of the expert organizations that help circulate the Policy Report and the Manifesto on adherence.
SERVIER IN ACTION
New study into hypertension
Between 5 and 10% of hypertensive patients are difficult to treat, considered to suffer from resistant hypertension, meaning they must take four medicines each day to control their blood pressure. They run a greater risk of serious cardiovascular accidents. At the 2024 European Society of Cardiology Congress, we presented the findings of a study into a Single Pill Combination containing four molecules to treat hypertension.
Adherence to treatment in oncology – the next challenge?
The issue of adherence is primarily associated with chronic conditions. As certain cancers are being diagnosed at an ever earlier stage and treatments become increasingly effective, some experts believe the disease may become “chronic”, requiring long-term treatment. Servier is anticipating this shift by developing solutions for patients to maximize their adherence to treatment and improve their quality of life.
“In Portugal, the Missão 70/26 project aims to get hypertension under control for 70% of patients by 2026. It underscores the importance of sticking to the treatment to effectively manage high blood pressure and more generally all chronic conditions.”
Frédéric BENGOLD, Chief Executive Officer, Servier Portugal
+50 projects
relating to adherence to treatment throughout the world developed by Servier in collaboration with patient organizations in 2024.
Training pharmacists to improve adherence among patients
In 2022, the CONCORD study, led by the Servier teams in Greece, assessed the impact of a program to train pharmacists about therapeutic adherence. The impact of training 133 pharmacists about adherence for 1,146 patients was assessed over a four-month period. The results showed patient adherence improved on average by over 20% across the various parameters measured.
View form the field
It is fundamental all patients with chronic illnesses adhere to their treatment.
“In line with our vocation of being committed to therapeutic progress to serve patient needs, we action all solutions that could potentially encourage patients to better stick to their treatment. It is a fundamental concern for all patients with chronic illnesses that affects not only the efficacy of treatments, but also improves patients’ quality of life while reducing long-term complications. Bolstering engagement between patients and health care professionals on the matter is especially key in responding to the rising challenges of treating chronic illnesses. This ambition is reflected in every stage of the life cycle of our medicines, from the research and development stage through to patients taking the pills.”
Viviana Cortese,Head of Cardiometabolism & Venous Disease (CMVD) Global Medical & Patients Affairs, Servier
Viviana is helping to increase adherence to treatment among patients living with chronic conditions in order to significantly improve treatment efficacy, patient quality of life and prevent complications related to their condition.
1Adherence to Long-Term Therapies: evidence for action. World Health Organization 2003 2 https://www.institutsapiens.fr/observatoire/ameliorer-ladhesion-therapeutique-un-enjeu-de-sante-publique/ 3 Studies IMS Health et CRIP 2015 4 https://www.cardio-online.fr/Actualites/A-la-une/La-non-adhesion-therapeutique-origine-multifactorielle 5 Snyman, J., P. Balagopalan Jayagopal, A. Konradi, L. Bortolotto, L. Degli Esposti, V. Perrone, and C. Borghi (2022), EE478 Do Triple Single-Pill Combinations Make a Difference in Treatment Adherence, Outcomes and Healthcare Resource Utilization in Hypertension? A Real-World Analysis of Patients on Perindopril/Amlodipine/Indapamide in Italy. Value in Health, Vol. 25, Elsevier BV.
