According to the World Health Organization (WHO), nearly 50% of patients with chronic diseases do not properly follow their prescribed treatment plan1. To remedy the situation, we at Servier are seeking to address multiple factors that can improve patient adherence. Our objective is to propose a complete portfolio of therapeutic solutions by 2030 that can be tailored to all patients, regardless of individual profile. Viviana Cortese, Head of Cardiometabolism & Venous Disease (CMVD) Global Medical & Patient Affairs at Servier, shares more about this strategy and how it will be put into practice.
Viviana, why is therapeutic adherence such a major challenge for the healthcare sector?
Viviana Cortese: Therapeutic adherence refers to the extent to which the patient’s behavior matches the doctor’s recommendations. From a medical point of view, a patient is considered to be “non-adherent” if they follow less than 80% of their treatment2.
Non-adherence to treatment can have serious consequences for patients’ health. The more closely a patient follows their prescribed medical treatments, the better they can control risk factors, slow the progression of their illness, and avert potential complications. In other words, if someone with diabetes or cardiovascular disease does not adhere to their treatment, their blood pressure, lipid levels, and cholesterol will not be properly controlled. On the other hand, properly following the treatment prescribed reduces the risk of hospitalization and mortality.
In addition, apart from the potentially dramatic consequences for patients, non-adherence to treatment is also a heavy burden for healthcare systems. There is a considerable economic impact due to unused medication, unnecessary medical consultations, and avoidable hospitalizations. Estimates indicate that 25% of prescribed medication is never taken4, resulting in an additional cost estimated at €9.3 billion in France5 and €120 billion in Europe6! Globally, non-adherence represents a loss of €470 billion, or 8% of global healthcare spending3.
200,000
According to the WHO, if all patients with chronic illnesses followed their prescribed treatment plan to the letter, it would be possible to prevent 12,000 deaths in France and 200,000 in Europe each year.3.
Faced with this global dilemma, two objectives have been identified. The first is to improve the life expectancy and quality of life of patients, and the second is to optimize the efficiency of healthcare spending.
What strategy is Servier pursuing to improve patient therapeutic adherence?
V.C.: As a world leader in cardiometabolic diseases, and owing to our unwaveringly patient-centered approach, therapeutic adherence is central to our strategy in cardiovascular diseases, metabolic diseases, and venous diseases. In our view, this is an essential factor in ensuring the effectiveness of treatments and improving clinical outcomes for patients.
Since 2016, we have been dedicated to improving adherence through various initiatives, including raising awareness, generating evidence, and developing educational programs.
Our strategy is based on three main areas:
To find out more, read our article on training healthcare professionals to improve therapeutic adherence
We also recognize the importance of conducting real-world studies to collect relevant data on the patient and doctor experience. Providing a snapshot of the daily lives of both patients and doctors, these studies help deepen our understanding of a disease and give us valuable insight into the unmet needs of patients regarding therapeutic adherence.
What progress has already been made in terms of therapeutic adherence and what challenges lie ahead?
V.C.: Significant progress has already been made in strengthening therapeutic adherence. Notably, international guidelines are increasingly emphasizing a multidisciplinary and holistic approach to treatment for better management of chronic diseases. Another key advancement is the recognition of the therapeutic effectiveness of single-pill combinations in improving patient outcomes. At the 24th Expert Committee on the Selection and Use of Essential Medicines, the WHO included single-pill combinations for the first time as primary and secondary preventive treatment. With this move, the WHO acknowledged that combination therapies can improve patient adherence at a lower cost than multiple-component monotherapies.
One of the major challenges for the future is incorporating artificial intelligence (AI) and analyzing the data generated. As a result of a more in-depth comprehension of patients’ behavior in relation to their treatments, digital solutions could play a key role in real-time monitoring of treatments, facilitating personalized patient support, continuous tracking, identifying non-adherence risks, and ultimately, improving therapeutic outcomes.
Most patients these days have to manage several chronic illnesses and are often faced with following complex treatment plans. Each illness comes with its own medication, to be taken at specific times, and under different conditions. This level of complexity can make compliance particularly difficult.
Lastly, a collaborative care model is required, underpinned by clear and effective communication every time the patient interacts with healthcare professionals. This approach goes beyond therapeutic adherence, aiming to seize every opportunity to better manage risk factors and encourage health-promoting behaviors. To achieve this, close collaboration is key, not only with healthcare professionals, but also with public authorities to drive innovations forward more quickly for the benefit of all.
[1] Adherence to Long-Term Therapies: evidence for action, World Health Organization, 2003
[2] Médecine des Maladies Métaboliques, 2012, https://www.sciencedirect.com/science/article/abs/pii/S1957255712703577
[3] Institut Sapiens, https://www.institutsapiens.fr/observatoire/ameliorer-ladhesion-therapeutique-un-enjeu-de-sante-publique/
[4] Etude Observatoire Jalma, étude Observance, https://www.lemoniteurdespharmacies.fr/ressources/upload/imgnewspha/depot/synthese-observatoire-observance.pdf
[5] Améliorer l’observance. Traiter mieux et moins cher, étude IMS Health et CRIP 2015
[6] Université de Genève, https://www.unige.ch/lejournal/recherche/printemps-2023/adhesion-traitement