How much does the medication cost and what is my financial responsibility?  


These are the first questions that individuals typically ask when they are prescribed a new medication. Unfortunately, concerns about medication cost often prevents individuals from absorbing important information that may improve adherence such as why the medication is needed, how it works, potential side effects, and when to take it.  


While it’s unfortunate that individuals often lack proper education and knowledge about their therapies, the rise of virtual care has presented pharma with new, meaningful opportunities to engage individuals and improve adherence. Below are a few misconceptions observed by the Cecelia Health clinical team related to chronic disease management and medication adherence that Pharma companies should consider: 


Misconception 1 – Addressing Financial Barriers is the Key to Successful Adherence 


Insurance coverage, medication cost and copays are often the initial hurdle that individuals need to overcome to get started on a medication. And while understanding and navigating financial support options may seem straightforward, individuals typically face a complex web of savings options. They often need support in understanding the various financial resources available to them and who they should contact (HCP, pharma company, insurance company). Even if an individual can figure out how to pay for medication, it does not mean they will take it correctly and consistently. Although financial barriers may be the first thing individuals encounter, they often need additional support to overcome barriers such as forgetting to take their medication, managing side effects, perceived lack of efficacy, challenges around injecting or swallowing medication, and uncertainty about on dosing levels and/or timing.  


Misconception 2- Adherence is not an issue with Oral Medications 


Although self-administered injectables often present additional layers of complication, individuals still need support taking oral medications with some 50% of individuals with chronic illness dropping off in the first year on therapy. Individuals taking oral medications often feel “pill overload” as they juggle multiple oral medications each day and can benefit from creative strategies to prevent missed dosing or overdosing. Thus, it is important for individuals taking orals to also understand how to take their medication correctly (with or without food, number of hours from meals, with fluid, apart from other medications, etc.) and as prescribed (dosing regimen, time of day, number of pills, etc.). By supporting individuals and helping them understand how their medication of any form fits into their lifestyle, Pharma and Device companies can empower them to be more successful in managing their condition. 


Misconception 3 – Support is only needed at initiation  


Supporting individuals when they start a new medication is important to help overcome initial barriers as well as drive good habits and routines for medication adherence. It’s evident that starting a new medication can be overwhelming as individuals adjust to new routines and possible side effects. Given this, individuals often retain information more effectively and feel less overwhelmed when support is spread out over time. Offering virtual check-ins with individuals during the first few months helps them feel supported and more empowered to take their medication as prescribed. It is also important to consider that many conditions are episodic in nature and change over time. These episodes present unique challenges and barriers to disease management and it is often the time when individuals experience the most frustration.  


Misconception 4 – Clinical credentials are not an essential aspect of adherence programs  


Chronic conditions are complex and having a clinician who can build trust with individuals, deliver clinical interventions, and educate about disease management can make a dramatic difference in overall medication adherence and disease management. A credentialed clinician with expertise in the supported disease state is essential for optimizing disease management and driving positive outcomes as they have the acuity be able to respond to the specific needs of an individual. While health coaches may be able to deliver scripted responses and build relationships, they lack the depth of knowledge to provide tailored support that drives optimal outcomes. For example, in diabetes, continual increase in prescribed insulin dosing without any change in blood sugar level may indicate an improper injection technique. Trained clinicians can use their knowledge to identify a barrier like this and provide the clinical support needed to get an individual back on the right track.  Connecting individuals with expert clinicians often leads to increased engagement and improved outcomes due to the trust that is formed as a result of understanding the disease state; thus, they should be an integral part of any manufacturer support program. 


Misconception 5 – Individuals will reach out for support when they’ve identified a need  


While some individuals may be interested in proactively engaging with inbound support, most prefer not to call a number that may or may not provide them with the support that they need to stay healthy. Thus, most individuals often wait until their next doctor’s appointment to ask questions creating a gap between when a need arises and when it’s addressed. Pharma and device companies need to think about this gap that often contributes to drop off and offer something more than inbound support. It follows that offering a support program that proactively engages individuals initiating a new medication to provide them with a trusted advisor to address their concerns is an ideal solution to prevent drop off. This transforms the overall offer from just a medication to manage their condition to a full support program to empower individuals to manage their condition thus stemming drop off and promoting brand loyalty. 


About the Author

Teresa McArthur Headshot

Teresa McArthur is Cecelia Health’s SVP of Clinical Services. She is also a Registered Dietitian and Certified Diabetes Care and Education Specialist with a Masters Degree in Clinical Nutrition. Teresa has experience working with diabetes, health and wellness, nutrition support, weight and chronic disease management. She has worked in various capacities including higher education, long-term acute care, critical care, community nutrition, and inpatient and outpatient accredited diabetes management programs. Teresa has a wealth of experience working with children and adults with type 1 and type 2 diabetes and women with gestational diabetes while serving as a diabetes educator in the inpatient, outpatient and community settings