Patient Education at the Point of Dispensing Improves Adherence and Increases Sales

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1 Patient Education at the Point of Dispensing Improves Adherence and Increases Sales A COPD study in Germany Reach. Connect. Understand.

2 Executive summary Introduction More than half of patients with chronic obstructive pulmonary disease (COPD) struggle to use a metered dose inhaler properly.* Moreover, their views regarding regular COPD therapies are generally negative, with thirty five percent of COPD patients admitting they adjust their regular therapy in relation to how they felt. The topics covered in this white paper include: An overview of non-adherence in COPD, including critical reasons why COPD patients do not adhere to medications, and how Patient Connect addresses the unmet clinical needs of these patients. Patient Connect s methodology including how our s are designed, how our services are delivered to patients, and how the results are measured and analysed. The benefits to the patients and to the industry. Analysis carried out by an independent third party, and their recommendation of our adherence programmes. COPD is a disease of the lungs that is characterised by shortness of breath, prolonged cough and phlegm. This chronic condition is usually progressive and typically gets worse over time. Although not fully reversible, early diagnosis and treatment can markedly slow the decline in lung function and lengthen the period in which a patient can enjoy an active life. The vast majority of COPD cases in Europe is caused by smoking. Estimates of COPD prevalence vary widely, from 0.2% to 18.3%, partly because of real differences in prevalence among countries and regions, and partly because of other factors, including the diagnostic criteria used. In 2005, the number of deaths attributed to COPD was 270,000. This number is expected to increase to 338,000 deaths by According to the World Health Organization, the age standardised hospital admission rate for COPD in Germany is among the highest in Europe, at 262 per 100,000 population. *Sanduzzi A et al COPD: adherence to therapy. Multidiscip Respir Med Nov 22;9(1):60. pdf/40248_2014_article_185.pdf 1

3 The behaviour of patients with COPD regarding their treatment has been surveyed. Commonly found reasons for poor adherence include: concerns about developing a tolerance against the medication when applied daily; concerns about the medication s side effects; complaints about only minor immediate benefits of regular treatment; relaxed attitude when forgetting a dose; and using the medication solely as an emergency reliever. Clinical messages tailored to a maintenance bronchodilator medication were designed by Patient Connect, in partnership with a top 10 pharmaceutical company, to closely address these points. Measured prevalence of COPD in Europe UK 3m BELGIUM 400k GERMANY 2.7m FRANCE 3.5m ITALY 2.6m SPAIN 1.5m 2 Reach. Connect.Understand info@patientconnect.co.uk

4 How Patient Connect helps COPD patients Patient Connect tackles the issue of non-adherence in chronic health conditions and develops services tailored to specific prescribed medication, empowering patients to take control of their disease. These services include clinical messages delivered to patients at the point of dispensing, addressing known issues that lead to poor adherence. Patient returns to pharmacy regularly to fill in prescrition 1. Patient Connect s clinical team develop clinical messages addressing specific issues of non-compliance 2. Patient comes into the pharmacy with prescription 3. Pharmacist is alerted at point-of-dispensing about the compliance challenge of the medication 4. Pharmacist engages in a conversation with the patient about their medication Most common reasons for poor adherence to treatment by COPD patients: Fear of developing tolerance against medication Health illiteracy and innumeracy Fear of side effects Immediate benefits of treatment are not impressive Forgetfulness - missing a dose Belief that one will be punished by the prescriber Use of medication only as emergency aid To measure the performance of each at a national level, we compare data obtained from Patient Connect s network of pharmacies (test) vs pharmacies outside of the network (control) in each country. This comparison is done by collecting dispensing information pre, during and post, from both groups of pharmacies: 12 months historic data, i.e., number of packs dispensed per pharmacy prior to the start of the Actual monthly data, collected during the 3 months post data, to evaluate the sustained impact after the end of the 3

5 A very successful example, which has been validated through a third party company, is a compliance applied to a specific bronchodilator medication. Bronchodilator medications are used to relieve symptoms in adult patients with COPD. This chronic condition is not fully reversible, but early treatment can reduce the frequency and severity of exacerbations and lengthen the period of an active life. The was sponsored by a top 10 pharmaceutical company and initially launched in Germany. In the German market, Patient Connect s network of pharmacies consists of 8,700 pharmacies, which represents 45% of the total number of pharmacies in the country. During a six-month period, between June and November 2015, the number of clinical messages triggered whenever the broncho dilator medication had been dispensed, added up to more than 92,000 patient interactions. Adherence to treatment increases pack sales An independent company in Germany was commissioned as a third party to analyse how much Patient Connect s activity had contributed to the increase in sales of the bronchodilator medication. To this end, they have identified a group of pharmacies (control sample) that matched Patient Connect s network of pharmacies (test sample) in size, location and sales performance of the bronchodilator medication prior to the start. Notably, the control pharmacies are not covered by Patient Connect. Subsequently, the compared sales of the bronchodilator prior to the start and after start for both the test and control samples in a similar period. In accordance with the matching criteria that identify a comparable pharmacy population in the test and control samples, the average sales of the bronchodilator of about 6.5 units per pharmacy is alike in both samples prior to the start of the. In contrast, for the period, the sales of the bronchodilator are about 7.1 units per pharmacy for the control sample and 7.5 units per pharmacy for the test sample. Although both samples exhibit a growth in sales, the increase in the test sample is greater by 6%. 4 Reach. Connect.Understand info@patientconnect.co.uk

6 Our services recommended by an independent third party Depending on viewpoint the activities delivered an uplift of 6%and a total value of 6,500 more packs sold or an equivalent of 730k sales. 6.5 Prior to start +15% +9% Active 7.5 Following 6 months 6.5 Prior to start Control 7.1 Following 6 months The investigation conducted by the third party in Germany concluded that an increase of 6% in sales corresponding to 6,500 more packs in total can be attributed to Patient Connect s activity at a statistical significance level of 99.6%. This equates to an uplift of 83 per pharmacy during the, resulting in an additional income of 730,000 to the client. The German company proclaims the a success and recommend, depending on investment, Patient Connect services to be continued in the future. Remarkably, the final return of investment, including setup fees and data acquisition, was 349% for the German market in February Depending on investment we can consider the Patient Connect activities as successful and can recommend to continue it in the future. 5

7 Conclusion By specifically addressing the unmet need of the COPD patients in Germany Patient Connect has both optimised patient care and improved patient adherence. To ensure the credibility of our services, the analysed data were verified by an independent third party. Their report indicates that Patient Connect programmes were effective and are recommended. As a direct result of this pilot, the support to COPD patients was extended for further 18 months in Germany and to the other three European countries: France, Spain, and Belgium. In these four markets, the estimated number of people living with COPD is about 8.1 million. Considering that the average patient only takes half of their medication, adherence to treatment not only helps chronic patients themselves, but also has a profitable impact in sales for the pharmaceutical industry. 6 Reach. Connect.Understand info@patientconnect.co.uk