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Beyond Price: The Role of the Patient Experience in Specialty Rx Abandonment


Inconceivable as it may seem, we live a world where medicine is readily available but not taken by the very patients who need it. Forty-one percent of heart attack patients don’t take their blood pressure medications. Half of children with asthma either don’t use their inhalers or use them inconsistently. This trend also holds true for patients with life-threatening, rare conditions. For example, a third of kidney transplant patients don’t take their anti-rejection medications.


Prescription abandonment, when the patient does not fill or pick up a prescription, is a serious problem, posing a heavy financial and human toll on all constituents, most notably patients, the healthcare system and the pharmaceutical industry. According to Annals of Internal Medicine, nonadherence causes approximately 125,000 deaths and at least 10 percent of hospitalizations in the U.S. It also costs the healthcare system between $100 billion to $289 billion a year. On the revenue side, the U.S. pharmaceutical industry loses an estimated $250 billion annually and the global market an estimated $637 billion annually due to medication non-adherence.


Research has shown that prescription abandonment rises with patient out-of-pocket costs, so branded specialty drugs are especially vulnerable. These drugs treat chronic, complex or rare diseases and have a list price of more than $6,000 per year. Smaller patient populations make each lost script that much more significant. And they are sold by specialty pharmacies, which have their own set of challenges. Interventions to improve specialty medication adherence are a top priority for the biopharmaceutical industry and will prove beneficial to all stakeholders. But without a fuller understanding of what drives Rx abandonment, it is difficult to intervene in a
meaningful way.


In March 2020, Syneos Health’s Value and Access Group surveyed specialty pharmaceutical patients about their experiences in filling—or not filling—their recent prescriptions. 


The research team canvassed 73 U.S. patients aged 20 to 92 who, within the last 12 months, were prescribed a specialty pharmaceutical to fill at a specialty pharmacy. The patients’ medications, including injectables, orals, inhalers and other treatments, were prescribed for psoriasis, rheumatic arthritis, cancer, Crohn’s disease and other chronic illnesses. Syneos Health also conducted in-depth interviews with specialty pharmacy patients to gain a deeper understanding of their experiences. Some stories are highlighted here.

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