Measuring Adherence -
Introducing Rolling Multiple Cohort (RMC) Methodology™
Item Number: 0204, 27 pages
Price: $1,495

1.0	Introduction: The Insight Gap	1
2.0	The Adherence Measurement Needs of Pharmaceutical Executives	6
	Background: Primary Research & Adherence Measurement	6
	Self-Reported Bias	6
	Poor Historical Recall	6
	The New Requirements for Measuring Adherence	6
	Longitudinal Patient-level Data	7
	Periodic Measurement	7
	Modular Methodology	7
	Concise Measures & Easy to Use Reporting	8
3.0	The Limitations of Traditional Adherence Measurement Methods	9
	Extrapolating Adherence from Physician/Channel-level Data	9
	Source of Business Reporting	9
	Traditional Persistence Analysis	13
4.0	Properly Measuring Patient Behavior with Rolling Multiple Cohort (RMC) Methodology™	16
	RMC™ Measurement Methodology	16
	How Patient Cohorts Are Defined in RMC™	17
	RMC™ Curves vs. Traditional Persistence Curves	17
	RMC™ Adherence Measures	18
	Adherence Rate	19
	Persistence Rate	20
	Compliance Rate	21
	Time-on-Therapy and Long-Term Value	22
	Classification of Patient Behavior Using RMC™	23
5.0	Making Adherence Measurement Usable	24
	RMC™ Adherence Reporting for Brand Managers	24
	RMC™ Adherence Performance Dashboards for Pharmaceutical Executives	26
6.0	Conclusion	27

Introduction: The Insight Gap

The promise of many drugs lies in their use as a course of therapy. When patients take their medication as prescribed, filling and refilling on time, both patients and pharmaceutical companies benefit through greater efficacy of treatment and greater pills sold. Yet patients do not complete their courses of therapy. Some fail to even fill their initial prescription. Some routinely go for weeks without taking their medication, while others cease treatment altogether. This erratic behavior on the part of patients does not only put the patient at risk, but also has a direct impact on a pharmaceutical brand’s bottom line. So one would expect pharmaceutical companies to carefully measure brand performance using patient-level behavioral measures — adherence, persistence and compliance – to better understand patient behavior and identify critical influencers. While most pharmaceutical executives claim they are focused on improving patient adherence, what exactly are they tracking? What proven scientific method are they following? What standard industry definition are they using to calculate patient adherence to physician prescribed treatments? The answer: None.

Yes, studies of adherence have been published in medical literature for more than 50 years. These studies show that non-adherence to prescribed treatment leads to recurrent symptoms, complications, increased healthcare utilization, decreased functional status, development of drug-resistant condition strains and death. Improving adherence is even identified as a priority by physicians, managed care companies, and pharmaceutical brand managers to drive improved patient outcome and reduced healthcare costs. Yet despite the thousands of published articles, the concept of adherence lacks not only a standard method of measurement, but even a standard definition. Studies vary widely in methodologies, and operational definitions of adherence are as varied as the diseases, regimens, and patients examined. Both measurement and context differences produce broad variations in adherence estimates, correlates, and outcomes. Studies that so clearly identify the problem do not clarify adherence beyond a generalized notion and leave pharmaceutical marketers without a method of assessment or measurement.

The result: Many brand managers do not actually utilize adherence measures at all, while others rely on analyses that are analytically questionable. The traditional methods of calculating adherence yield vague patient behavioral directions at best and, at worst, completely misrepresent what patients are doing and why – leading pharmaceutical executives to invest in ineffective strategies and brand managers to target the wrong audience with the wrong message.

This white paper was developed by DB Marketing Technologies to give pharmaceutical executives, including brand managers and market research managers, a better understanding of adherence measurement methods and how to accurately calculate and project patient adherence. Specifically, this paper will provide:

• Detailed characterization of what is needed in adherence measurement for the pharmaceutical industry.
• Detailed illustration and analysis of how and why current methods of adherence measurement are leading pharmaceutical executives astray, failing to accurately represent patient behavior.
• Detailed explanation of Rolling Multiple Cohort (RMC) Methodology™, the only analytic technique to meet the industry's need for analytical accuracy and ease of use in adherence measurement.

Back to top