A blog exploring pharmaceutical relationship marketing, emarketing and innovation with a focus on rare disorders.
The convergence of rare disease, digital communications, and pharmaceutical marketing communications

Should Patients Be Paid To Take Medication?

Posted by | 8:25pm on Wednesday, July 7, 2010

one-third to one-half of all patients do not take their medications  

The New York Times recently reported on patients receiving financial incentives to take their medications or to comply with prescribed treatments. For example, a program in Philadelphia allows people to win $10 or $100 each day they take their drug — a lottery using a computerized pillbox.

According to the article, one-third to one-half of all patients do not take their medications and one-fourth do not fill prescriptions at all, which adds up to more than $100 billion in healthcare costs each year.

I usually have very strong opinions, but with this topic I can see both sides.

The Pros of Paying Patients
A modest amount awarded to patients would be cheaper than the cost of hospitalization. The article gives examples of affordable incentive programs that were successful.  Even with people who know it’s essential to take their meds, such as transplant patients and their anti-rejection drugs, there are problems with adherence. So if this works, why not?

The Cons of Paying Patients
Once you’ve started by compensating people do you have continue indefinitely? What about rewarding the people who are following their doctor’s advice and taking medication?

During the #SocPharm tweetchat on June 16 this article generated some strong and interesting responses which you can read on SocialPharmer.  As my colleague Frieda Hernandez tweeted: “I have really mixed feelings about paying patients for adherence. If it works, I guess ok, but it doesn’t pass the smell test.”

The Physician Point of View
This topic was addressed in the British Medical Journal in 2007 with arguments for and against.

What do you think?

This post was contributed by Eileen O’Brien, Director of Search & Innovation for Siren Interactive. You can connect with her on Twitter at @eileenobrien.

(Image courtesy of clevercupcakes on Flickr)

About Eileen O'Brien

Eileen has more than 16 years of digital healthcare marketing experience. She is an opinion leader on social media and biopharma, and has been invited to speak at industry conferences and quoted in publications.

View other posts from Eileen

  • Dana Webster

    Interestingly, we touched upon this on a Linkedin discussion about the future of pharmaceutical detailing and bringing value to physician’s offices.

    We all know compliance is a huge issue for patients taking chronic medications (especially those the patient perceives as being too expensive and not effective enough to justify the cost). Many companies offer persistency programs to help encourage patients to maintain medications with Patient Support.

    Health providers are currently assessed on their performance related to percent of patients within an A1c range (diabetes), within goals for CV issues. For many chronic illnesses, the majority of the accountability falls upon the patient’s choices, not the physician’s choice of a generic vs. branded medication. So, how can we incentivize patients to be more engaged and accountable? Unfortunately, paying them to take prescriptions may be one way to reduce overall health care costs.

    Interesting blog. Thanks for getting the wheels turning….

  • http://inthecrowds.wordpress.com Coreen Tossona

    Hi Eileen,
    This is definitely a hot topic. To me, payment seems like a misguided incentive instead of a long-term solution to a serious problem. To get people to adhere to their medication dosing, we have to attack the reasons people go off their meds. These include:
    –Cost of medications
    –Fear of side effects
    –Misunderstanding doctor or pharmacist instruction
    –Not understanding the health consequences of non-adherence
    –Depression (especially with chronic or serious conditions)

    I’m sure there are other reasons, but you can see what I’m getting at here. These proposed payments might help with the cost of medications (and I’d be interested to hear more specific plans on payments), but wouldn’t it be simpler to find ways to lower the costs overall?

    You have a great blog post here. Thanks for including links to other stories and viewpoints. (And since I work in the industry, let me just add that my opinion is solely my own, not my employer’s.)

    • http://twitter.com/eileenobrien Eileen

      Dana and Coreen,

      Thanks for taking the time to comment. As you both note, adherence is an extremely complicated issue driven by a variety of reasons.

      My hope for the future is the increasing amount of information and support available to patients online will help to empower them and alleviate this issue.


  • http://www.worldofdtcmarketing.com Richard Meyer

    The advantages of paying people to be compliant is one that has been debated for a long time. However if more patients are compliant than overall health costs to the system can be reduced. The key question is thusly: who should compensate patients ?

    I don’t believe that the drug industry should pay patients for compliance as there is a big conflict of interest an the media would jump all over this. That being said I believe that insurance companies should reward and compensate people for changes in their lifestyles that lower costs. The compensation could be in the form of lower premiums or other rewards. Let’s face it if they are successful their costs will also be lower. I also believe that consumers who are overweight, have high blood pressure or high cholesterol should pay higher premiums than someone who goes to the gym and watches what they eat.

    I ride my bike 80 miles a week because I know it’s good for my health. I have cut down on my portion sizes, salt intake and limit sweets and I am someone who loves to cook and eat. I do so because I know I have to take personal responsibility for my health. Maybe it’s time for others to step forward and help reduce health costs for an aging America.

Siren Interactive
  • Siren Interactive
  • Rare Disease Relationship Marketing Experts
  • 626 West Jackson Blvd, Suite 100
  • Chicago, IL 60661
  • 312.204.6700
  • 866.502.6714 (Toll Free)
  • www.sireninteractive.com