Norwalk, Connecticut-based medication adherence platform company HealthPrize says it has succeeded in raising medication adherence an average of 54 percent across a series of pharma-sponsored pilot programs for various medical conditions, with sample sizes ranging from 250 to more than 7,000. That's a 54 percent increase in the mean total number of prescription fills per patient.
HealthPrize, which works with pharmaceutical customers, released engagement and adherence data from five case studies it has conducted with various partners across a range of conditions: diabetes, hypertension, acne and asthma or COPD.
"If you look at it historically, significant movement [on adherence] has been a few percentage points, low to mid single digits," HealthPrize CEO Tom Kottler told MobiHealthNews. "Our average is an increase of 54 percent over baseline. We are clearly not just getting the adherent to be very adherent or the good to be great, but we’re moving the bar for people much further down the scale as well. So that’s pretty critical."
Diabetes patients in one study reduced the mean time interval between medication refills by 39 percent, a statistic Kottler says shows that even already adherent patients had a behavior change prompted by the system.
"We started HealthPrize with the vision that traditional approaches were all based on reminders and cost reduction, which are important but really don’t address the psychological barriers to adherence," cofounder and chief medical officer Dr. Katrina Firlik told MobiHealthNews. "But finally there’s starting to be a greater recognition that the psychological barriers are equally if not more important than the cost or the forgetfulness barriers."
HealthPrize uses a combination of gamification, rewards, and daily educational content to motivate patients to take their medication and to refill prescriptions. The company also tracks whether patients refill prescriptions rather than relying on self-reported data.
"The act of nonadherence is an intentional act," Kottler added. "It’s not that people forget, it’s that they go off therapy. We like to say you can’t remind someone to take a medication they’ve chosen not to purchase. So we come at the problem from a very different perspective. This really is a problem of human psychology instead of just 'Gee, I forgot' or 'I don’t want to pay for it.'"
HealthPrize's approach is a combination of extrinsic motivation (the rewards) and intrinsic motivation (educating people about their condition and possible negative outcomes that can come from neglecting treatment). HealthPrize found across the pilot studies that approach leads to high engagement numbers -- comparable, Kottler says, with social media outlets like Facebook, Twitter, and LinkedIn.
"According to Comscore, 77 percent of Facebook members are active on a monthly basis; our hypertension patients were at 72 percent," he said in a statement. "The average LinkedIn user spends 17 minutes on their site per month; our diabetes 2 group spent an average of 43 minutes monthly on web or mobile with HealthPrize, and across all programs the average user spent almost 37 minutes engaged with the platform each month.”
Different demographic groups and different condition groups had some eccentricities to their engagement, but they were all fairly high. The diabetes programs averaged 53 percent adherence, acne was at 46 percent, and hypertension hit 64 percent.
"For instance in our acne program our average age was about 22 years old. Those patients tended to spend less time every time they came into the system, but they tended to log in frequently and they were more mobile," Kottler said. "About 80 percent of our engagement was mobile vs online. In our hypertension and diabetes program, more than 50 percent of our engagement was online as opposed to mobile and patients tended to spend a little bit more time each time they logged in."
HealthPrize currently works with seven of the top 20 largest pharmaceutical companies, Kottler said, and 22,000 patients have gone through the system since HealthPrize was founded in 2009. In 2015, the company plans to expand its business to market to payers and ACOs as well. In light of those two customer areas, the company announced yesterday that two new members joined its board of directors: Dieter Weinand, President and CEO of Bayer Pharma AG and Dawn Owens, former CEO of OptumHealth.
Kottler believes medication adherence is a good area where payers, ACOs, and pharma can come together.
"It’s one of the few things in healthcare everyone agrees on," he said. "If patients take their medications more consistently, everyone benefits. We’re hoping in the new world, when we have a lot of accountable care, incentives will be more aligned and we’d like to be at the center of that with our platform."