Predicting Health Outcomes: The Crystal Ball Effect

Patient adherence in the United States continues to be problematic.  There are a number of factors that need to be addressed to fix the problem; cost, infrastructure and education being just a few of the issues that contribute to:

  • 33% of medication prescriptions are never filled[i]
  • 75% of patients sometimes failing to take their medications as directed[ii]
  • 50% to 60% of the time, patients with chronic conditions do not take their medications[iii]
  • 33% to 69% of medication related hospitalizations are linked to drug non adherence[iv]
  • 125,000 patient deaths each year are linked to drug non compliance[v]
  • $290 billion is spent annually on care needed because of medication non compliance[vi]

While I agree in principle that these factors need to be addressed, I would argue that a more deep rooted issue in our culture must be solved first, which is the inability to manage critical life events.  One such area is personal finances; there are strikingly similar dynamics at play in how Americans manage their financial health:

  • 36% don’t know the interest rate on the credit card they use most often[vii]
  • Average credit card debt per household: $15,799[viii] (Median household income is $49,445)[ix]
  • 26% of Americans, (58 million adults), admit to not paying all of their bills on time[x]
  • More than one-third of American adults (37%) admit that they do not know their credit score[xi]

While many would point to financial mismanagement as an effect of the current economic climate, I believe it points to a more fundamental problem in the development of appropriate life skills.  Given this dynamic as well as working in an environment where patient level data is unavailable it becomes critical for Pharmaceutical marketers to evolve their capabilities to incorporate “crystal ball” capabilities to achieve business goals and impact patient behavior to facilitate positive health outcomes.

Designing the right solution is a blend of art & science

The fundamental challenge that all Pharmaceutical marketers face in rapid development and deployment of a “crystal ball” methodology is not having access to transactional data (filled and not filled prescriptions) to help drive key strategic decisions.  This presents two problems, 1.) Who to target and 2.) How to create engagement.

“Who to target” is the starting point in which everything else follows.  Other industries have demonstrated the power of leveraging customer or patient level data to convert prospects.  Purchase, media usage, psychographic and other forms of data have all been utilized to create multi-regression models that contribute to audience segmentation, targeting and engagement design.  This represents a shift in thinking and acting which would provide Pharmaceutical marketers significant advantages; most importantly, the capability to predict future behavior, financial and health outcomes by patient segments.

There are solutions available today that are HIPPA compliant which have compiled thousands of data points to score patients medication adherence.  One such organization markets their adherence tool as an innovative solution; but, as a leader in credit scoring its clear they miss the opportunity to innovate by not leveraging aspects of patient level credit information as a data element in their multi-regression model.  This is another perfect example of pharmaceutical patient segmentation limited by a lack of vision.  The journey to achieve patient centric segmentation begins with having a holistic view of the person, not just one aspect of their lives.

Facilitating change will not be easy

While the Pharmaceutical industry is not in a position to fix the fundamental societal issues, it can and should take a leadership role in helping people learn, grow and succeed in one aspect of their lives, their wellness.  Predicting patient behavior is not an easy exercise and requires intimate knowledge of Pharmaceutical protocols, data sources and the vision to create a truly meaningful solution.

There are many dimensions to individualized health outcomes and while there are emerging approaches to patient conversion the point of arrival is only achieved when beginning the journey by asking and answering the right questions before embarking on this journey.


[i] Medication Adherence: Making the Case for Increased Awareness, National Consumers League

[ii] Medication Adherence: Making the Case for Increased Awareness, National Consumers League

[iii] Medication Adherence: Making the Case for Increased Awareness, National Consumers League

[iv] Medication Adherence: Making the Case for Increased Awareness, National Consumers League

[v] Medication Adherence: Making the Case for Increased Awareness, National Consumers League

[vi] Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease, NEHI, Aug. 12, 2009

[vii] FINRA Investor Education Foundation, “Financial Capability in the United States,” December 2009

[viii] Creditcards.com http://bit.ly/zGDfBo

[ix] www.census.org

[x] National Foundation for Credit Counseling, 2009 Financial Literacy Survey, April 2009

[xi] National Foundation for Credit Counseling, 2009 Financial Literacy Survey, April 2009