Patient Empowerment: Consequences for Pharmaceutical Marketing and for the Patient–Physician Relationship - Innovation and Marketing in the Pharmaceutical Industry - page 436

Non-branded channels can be important in therapy promotion, not only in Europe
but also elsewhere, including in the US Non-branded disease awareness campaigns,
for example, may be able to increase patients' awareness for specific health risks
and benefits of treatment, possibly increasing primary demand (Gilbody et al. 2005 ).
However, firms need to keep the goals of the campaign transparent and focused on
maximizing value for the patient through promotion of patient empowerment.
Failure to do so can trigger public outcry. In 2000, for instance, Novartis started a
disease awareness campaign in the Netherlands for onychomycosis, a fugal nail
infection for which there were two treatments: Novartis' terbinafine and itracon-
azole ('t Jong et al. 2004 ). Novartis claimed that its campaign would benefit all
prescription drugs for onychomycosis. However, because medical guidelines
favored terbinafine, the campaign had a significant influence both on primary
demand and on market share. These effects generated heated criticism which led
Novartis to voluntarily stop the campaign in May 2002 ('t Jong et al. 2004 ).
Another important goal of firms' direct-to-patient communication management
strategies should be to increase correct use of prescription drugs. Patients' correct
use of therapies is pivotal for their clinical value and cost-effectiveness to material-
ize. For example, patient usage of prescription drugs without a script or deviation
from the physician's advice (such as non-adherence, which I discuss below) can
bring about negative consequences for patients and for the image of the brand. More
research is needed to better understand the drivers of correct use of prescription
drugs by patients. 13
Careful labeling and packaging can help reduce these problems. For example, a
2005 report indicates that one of the causes driving an increase in the abuse of pre-
scription drugs is the fact that such drugs are abundantly found in family medicine
cabinets and are easily shared among friends and relatives who erroneously assume
that FDA-approved drugs are safe for everyone (National Center on Addiction and
Substance Abuse 2005 ). Customized packages for different prescription regimens
could help reduce this risk by limiting the amount of pills left unused in patients'
cabinets. These goals can also be achieved via direct-to-patient non-promotional
correspondence, which can be used to fight the use of prescription drugs without
consent and other problems like patient non-adherence, a goal that can also be
achieved through patient adherence programs.

14.4.2.4 Stimulating Patient Adherence to Therapy

Patient adherence programs are also a key direct-to-patient marketing strategy.
Therapy non-adherence costs the pharmaceutical industry about $30 billion a year
and is responsible for 125,000 deaths per year in the United States alone (Bates 2008 ).
It also results in direct and indirect healthcare costs in excess of $177 billion in the

13 In a rare study on this topic, Myers et al. ( 2011 ) show that in the erectile dysfunction category,
individual traits are capable of predicting a patient's likelihood to use prescription drugs without
seeing a physician.