Choosing the carrot instead of the stick
The latest company to take a stab at making sure people fill their prescriptions and stay on their medications is focused on one popular concept: Nobody wants to be a patient.
“A lot of well thought-out solutions ignore the fact that people don’t want to be treated as patients,” said Katrina Firlik, chief medical officer of HealthPrize. “They want to be treated as people.”
That’s the underlying principle behind HealthPrize, which is running feasibility studies now on its online process for tracking medication-taking habits and promoting compliance through communication, education, competitions, sweepstakes and reward points. The Norwalk, Conn.-based company, founded by Firlik, CEO Tom Kottler and Chief Innovation Officer James Jorasch, hopes to market its program to health plans, pharmacies and other managed care programs within the month.
“The adherence problem is a massive, massive problem,” says Kottler a self-described “serial entrepreneur” who has launched four startups, including two medical device companies. “If you could solve this problem, you could probably save healthcare more in general spending than any other single problem.”
According to the New England Healthcare Institute, medication non-adherence is responsible for roughly $290 billion in “otherwise avoidable medical spending” in the United States each year. Among the other statistics Kottler uses:
As many as 30 percent of all prescriptions are never filled;
As many as 40 percent of all people stop taking their medications within 90 days (the so-called “90-day cliff”) due to cost, side-effects or lack of interest.
Roughly 75 percent of college students and 70 percent of transplant patients adhere to their medication regimens.
Lack of adherence is the number one reason for rejection among transplant recipients.
Kottler and Firlik say the key to adherence lies in motivation.
“We are in the business of motivating patients to initially fill and stay on their medication,” Kottler said. “Our goal is to move the bar as far as we can.”
Kottler and Firlik say the company’s goal is to develop a system of rewards that will encourage people to fill their prescriptions and ensure adherence over time. And while the philosophy focuses on “making it fun as opposed to onerous or scary,” there’s no set formula as of yet for continued adherence.
“No one knows what works best in the long run,” said Kottler. “We’ll be a living laboratory.”
HealthPrize isn’t the only company to use rewards to compel better healthcare practices. In July, The Michigan Academy of Family Physicians and the Michigan Purchasers Health Alliance forged a deal with MedEncentive, an Oklahoma City, Okla.-based company that offers a Web-based system of incentives designed to encourage both doctors and patients to promote best medical practices.
Through that program, physicians are rewarded for incorporating best medical practices and advancing patient education and empowerment, while patients are rewarded by demonstrating knowledge of their medical conditions and engaging in self-management of their health.
“After reviewing numerous quality improvement and cost containment initiatives, our organization is convinced of MedEncentive’s viability,” said Marilyn Bell, RN, executive director of the MichPHA. “A partnership between the medical and business communities to promote this innovative program is incredibly important.”
“We believe MedEncentive provides an innovative solution at a time when our state is in desperate need for new ideas,” added MAFP President Jennifer Aloff, MD. “The program offers a cost containment strategy that does not interrupt the physician-patient relationship and, in fact, shows promise to enhance it.”
