Economic Crisis: Pharma Sales Will Drop As Patients Cut Back on Prescriptions

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Pharma has the greatest potential of any industry in the world to recapture lost sales and increase their products' long-term success.

Dr. Dorothy L. Smith, President and CEO of metropolitan Washington, DC-based Consumer Health Information Corporation (CHIC) and a leader in evidence-based patient adherence program development, spoke about the importance of the patient's role in successful therapeutic outcomes to an audience comprised of pharmaceutical industry executives, clinicians and researchers. She was invited to address the Pharmaceutical Industry session at the Annual Meeting of the American College of Clinical Pharmacy (ACCP) in Louisville, Kentucky.

Dr. Smith, a founding member of the ACCP, stressed that, "The patient holds the power to the success of your products. In today's volatile economy, at least 20% of patients are cutting costs and are not filling their initial prescriptions. As many as 50% - 85% do not refill their prescriptions."

In the current economic crisis, patients are cutting back on purchasing prescription drugs and taking lower doses in an attempt to make their prescription medications last longer. Not only is this dangerous to their health but it hurts the bottom line of a company's products.

Patient nonadherence costs the nation's health care system billions of dollars annually. In fact, it costs twice as much to treat the effects of nonadherence and lost employee productivity than it does to purchase all the drugs in the United States. The cost to pharmacy and the pharmaceutical industry is staggering when patients do not fill their prescriptions.

The facts are alarming. Patients are trying to make wise decisions but often make potentially dangerous choices:

In the doctor's office:

  • Approximately 10% - 20% of patients decide not to fill their prescription right in the doctor's office and skip the pharmacy altogether. This is because the doctor has not convinced them why they need to take the medication.

After discharge from the hospital:

  • At least 50% of medication problems were due to patient nonadherence.
  • Of patients who had a medication adherence problem after discharge, 14% were readmitted to the hospital within 30 days.

At the pharmacy:

  • Most patients cannot understand the computer-generated printouts stapled to their prescription bags.

At home:

  • After getting prescriptions filled at the pharmacy, 50% of patients on chronic therapies do not take their medications correctly for a variety of complex behavioral and drug response reasons.
  • At least 30% of prescriptions are not refilled, and more than 50% of patients drop out of therapy within the first year.
  • Patients will only stay in long-term therapy if they know how to monitor their progress and believe the drug is working.

The Washington Post (October 16, 2008) reported the results of a Rockefeller Foundation/Time Magazine survey ( Consumers were asked the question: "In the past year, was there ever a time when you have not filled a medical prescription because of cost?" 23% responded "Yes". These numbers are going to get worse because of the economy.

When patients decide to stop taking a prescription drug, they usually do not discuss their concerns with a health professional. Some of their reasons for stopping a medication include:

"I am not going to follow the treatment recommendations."
"I think it is safer to try juicing, natural remedies, yoga first."
"I am going to adjust the dose because this will lower my chance of developing side effects."
"If I take half the dose, I will save money because the prescription will last longer."
"I am not going to get my next refill because I don't think the drug is working."
"I am going to wait until I start to feel "sick" again."
"I'll look on the Internet, and cancel my appointment."

Pharma companies need to make sure patients receive clear information they can understand.
Pharmaceutical companies need to make their product-specific FDA-approved Patient Package Inserts (PPIs) available in electronic format to pharmacies. This will ensure that patients receive high-quality and up-to-date information. Patients need different information at different stages of their therapies. Usually the same printouts are given at every pharmacy visit and patients just throw them away. Behavior modification techniques need to be integrated so that patients are motivated to stay in therapy in order to obtain the most therapeutic benefit. Until the needs of patients are met, patients will continue to make decisions that are not wise or safe.

Dr. Smith summarized that, "Patients can make or break the success of a product. Product teams that are able to meet the needs of their patients will not only survive these tough economic times but they will also recapture lost sales."

About Consumer Health Information Corporation
Consumer Health Information Corporation ( is internationally recognized for innovative patient education programs that help patients understand how to manage their medications and medical treatments wisely and safely ( The company was founded in 1983 by Dr. Dorothy L. Smith. She saw first-hand in her clinical pharmacy practice settings that many patients were needlessly suffering serious medical complications because they did not know how to manage their prescription drugs or treatments correctly. Since that time, the company has been dedicated to bridging the communications gap between patients, health professionals, pharmaceutical companies, employers and insurance companies. The company's team of health professionals and creative experts work together to ensure that medical terminology is translated into language that people can understand and that the final design makes the information even easier to comprehend. The company has won major national and international awards for excellence in patient education and consumer information.

Dr. Smith is a strong patient advocate and has appeared on hundreds of television and radio programs across the country to increase consumer awareness of their important role in prescription drug therapy and what they can do to get the most benefit from these therapies. She is the author of 23 books on prescription medicines for consumers and has delivered more than 200 addresses to professional, regulatory, government and consumer audiences in the United States, Canada and Europe.

Consumer Health Information is affiliated with more than 30 universities and offers a clinical clerkship teaching program for senior Doctor of Pharmacy students who learn how to integrate their drug information expertise and patient counseling skills. The company has served on the Board of Directors for the National Council on Patient Information and Education (NCPIE), the National Board of Advisors for the University of Arizona, College of Pharmacy, and the Dean's Advisory Council for the University of Cincinnati Medical Center, College of Pharmacy.

About ACCP
The American College of Clinical Pharmacy ( is a professional and scientific society that provides leadership, education, advocacy, and resources enabling clinical pharmacists to achieve excellence in practice and research. ACCP's membership is comprised of practitioners, scientists, educators, administrators, students, residents, fellows, and others committed to excellence in clinical pharmacy and patient pharmacotherapy


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