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The Role of Dose Titration in Medication Adherence

Tags: Adherence

There is an aspect of non-adherence that is often overlooked, but critical to treatment success. It’s dose titration, and the truth is, in many categories, doctors aren’t that good at it. We recently completed a patient market research study for a brand launched almost six years ago in which 60% of the patients who had discontinued for suboptimal results had not been titrated to the maximum dose prior to discontinuation. Seriously?!

Well it turns out that when ROF conducted market research on the MD side, we confirmed this finding and determined that, despite the product being on the market for a number of years, there was a surprising lack of awareness of the actual dosing used in the clinical trials. Physicians had believed for years that the starting dose was the optimal dose. In fact, less than 50% of the brand prescribers who participated in the research were aware that the vast majority of patients in the trials were treated with the higher dose.

Marketing efforts to increase awareness of optimal dosing have resulted in increased use of the higher dose over time—from 16% of total brand sales last year to 21% this year with the most significant gains among frequent prescribers.

Pharma is often quick to blame patient behavior as the root cause for the levels of non-adherence that plague our industry, but there are often other contributing factors that need to be considered. Convincing one physician to titrate the majority of patients on a given brand versus persuading a single patient to be more adherent to a sub-optimally dosed product provides deeper, more lasting returns.

Before you invest significant dollars in a program designed to improve adherence with your brand, make sure you know what is driving non-compliance and discontinuation in the first place. What you find might not just impact what you say, but to whom you need to say it.

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