TDL Brief: Pharmaceutical Companies
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Pharmaceutical companies face a great deal of criticism, often being characterized as an industry far more interested in profit than helping people. However, at least on a basic level, their role is to discover, develop and produce drugs to try and improve patients’ health. These days, medical interventions are evolving beyond the administration of drugs – people’s problematic or unhealthy behaviors need to be tackled in order to reduce the number of people who actually need pharmaceutical drugs. As a result, pharmaceutical companies are expanding their horizons to better capture the complexity of the field of health and medicine where the biological, psychological and behavioral all intersect.
There is one specific behavior that pharmaceutical companies have to deal with: addiction. Unfortunately, many patients who are originally prescribed certain medication go on to become addicted. As humans are prone to an illusion of control, where we believe we have greater control over events than we do, we are not prepared for how pharmaceutical drugs might negatively impact our habits and behaviors. Pharmaceutical companies need to be aware of this in order to help avoid propagating addiction epidemic and avoiding liability in lawsuits.
But it is not just addiction that challenges the work that pharmaceutical companies are doing. Human biases also mean that people aren’t taking their prescribed medicine when it would be beneficial for their health. Pharmaceutical companies also need to understand what motivates human behavior in order to best market their products in a manner that will encourage people to fulfill their course-of-action.
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1. Behavioral Barriers to the Success of Pharmaceutical Drugs
By Pharma Phorum, Assessing provider (and patient) motivation (Sep 2019)
If pharmaceutical companies want to ensure that patients are getting the best care possible, they not only need to develop the best medicinal drugs, but also ensure that they are being administered properly. Although as a scientific community, pharmaceutical companies are constantly discovering new break-through drugs that can help combat different diseases, people are often reluctant to get on board with things that they are not familiar with.
One barrier to the success of new pharmaceutical drugs is humans’ self-efficacy. We have a psychological desire to feel competent, a desire that is challenged by the introduction of a new drug from a health-care professional. Often, people reject medicine because they do not want to admit that they need it or because they feel as though it’s being externally forced on them. That is why health-care professionals and pharmaceutical companies need to be aware of how to manage a patient’s perceived control over the situation. Instead of simply giving patients information on new innovative drugs, health-care professionals need to try and motivate patients to follow the course of action which they are being prescribed.
Similarly, there might be barriers stopping health-care providers’ willingness to prescribe new drugs because of their own self-efficacy. They may feel confident in their ability to prescribe a particular course-of-action and be hesitant to have to learn a new skill or learn about a new kind of drug. This can lead to habitual prescribing with a lack of attention to what individual patients really need.
Humans are also habitual creatures, which provides a plethora of challenges to pharmaceutical companies. On the one hand, it means that people are resistant to new courses of actions and would prefer to adhere to drugs which they are used to, despite data that demonstrates new therapies are more effective. It is difficult to get people to form new habits because it requires long-term sustained behavior and patients that do not immediately feel the beneficial impact of new therapies might give up. On the other hand, after a patient does adopt a new prescription, habit-formation can be dangerous because it can lead to addiction.
2. Gamification as a Tactic for Pharmaceutical Companies
By Medical Marketing and Media, How pharma marketers are using behavioral science (April 2017)
Human’s psychological biases do not need to be a barrier for the success of pharmaceutical companies; they can be leveraged in order to motivate behavior as well. If pharmaceutical companies understand what motivates human behavior, they can create marketing campaigns that will best help them achieve their goal, which ultimately, should be to get medicine to the people that need it.
One pharmaceutical company, Boehringer Ingelheim, manufactures Spiriva Respimat, a drug used for the management of pulmonary diseases and asthma. They used gamification in order to create an engagement with their product. Gamification is the application of game-like features to a non-game like environment. The company decided to motivate patients that had been prescribed Spiriva to take their medicine by creating a program that would give patients rewards if they follow their course-of-action.
Additionally, the pharmaceutical company used the created engagement between patients and the program to further educate patients on their health condition and the benefits of the drug. While the program provided activities that would give people points that could be redeemed for a prize, it also provided educational content in the form of quizzes, which once again incorporated a game-like element. When information is presented in this fun, engaging manner, people might be more likely to retain it because they are motivated to learn it in order to get questions right. Additionally, programs like the one created by Boehringer Ingelheim might help overcome a self-efficacy issue, as people will begin to feel competent about their condition and treatment of their condition when they are performing well on the quizzes.
3. Improper Disposal of Pharmaceutical Drugs has Serious Consequences
By Environmental Health Perspectives, Drugs in the Environment: Do Pharmaceutical Take-Back Programs Make a Difference? (May 2010)
There are various different risks that are associated with people not fulfilling their pharmaceutical course-of-action. For one, when you don’t finish off the course treatment because you are feeling better, the disease might relapse or it may lead to the development of antibiotic-resistant bacteria. While these side-effects are more commonly discussed as reasons that we should always take the full course of antibiotics, there is another side to the story less often debated that pharmaceutical companies need to consider. When people don’t finish their prescription, what do they do with the leftover drugs?
Research has shown that often, leftover drugs end up in our trash or flushed down the toilet. At a first glance, this doesn’t seem too problematic – however, as we are becoming increasingly aware of the damaging effects that human behavior is having on our planet, the improper disposal of pharmaceutical drugs is becoming a growing concern. Traces of antibiotics have been found in water and has led to the collapse of entire populations of fish.
While encouraging people to finish their course-of-action is a logical way through which to combat these various dangers, the fact of the matter is that people will not always do this. That means that pharmaceutical companies might need to consider more inventive ways to prevent the improper disposal of antibiotics and other drugs. One strategy that is already present in some places like Europe and Canada, is pharmaceutical take-back programs. In these places, patients can return their unused or expired medicine back to pharmacies to avoid the misuse and abuse of them, which also contributes towards reducing the pollution caused by improper disposal.
4. Pharmaceutical Companies Need to Use Behavioral Science to Counter Non-Adherence
By Reuter Events, Could Behavioral Science Crack Non-Adherence? (Apr 2018)
One of the biggest challenges that pharmaceutical companies face is how to get people to take the drugs that are necessary to help manage or improve their health conditions. Research suggests that 75% of patients do not take their course-of-action as directed, which leads to suboptimal health results. Despite vast amounts of data that show the benefits of different treatments, people still do not comply. In part, this might be due to the base rate fallacy, which suggests that we listen to information that is specific to us over objective statistical data. Therefore, if we think we feel better, we might not take the treatment as directed.
If pharmaceutical companies want to achieve their goal of helping improve people’s health, they need to be aware of the barriers to following treatment. This means that pharmaceutical companies need to pay attention to behavioral science and incorporate it into their marketing. By understanding what factors lead to non-adherence, companies can decrease the likelihood of people not following through with their treatment.
According to a medical director at a behavior-change consultancy, when people decide whether or not to take prescribed medicine, they base their behavior on how necessary they believe it to be for their wellbeing. As pharmaceutical drugs are often marketed in objective terms, people may not feel that they personally need to take it. To overcome this challenge, pharmaceutical companies can try to dissipate more personal information to patients, potentially through the use of digital programs that build a patient profile and then sends personalized messages.
5. Technology Can Help Overcome Non-Compliance
By The New England Journal of Medicine, Digital Health Support in Treatment for Tuberculosis (Sep 2019)
While in the past, the only contact that patients had with health-care professionals was confined to visits to the doctor’s office, these days, technology has changed the way that people access health-related information. Although this can at times make it difficult to monitor what information people are being receptive to, digital tools can also be leveraged to encourage patients to follow their doctor’s orders.
In our incredibly busy lives, it may be easy to forget to take our medicine. However, you can almost always count on the fact that the majority of the population has their smartphones on them regardless of what they are doing. Digital health interventions therefore might be the answer to combat non-adherence to treatment programs, as technology is an embedded part of our daily lives. Doctors and pharmaceutical companies can create digital initiatives that help remind people to take their medicine by sending them a message.
However, consider how often you ignore a text, or think to yourself that you’ll answer it later. Similarly, when someone gets a text reminder to take their medicine, that doesn’t necessarily mean that they will be motivated to immediately do it. Yet, if a program is devised that asks people to respond to the reminder, studies suggest that they will be more likely to actually complete their treatment. Not only does it create a level of accountability because it necessitates an action from the patient, but the digital program can send follow-up messages if they do not receive confirmation that the patient has adhered to the program. Repetition is a great way to induce behavior, showing how technology can help combat non-compliance.
6. Big Pharma and the Creation of a COVID-19 Vaccine
By Fortune, ‘The whole world is coming together’: How the race for a COVID vaccine is revolutionizing Big Pharma (Sep 2020)
A lot of the controversy surrounding pharmaceutical companies is due to companies that are known as “Big Pharma”. Big Pharma refers to the fact that a number of pharmaceutical companies have become frontrunners in the industry and make millions of dollars every year, turning the pharmaceutical industry into a profit-driven business.
The money that can be gained from the development of drugs often causes a great deal of competition between Big Pharma companies. If they were driven by a desire to help improve health in the population, it would follow that these companies would share important research and findings so that they could work together to discover new effective treatments. Historically, this has not been the case – pharmaceutical companies employ a winner-takes-all mentality and compete with one another to be the first to develop a drug.
However, the ongoing global pandemic might revolutionize the way that Big Pharma companies operate. In an attempt to develop a vaccine against COVID-19, pharmaceutical companies have begun to team up in order to more quickly develop a treatment. There are few pharmaceutical companies that are not working to create a COVID-19 vaccine, with over 200 in development, but what is unique about this rush of initiatives is that for once, companies are willing to work together. Instead of being driven by profit, pharmaceutical companies are banding together for an important cause that has led to millions of deaths and worldwide shutdowns.
Usually, another complaint about Big Pharma companies is that they tend to be located in a few particular countries (the U.S. is home to many of the largest pharmaceutical companies). As a result, there is an unfair distribution of treatments, heightened by the fact that only some countries can afford to secure the drugs and vaccines. Thankfully, nations have responded differently to these unprecedented times – a new enterprise, the COVAX Facility, has been created. The COVAX Facilityplans to combine the purchasing power of the wealthiest nations in order to coordinate worldwide efforts to combat the virus. Over 170 countries have signed the agreement and will contribute their funds towards the development and distribution vaccines that prove to be developing successfully.
While the term Big Pharma has long been accompanied by criticism, the way that the industry is handling the COVID-19 pandemic may help remind people of the original intent of pharmaceutical companies: to help improve the world’s health.
- Zipfel, P. (2019, September 17). Assessing provider (and patient) motivation. Pharma Phorum. https://pharmaphorum.com/views-and-analysis/assessing-provider-and-patient-motivation/
- McCaffrey, K. (2017, April 5). How Pharma marketers are using behavioral science. Medical Marketing and Media. https://www.mmm-online.com/home/channel/commercial/how-pharma-marketers-are-using-behavioral-science/
- Lubick, N. (2010). Drugs in the environment: Do pharmaceutical take-back programs make a difference? Environmental Health Perspectives, 118(5), 210-214. https://doi.org/10.1289/ehp.118-a210
- Osborne, K. (2019, April 19). Could behavioral science crack non-adherence? Reuters Events. https://www.reutersevents.com/pharma/patients-and-medical/could-behavioral-science-crack-non-adherence
- Yoeli, E., Rathauser, J., Bhanot, S. P., Kimenye, M. K., Masini, E., Owiti, P., & Rand, D. (2019). Digital Health Support in Treatment for Tuberculosis. The New England Journal of Medicine, 381(10), 986-987. https://doi.org/10.1056/NEJMc1806550
- Leaf, C. (2020, September 21). ‘The whole world is coming together’: How the race for a COVID vaccine is revolutionizing Big Pharma. Fortune. https://fortune.com/longform/covid-vaccine-big-pharma-drugmakers-coronavirus-pharmaceutical-industry/
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The Decision Lab
The Decision Lab is a Canadian think-tank dedicated to democratizing behavioral science through research and analysis. We apply behavioral science to create social good in the public and private sectors.