The Booz & Company/Bertelsmann Foundation study evaluated the direct productivity benefits from improving adherence to medical therapy, drawing upon data for five chronic diseases - depression, chronic back pain, asthma, hypertension and rheumatoid arthritis. Key findings from this research include:
- On average, across chronic diseases, between 20 and 30 per cent of patients do not follow at least some significant part of the therapy recommendations given to them by their doctor(s)
- Depression is the greatest cause of lost productivity in the UK, with a productivity loss per patient of between €7,000 and €11,000
- The high rate of non-adherence found is driven by three things: lack of information, lack of motivation, or inadequate strategies
- The cost of lost productivity to society is at least as significant as the medical cost associated with these chronic diseases. For chronic back pain, for example, medical costs only contribute 10 to 20 per cent of the total cost to society
- Employers in the UK could gain as much as €3.1 billion through therapy adherence due to reduced absenteeism, symptoms less likely to reoccur and reduced early benefits
Unfortunately, employers - the stakeholders that would benefit the most from these improvements - actually have the least influence on adherence. Employers and policy makers alike have much to gain from investing in therapy adherence but have few ready-made tools to intervene. Similarly, for health service providers, investing in therapy adherence is unattractive in the current system as the focus and financial incentives are on diagnosis and treatment selection, rather than therapy follow-through.
"The core problem is the lack of coherence between therapy and the world of employment,” says Tobias Handschuh, healthcare expert at Booz & Company. “All stakeholders need to work together to find the optimal solution. Therapy adherence strategies improve patients’ health, but can also achieve significant cost savings in the health care system and productivity gains in the economy.”
Booz & Company identified four levers that can overcome barriers to adherence:
- Create and deploy incentives for doctors, nurses, and patients to integrate therapy adherence in treatment plans, paying for quality instead of volume
- Engage employers and social security in therapy adherence, aligning health gains with productivity gains
- Explore new service and business models in healthcare that are better equipped to foster improved therapy adherence
- Stimulate further scientific studies to evaluate the impact of adherence, study best practices and optimise incentive models
Now is the time to make changes. The baby boomer generation are reaching retirement age and, as a result, the labour market will tighten and wage inflation could become more prevalent. Both in the industrialised world and in emerging economies, life spans are increasing. These positive developments, however, are accompanied by a rising prevalence of the chronic diseases associated with aging. Successful approaches to improve adherence have been shown to work on a small scale, but it is the responsibility of the employers, policymakers, insurers and healthcare providers to roll out these measures on a large scale to the benefit of themselves and, more importantly, their patients.
To view the study, “Unleashing the Power of Therapy Adherence: High-Leverage Changes in Patient Behavior for Improved Health and Productivity”, in full (including methodology), follow this link: