Tuesday, January 4, 2011

Patient Adherence: Money Can't Change Everything

Even if providers slash medication prices, some patients are not adherent. To wit: Patients’ decision not to get vaccinated during the current flu season.

It seems that some major retailers, like Rite Aid and Kroger, and smaller venues, like doctors’ offices, are awash in flu vaccine, and cutting vaccine prices to salvage their losses. The WSJ reports there aren’t enough takers for this year’s 163 million doses of flu vaccine.

Last year, there were 110 million doses manufactured, not enough to cover the demand for the potentially fatal H1N1 viral strain. Pharma ramped up production this year, hoping that the public’s demand would be the same as in the prior flu season, and because the CDC now says all people over six months old should get the shot.

During last year’s epidemic, in which 12,000 people died and millions were sickened in this country, you couldn’t turn to a media outlet without hearing about H1N1, the CDC, WHO, problems with the vaccines, and so on. If you’ll recall, there was even a huge stink involving the WHO and conflict of interest. This year, stories about the flu season have been perfunctory, found essentially on medical web sites.

But the general feeling about last year’s flu season was that the medical community, including pharma, cried wolf. One of the comments to the WSJ article was that “H1N1 was an overblown marketing effort for the most part.”  Said another: Of course it was overblown."  Comments such as these certainly help explain the public’s ambivalence to getting their flu vaccine – and to those in public health in trying to accurately forecast the reach of the flu.

This year's flu season is still early, January is just starting. It will be interesting to see what happens in the waning months of the winter. Imagine the public's outcry if the flu season gets really out of hand.

Which raises this point: Will industry and public health officials pay attention to how patients are reacting this year to getting their shots? We think that people choose not to  get vaccinated because there is no immediate value to them in doing so. We believe that focused efforts on adherence to medical evidence, providing reminders for vaccinations via text messages can help overcome the delicate balance of supply and demand for vaccines.

This is important public health work.  We believe those who are casting aspersions on the industry need to be educated to the real challenges industry faces in forecasting this often fatal disease.

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