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Peter_hunter_johnston_ft_healthcare_in_greece

Caring and Curing through improved Patient Adherence
Shaping the future of Healthcare in Greece: Caring, Curing, Securing
20 March 2012
Peter Hunter Johnston, Vice President Global Sales, 2012 BIOAXIS Healthcare Ltd. All rights reserved Caring and Curing Through Improved Patient Adherence
Appropriate treatment is prescribed to "Care for and Cure" patients
Many patients don't follow the prescribed treatment
There are significant consequences for all Healthcare Stakeholders
All Stakeholders also have a role to play in improving Patient
2012 BIOAXIS Healthcare Ltd. All rights reserved




Declaration of interest o BIOAXIS is a global medical company that engages directly with Patients to help them manage their health.
o Primary focus: Patient Support and Patient Adherence (compliance) programmes sponsored by the Pharmaceutical, Biotech, Device and Diagnostics industries.
o Activities range from o Sending a fully qualified BIOAXIS nurse to a patient's house to administer an injectiono Prescription refill and deliveryo Phone calls, e-mails, SMS reminders etc 2012 BIOAXIS Healthcare Ltd. All rights reserved Definitions: Patient Adherence and Patient Persistence – Also referred to as "Compliance"– "The degree or extent of conformity to the recommendations about day-to- day treatment by the provider with respect to the timing, dosage, and frequency"* – The duration of time from the initiation to the discontinuation of therapy *Cramer JA, Roy A, Burrell A, et al. Medication compliance and persistence: terminology and
definitions. Value Health. 2008;11: 44-47.
2012 BIOAXIS Healthcare Ltd. All rights reserved 2012 BIOAXIS Healthcare Ltd. All rights reserved 2. Non-Adherence is widespread – even in Oncology! Adherence studies in Breast Cancer patients taking (oral) Tamoxifen ADHERENCE OR
ADHERENCE OR PERSISTENCE RATE
TIME PERIOD STUDY
PERSISTENCE MEASURE
97.9% by self-report; 92.1% by pill counts; 76% missed 1 dose per wk Prescription refill records 77% filled prescriptions that covered at least 80% of doses over the 1st y; 50% did so by 4th y Not stated Grunfeld 55% reported non-adherence to Single point Atkins 2006 medication frequently or occasionally Prescription refill records 77.9% at 1 y; 64.8% at 3.5 y Clinical notes, audit records, cancer registry data, prescription Adapted from Patient Adherence and Persistence With Oral Anticancer Treatment; Kathryn Ruddy, Erica Mayer, Ann Partridge, CA Cancer J Clin 2009;59:56-66.
2012 BIOAXIS Healthcare Ltd. All rights reserved 3. The consequences of poor Adherence: Payers/Societal stakeholders "More than half of the total medications prescribed annually in the
United States may be used incorrectly, leading to inferior outcomes and
an estimated cost to society of $100 billion."

Dezii CM. Medication noncompliance: what is the problem? Manag Care. 2000;9: 7-12. •"Poor adherence has been estimated to cost approximately $177
billion annually in total direct and indirect health care costs.

Enhancing Prescription Medicine Adherence: A National Action Plan. National Council on Patient Information and Education. August 2007 "Patient non-adherence is estimated to represent $290 billion per year
in avoidable medical expenses in the United States alone."

New Thinking in Patient Adherence. First Word Dossier; March 2012 Greek economy = approx. 2% of US economy
–Cost to Greek society = $2 - 5 billion?
2012 BIOAXIS Healthcare Ltd. All rights reserved


3. The consequences of poor Adherence : Payers/Societal stakeholders Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Gilmer TP, Dolder CR, Lacro JP, Folsom DP, Lindamer L, Garcia P, Jeste DV. Am J Psychiatry. 2004 Apr;161(4):692-9.
2012 BIOAXIS Healthcare Ltd. All rights reserved 3. The consequences of poor Adherence is significant: Payers/Societal stakeholders Blood pressure reduction, persistence and costs in the evaluation of antihypertensive drug treatment--a review. Cardiovasc
Diabetol. 2009 Mar 27;8:18
2012 BIOAXIS Healthcare Ltd. All rights reserved 3. The consequences of poor Adherence: Patient perspective Blood pressure reduction, persistence and costs in the evaluation of antihypertensive drug treatment--a review. Cardiovasc Diabetol. 2009 Mar 27;8:18 2012 BIOAXIS Healthcare Ltd. All rights reserved 3. The consequences of poor Adherence: Patient perspective – Patients with poor adherence (<80%) have a 10% increase in mortality
McCowan C, Shearer J, Donnan PT et al. Cohort study examining tamoxifen adherence and its relationship to mortality in women with breast cancer. Br. J. Cancer 99(11), 1763–1768 (2008).
10 year surviv.al
Of Patients that start therapy
80.7% for patients who continue therapy
73.6% for patients who stop therapy
Of Patients that continue therapy
81.8% adherent (>80%)
77.8% non-adherent (<80%)
Hershman DL, Shao T, Kushi LH et al. Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer. Breast Cancer Res. Treat. 126(2), 529–537 (2011) 2012 BIOAXIS Healthcare Ltd. All rights reserved 3. The consequences of poor Adherence: Industry perspective o Injectable therapies (biological)o Typical 12-month adherence rates are between 20% - 60% Adherence, discontinuation, and switching of biologic therapies in medicaid enrollees with rheumatoid arthritis. Li P, Blum MA, Von Feldt J, Hennessy S, Doshi JA. Value Health. 2010 Sep-Oct;13(6):805-12 Efficacy of abatacept and tocilizumab in patients with rheumatoid arthritis treated in clinical practice: results from the nationwide Danish DANBIO registry. Leffers HC, Ostergaard M, Glintborg B, et al. Ann Rheum Dis. 2011 Jul;70(7):1216-22. o Typical cost of therapy = €4,000+ per patient per year Injectable therapies Typical 12-month adherence rates 50% - 60% Adherence to therapy in multiple sclerosis and schizophrenia. Bussfeld P, Czekalla J. Fortschr Neurol Psychiatr. 2010 Mar;78(3):139-46 o Typical cost of therapy = €5,000+ per patient per year 2012 BIOAXIS Healthcare Ltd. All rights reserved 4. Solutions: Roles for all Stakeholders Regulators & Payers
o Remove Legislative and Regulatory barriers to, and encourage,o Patient support programmes and services Patient information, education and communication o When evaluating pricing, consider "product + services" Healthcare Professionals (HCPs)
o
Improve communication to increasingly enquiring and sceptical patients The vast majority of patients what to be more involved in decisions that affect their healthcare Its not just the Doctor! Nurses & Pharmacists also have important roles to play o Look for partnerships with stakeholders and HCPso Develop the value proposition of "product + services"o Invest in patient support services and programmeso Exploit the opportunity to combine Pharmacovigilance / Risk Management Plans (RMPs) with Patient Support Programmes: Directive 2010.84 EU "The marketing authorisation holder should be responsible for continuously monitoring the safety of its medicinal products, ." 2012 BIOAXIS Healthcare Ltd. All rights reserved Patient Adherence "Drugs don't work well in patients who don't
C. Evert Coop. M.D.
Former US Surgeon General
2012 BIOAXIS Healthcare Ltd. All rights reserved


BIOAXIS Healthcare Ltd.
BIOAXIS Healthcare Hellas S.A.
Advanced Healthcare Services Advanced Healthcare Services 500 Chiswick High Road, 70 Pentelis Avenue, Tel:+44 20 8956 2554 Tel: +30 210 6100 330 Fax:+44 20 8956 2555 Fax:+30 210 6100 330 e-mail: info@bioaxis.eu e-mail: info@bioaxis.eu 2012 BIOAXIS Healthcare Ltd. All rights reserved

Source: http://healthcareconference.boussiasconferences.gr/files/_presscorner/_2012/peter_hunter_johnston_FT_healthcare_in_greece.pdf

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Second to Fourth Digit Length Ratio (2D:4D) and Adult Sex Hormone Levels: New Data and a Meta-Analytic Review Running title: 2D:4D and adult sex hormone levels [ Accepted for Publication in Psychoneuroendocrinology. Final Unedited Draft ] Johannes Hönekopp*, Luise Bartholdt Technische Universität Chemnitz, Institut für Psychologie, Wilhelm-Raabe Str. 43, D-09120

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