“Gamification” proceeds from the principle that individuals naturally are biased toward short-term gratification or fulfillment, in preference to longer-term benefits; what psychologists call the “present bias” of human psychology; another way to look at it is the old truism of a “bird in hand…” HealthPrize (Norwalk, CT) is one of several companies that have arisen in recent years to apply these principles to medication non-adherence. By getting patients to join in on a Web-based patient portal, where registering refills, completing simple educational tasks and the like are rewarded with gifts or other incentives.
Now, the company says that a recent program oriented around adherence for cholesterol-reducing medication—and across a cohort of patients who had already demonstrated an above-average level of compliance—showed a 99% reduction in “gap days”—the time between one refill and the next, when patients are ostensibly without medication. Around 1,000 patients were in the study; they had already demonstrated an average refill rate of 13.8 prior to entering the program; and 5.0 refills, post-registration, within the study timeline. Gap days post-enrollment dropped from 8.81 days to 0.06—a 99% reduction. How well gap-days analysis correlates with long-term adherence remains to be seen; however, as Tom Kottler, HealthPrize CEO notes, “This cohort represents an already reasonably persistent group, but even in this group our platform significantly improved refill behavior, as the program is focused on motivating patients towards more timely refills—arguably the most important adherence behavior. We were able to turn good patients into great patients.”
HealthPrize has worked with about a dozen pharma companies (at least those publicly acknowledged), including Novo Nordisk, Mylan, Galderma and Daiichi Sankyo, and also has partnerships with West Pharma Services, the parenteral packaging developer, and Aprima Medical Software, an electronic health-records (EHR) system vendor. The company says that overall, its project experience to date indicates a 50% improvement in adherence.