Yesterday’s post about compliance was pretty popular and generated a number of comments, so I thought I’d continue a bit with that theme. I received a piece of mail yesterday that sparked my memory about another big issue around compliance and one of the more common techniques that is used to try to improve it. I call them “Nag Letters,” but they’re technically called “Reminder Letters” I suppose.

You’ve likely gotten one of these before. It’s a letter from your pharmacy (maybe, keep reading) that reminds you that you haven’t filled your prescription in a while and it’s past due. It then goes onto remind you of all the reasons you should be taking the medication and potentially what might happen if you don’t. It’s a rather unobtrusive reminder, a courtesy I guess. No one really gets hurt or probably too bothered. It is your pharmacy after all, so they’re just trying to help. You probably should know that most of these are paid for by the pharma company who markets the drug you’re being reminded about. I personally, don’t think that’s a big deal. They don’t get access to your information, they simply pay the pharmacy to take care of this for them.

The intention is good. Your doctor wants you taking this medication presumably to make you healthier and they’re helping make sure that you do. Clearly, the pharma company has a stake in you refilling your prescription, but so what? This is probably the most innocuous form of direct to consumer (DTC) marketing that a pharma company can do. You’re simply reminding current patients who should be continuing a drug to keep taking it. Everyone benefits, right?

Here’s where it gets dicey. Who’s responsible for sending out these reminders? Who has a vested interest here? The interest may be your health or the company’s finances, but have you stopped to think who might send you a letter like this? This someone has to have information on what drugs you’re taking. So who’s got this information? 

As a former brand manager, one year we were pitched a number of these programs by different companies and even other divisions within our company. At the end of all this, we discovered that if we did all the programs, a single patient could potentially receive 6 (yes, 6) different reminder letters from different entities. Who? Here’s the list along with the incentive for each company (besides the moral fact that each group wants patients to be healthy of course). This is sure to offend someone, but I’m trying to make is simple here:

• The pharma company that makes the drug: more refills, more revenue
• The pharmacy that fills your prescription: more refills, more revenue
• Your insurance company: compliant patients end up costing less in medical benefits later
• Your doctor: if your treatment works, you stay their patient
• The pharmacy benefit manager (PBM): more refills, more revenue
• The physician network (a large national group [such as US Oncology] practice with many independent offices): better compliance, better outcomes to report

Six letters all saying the same thing arriving at roughly the same time. How do you think that would make you feel as a patient? Annoyed for sure. Probably concerned about the security of your health information. And likely more inclined to stop your treatment.

So, why do these programs exist? Simple math. These programs “work.” Reminder letters “work.” I use “work” in quotes intentionally. These programs result in more refills and more revenue for interested parties, but do they really impact compliance? They don’t. In effect, these programs encourage a handful of people to refill their prescriptions a few more times each. Because these programs are relatively inexpensive to run, there’s usually a very positive ROI. However, these programs don’t change people’s perceptions of the drug, nor do they change the person’s deep seeded understanding of why this drug is critical to their health. A standard form letter cannot do that.

There’s not really a digital lesson here. I’m not going to tell you that 6 emails is better than 6 letters (though recipients might think email was better because they can block the next one). My point is simply this: just because you can do something doesn’t mean you should. All of those groups who could send those reminders should all be working together to create something that is likely to truly impact compliance. Instead of making a short-term spend for quick revenue, why not take that same money and invest it in understanding the real reasons why people stop their treatment? From there, you can create programs that will be more effective by huge orders of magnitude.

So before starting your next initiative ask yourself: “Am I doing this just because I can?”

Possibly related posts (auto-generated):

1. Healthcare Marketing New Year’s Resolutions – Part 1
2. “Glorified Alarm Clocks”
3. Are You Reminding Me or Annoying Me?