Policy report

Unlocking the potential
of therapeutic adherence as a priority for a forward-looking approach to healthcare policies

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Introduction

Our multistakeholder collaboration looked into the challenges posed by therapeutic non-adherence, the barriers to action and outlined recommendations for policy actions based on best practices already implemented around the world.

The problem of therapeutic non-adherence

  • Main factors in (non) adherence and the challenges posed
  • Barriers to therapeutic adherence (the WHO multi-dimensional model)
  • The urgent need for action

Our recommendations for policy actions:

  • Relations Patient- and Healthcare Professionals (HCPs), coordination between HCPs, and treatment governance
  • Accelerating technology and innovation
  • Future-proof and agile regulations

The burden of cardiovascular diseases as the most impactful non-communicable disease (NCD)

NCDs represent a major challenge for public health systems in Europe, where they cause 90% of all deaths.9 Cardiovascular disease is the leading NCD in EuropeEvery

Every year in the EU, more than 6 million new cases of cardiovascular disease are diagnosed and over 1.7 million people die from diseases of the circulatory system10,11

Legend
€45 billion (21%) informal care
€54 billion (26%) productivity losses
€111 billion (53%) health care

These costs will increase each year under the triple threats of demographic changes, lifestyle factors, and climate change (the combined effects of extreme heat and air pollution are documented factors in acute cardiovascular events).12,13

Challenges and benefits of therapeutic adherence associated with cardiovascular diseases

Non-Adherence representes a major challenge for the treatment of CVD

Non-adherence to cardiovascular disease mediciation has been estimated to be higher than 60%23

Nearly one in four patients is partially or completely non-adherent to their treatment following a hospital dischage.24

Adherence to treatment could make a real contribution to improving patient outcomes and saving resources.

40%

of patients do not properly adhere to their cardiovascular disease medications, according to analysis of nearly 2 million patients.25

≈9%

of all cardiovascular disease events in Europe could be attributed to poor adherence to vascular medications, and that the level of optimal adherence confers a significant inverse association with subsequent adverse outcomes.26

up to 50%

of hospital admissions for cardiovascular disease may be due to poor adherence.27

Barriers to therapeutic adherence (the WHO multi-dimensional model)

Healthcare system/health team barriers

Condition-related factors

Therapy-related barriers

Patient-related factors

Socio-economic factors

This report :

Helping patients to adhere more closely to their treatment could save almost 200,000 lives every year in Europe and reduce costs to healthcare systems and society by €125 billion. The consequences of non-adherence are serious, compromising the effectiveness of treatment and, in the most extreme cases, leading to death and inefficient use of healthcare resources.

We want to address the challenge of non-adherence by promoting concrete solutions that can be implemented. To that end, we have come together in a multistakeholder, collaboration and produced this report outlining policy solutions to improve adherence. We call on policymakers to seize this opportunity to support implementation through policy actions that can improve the lives of patients and support our healthcare systems.

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Contact

If you would like to learn more about the initiative and how can you support therapeutic adherence, please fill out the following contact form.

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References :
9 - WHO (2021) Monitoring noncommunicable disease commitments in Europe. https://www.who.int/europe/publications/i/item/WHO-EURO-2021-4479-44242-6249410 -Timmis et al., 2022 https://www.eea.europa.eu/publications/beating-cardiovascular disease#:~:text=It%20is%20the%20most%20common,2022%3B%20WHO%2C%202022).
10 -Timmis et al., 2022 https://www.eea.europa.eu/publications/beating-cardiovascular disease#:~:text=It%20is%20the%20most%20common,2022%3B%20WHO%2C%202022).
11 - WHO, 2022, Global Health Observatory, World Health Organization, Geneva, Switzerland (https://www.who.int/data/gho).
12 - EFPIA (2022). Chronic diseases: sustainable solutions for europe powering up chronic disease management
13 - Peters Annette (2021), Cardiovascular risks of climate change. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649889/
23 - Kravitz RL, Hays RD, Sherbourne CD, et al. (1993) Recall of recommendations and adherence to advice among patients with chronic medical conditions. Arch Intern Med. doi: 10.1001/archinte.1993.00410160029002.
24 - Jackevicius Cynthia A, Li P, Tu JV. (2008) Prevalence, predictors, and outcomes of primary non-adherence after acute myocardial infarction. doi: 10.1161/CIRCULATIONAHA.107.706820.25 - Laufs, Ulrich, Rettig-Ewen, Volker, Bo, Michael. (2011) Strategies to improve drug adherence. European Hearth Journal. doi:10.1093/eurheartj/ehq297
25 - Laufs, Ulrich, Rettig-Ewen, Volker, Bo, Michael. (2011) Strategies to improve drug adherence. European Hearth Journal. doi:10.1093/eurheartj/ehq297
26 - Rajiv Chowdhury et al. (2013) Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. Eur Heart J doi: 10.1093/eurheartj/eht295. Epub 2013 Aug 1.
27 - Chen Chen, MD (Adherence with cardiovascular medications and the outcomes in patients with coronary arterial disease: “Real‐world” evidence. Clin Cardiol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9748759/