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Patient adherence – the key to restoring trust in pharma

Medication is a staple of modern medicine, with almost 50% of adults in the United States taking at
The post Patient adherence – the key to restoring…



Medication is a staple of modern medicine, with almost 50% of adults in the United States taking at least one prescription medication. Despite this, pharmaceutical companies have not won over public trust. A recent study found that only 48% of participants expressed trust in pharmaceutical companies. This lack of trust in such a crucial industry can lead to decreased compliance, poor treatment adherence, and negative health outcomes for patients. 

The perceived lack of transparency in the pharmaceutical industry is a major contributor to the overall lack of trust. With the recent rapid rollout of Covid-19 vaccines, many people have raised questions about whether adequate research was conducted on these vaccines before approval. What people did not understand was that “fast tracking” approval does not limit the rigorous process involved in ensuring that a medication or vaccine is safe for market use. Additionally, when patients are prescribed medication, they are often unaware of the mechanism of action, potential side effects, interactions, and contraindications. Even when medical providers communicate this information to patients, it can be confusing or overwhelming, often leaving people feeling like they’ve been left in the dark. This feeling contributes to a deep mistrust in both specific branded medications and the pharmaceutical industry producing those medications.

Another factor that impacts trust in pharmaceutical companies is the discrepancy between the efficacy of medications in controlled clinical trials and their effectiveness in real-world use. This discrepancy can be caused by a variety of factors, however, one of the primary and most solvable ones is patient non-adherence to their medications. There are many reasons for patient non-adherence, including high medication costs, fear of potential side-effects, and forgetfulness, amongst others. However, the result of non-adherence is consistent. When patients do not take their medications according to the prescribed instructions, the drugs will not work as effectively as they did under the controlled conditions of a clinical trial. As patients observe this gap in the efficacy claimed by pharmaceutical companies compared to their personal experiences of lower effectiveness, their trust in specific drugs, clinical trial results, and pharmaceutical companies drops. This ultimately impacts patient perception of healthcare services in general.

Finally, the belief that pharmaceutical companies prioritise their bottom lines over the health and well-being of patients is probably the largest contributing factor to lack of trust in the industry. Given the high price tags placed on many medications, it’s easy to understand why patients often feel that they are being taken advantage of. This is especially understandable if they don’t have the means to pay for essential, potentially life-saving medications. As the relationship between pharmaceutical companies and patients breaks down, and patients feel that the industry is apathetic to their holistic wellbeing, they further disengage from interaction with the entirety of the healthcare ecosystem – including their providers, who prescribe the medications produced by pharmaceutical companies.

Adherence and education solutions – the glue between patient and pharma

In order to restore trust in the pharmaceutical industry, individual companies must invest in solutions that address the patient’s overall health – proving care is extended beyond the business interests of pharmaceutical companies. Patient-first mobile health solutions can help address the various issues that contribute to the lack of trust in the industry and improve the relationship between pharmaceutical companies, prescribers, and patients.

The first issue that adherence and education solutions can address is the perceived lack of transparency from the pharmaceutical industry.  Many patient engagement applications have dedicated sections that educate patients about their prescribed medications and treatment protocols, providing them with necessary information about the mechanism of action, potential side effects, and contraindications of their medications. These explanations are provided in layman’s terms, often with videos that ease understanding and acceptability. By investing in patient education, pharmaceutical companies reduce the fear and uncertainty that many people experience when prescribed medication and dispel the perceived lack of transparency in the industry.

Patient engagement solutions can also help reduce the discrepancy between the efficacy of medications in clinical trials and their effectiveness in real-world use. By providing patients with tools and resources to help them better manage their medication regimens, such as reminders and tracking tools, pharmaceutical companies improve patient adherence, and close the gap between efficacy advertised based on clinical trial results, and personal real-world experience with medication effectiveness. As patients experience first-hand the effectiveness reported in clinical trials, trust in the validity of these trials and the intentions of the pharmaceutical companies that fund them improves.

Finally, adherence and education solutions help develop a holistic relationship between patient, provider, and pharma, so patients feel they are fully cared about and not simply walking wallets in the eyes of the pharmaceutical industry. Engagement apps dispel the notion that pharmaceutical companies are only focused on their bottom lines, by providing a source of real value to patients’ everyday lives, making them feel seen and recognised as individuals with unique lifestyles, needs, and treatment journeys. Patients experience a sense that there is a trusted voice that accompanies them, and this establishes a basis for trust and functions as a bridge between pharmaceutical companies and patients themselves.

Where are we going?

The industry is moving in the right direction to restore and strengthen patient trust. As pharmaceutical companies embrace digital solutions that engage patients, we expect to see a boom in patients becoming more empowered partners in managing their conditions (Participatory Health). We envision a future in which treatment will be comprised of a hybrid intervention model, utilising both digital disease management elements and medication elements together, to create better patient care and ultimately improved health outcomes. This dual model will empower patients to become more actively involved in their treatment decisions and will rebuild their trust in the pharmaceutical industry. Patients will live more healthily and take their medications. Pharma’s bottom line will improve. Trust between patients, physician prescribers, and pharmaceutical companies will be re-established. In this future, everyone wins – patients, pharma companies, physicians, and the overall healthcare ecosystem.

About the author

Yossi Bahagon, Chairman of Sweetch, has over 20 years’ experience in digital health. He is the founder of several digital health start-ups. Additionally, Bahagon founded a venture fund dedicated to digital health.

The post Patient adherence – the key to restoring trust in pharma appeared first on .

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Lower mortgage rates fueling existing home sales

To understand why we had such a beat in sales, you only need to go back to Nov. 9, when mortgage rates started to fall from 7.37% to 5.99%.



Existing home sales had a huge beat of estimates on Tuesday. This wasn’t shocking for people who follow how I track housing data. To understand why we had such a beat in sales, you only need to go back to Nov. 9, when mortgage rates started to fall from 7.37% to 5.99%.

During November, December and January, purchase application data trended positive, meaning we had many weeks of better-looking data. The weekly growth in purchase application data during those months stabilized housing sales to a historically low level.

For many years I have talked about how rare it is that existing home sales trend below 4 million. That is why the historic collapse in demand in 2022 was one for the record books. We understood why sales collapsed during COVID-19. However, that was primarily due to behavior changes, which meant sales were poised to return higher once behavior returned to normal.

In 2022, it was all about affordability as mortgage rates had a historical rise. Many people just didn’t want to sell their homes and move with a much higher total cost for housing, while first-time homebuyers had to deal with affordability issues.

Even though mortgage rates were falling in November and December, positive purchase application data takes 30-90 days to hit the sales data. So, as sales collapsed from 6.5 million to 4 million in the monthly sales data, it set a low bar for sales to grow. This is something I talked about yesterday on CNBC, to take this home sale in context to what happened before it. 

Because housing data and all economics are so violent lately, we created the weekly Housing Market Tracker, which is designed to look forward, not backward.

From NAR: Total existing-home sales – completed transactions that include single-family homes, townhomes, condominiums and co-ops – vaulted 14.5% from January to a seasonally adjusted annual rate of 4.58 million in February. Year-over-year, sales fell 22.6% (down from 5.92 million in February 2022).

As we can see in the chart above, the bounce is very noticeable, but this is different than the COVID-19 lows and massive rebound in sales. Mortgage rates spiked from 5.99% to 7.10% this year, and that produced one month of negative forward-looking purchase application data, which takes about 30-90 days to hit the sales data.

So this report is too old and slow, but if you follow the tracker, you’re not slow. This is the wild housing action I have talked about for some time and why the Housing Market Tracker becomes helpful in understanding this data.

The last two weeks have had positive purchase application data as mortgage rates fell from 7.10% down to 6.55%; tomorrow, we will see if we can make a third positive week. One thing to remember about purchase application data since Nov. 9, 2022 is that it’s had a lot more positive data than harmful data. 

However, the one-month decline in purchase application data did bring us back to levels last seen in 1995 recently. So, the bar is so low we can trip over.

One of the reasons I took off the savagely unhealthy housing market label was that the days on the market are now above 30 days. I am not endorsing, nor will I ever, a housing market that has days on the market at teenager levels. A teenager level means one of two bad things are happening:

1. We have a massive credit boom in housing which will blow up in time because demand is booming, similar to the run-up in the housing bubble years.

2. We simply don’t have enough products for homebuyers, creating forced bidding in a low-inventory environment. 

Guess which one we had post 2020? Look at the purchase application data above — we never had a credit boom. Look at the Inventory data below. Even with the collapse in home sales and the first real rebound, total active listings are still below 1 million.

From NAR: Total housing inventory registered at the end of February was 980,000 units, identical to January & up 15.3% from one year ago (850,000). Unsold inventory sits at a 2.6-month supply at the current sales pace, down 10.3% from January but up from 1.7 months in February ’22. #NAREHS

However, with that said, the one data line that I love, love, love, the days on the market, is over 30 days again, and no longer a teenager like last year, when the housing market was savagely unhealthy.

From NAR: First-time buyers were responsible for 27% of sales in January; Individual investors purchased 18% of homes; All-cash sales accounted for 28% of transactions; Distressed sales represented 2% of sales; Properties typically remained on the market for 34 days.

Today’s existing home sales report was good: we saw a bounce in sales, as to be expected, and the days on the market are still over 30 days. When the Federal Reserve talks about a housing reset, they’re saying they did not like the bidding wars they saw last year, so the fact that price growth looks nothing like it was a year ago is a good thing.

Also, the days on market are on a level they might feel more comfortable in. And, in this report, we saw no signs of forced selling. I’ve always believed we would never see the forced selling we saw from 2005-2008, which was the worst part of the housing bubble crash years. The Federal Reserve also believes this to be the case because of the better credit standards we have in place since 2010. 

Case in point, the MBA‘s recent forbearance data shows that instead of forbearance skyrocketing higher, it’s collapsed. Remember, if you see a forbearance crash bro, hug them, they need it.

Today’s existing home sales report is backward looking as purchase application data did take a hit this year when mortgage rates spiked up to 7.10%. We all can agree now that even with a massive collapse in sales, the inventory data didn’t explode higher like many have predicted for over a decade now.

I have stressed that to understand the housing market, you need to understand how credit channels work post-2010. The 2005 bankruptcy reform laws and 2010 QM laws changed the landscape for housing economics in a way that even today I don’t believe people understand.

However, the housing market took its biggest shot ever in terms of affordability in 2022 and so far in 2023, and the American homeowner didn’t panic once. Even though this data is old, it shows the solid footing homeowners in America have, and how badly wrong the extremely bearish people in this country were about the state of the financial condition of the American homeowner.

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SVB contagion: Australia purportedly asks banks to report on crypto

Australia’s prudential regulator has purportedly told banks to improve reporting on crypto assets and provide daily updates.



Australia’s prudential regulator has purportedly told banks to improve reporting on crypto assets and provide daily updates.

Australia’s prudential regulator has purportedly asked local banks to report on cryptocurrency transactions amid the ongoing contagion of Silicon Valley Bank’s (SVB) collapse.

The Australian Prudential Regulation Authority (APRA) has started requesting banks to declare their exposures to startups and crypto-related companies, the Australian Financial Review reported on March 21.

The regulator has ordered banks to improve their reporting on crypto assets and provide daily updates to the APRA, the Financial Review notes, citing three people familiar with the matter. The agency is aiming to obtain more information and insight into banking exposures into crypto as well as associated risks, the sources said.

The new measures are apparently part of the APRA’s increased supervision of the banking sector in the aftermath of recent massive collapses in the global banking system. On March 19, UBS Group agreed to buy its ailing competitor Credit Suisse for $3.2 billion after the latter collapsed over the weekend. The takeover became one of the latest failures in the banking industry following the collapses of SVB and Silvergate.

Barrenjoey analyst Jonathan Mott reportedly told clients in a note that the situation “remains stable” for Australian banks but warned confidence could be quickly disrupted, putting pressure on bank margins.

Related: Silvergate, SBV collapse ‘definitely good’ for Bitcoin, Trezor exec says

“Our channel checks indicate deposits are not being withdrawn from smaller institutions in any size, and capital and liquidity buffers are strong,” Mott said, adding:

“But this is a crisis of confidence and credit spreads and cost of capital will continue to rise. At a minimum, this will add to the margin pressure the banks are facing, while credit quality will continue to deteriorate.”

The news comes soon after the Australian Banking Association launched a cost of living inquiry to study the impact of the COVID-19 pandemic and geopolitical tensions on Australians. The inquiry followed an analysis of the rising inflation suggesting that more than 186 banks in the United States are at risk of a similar shutdown if depositors decide to withdraw all funds.

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Delta Move Is Bad News For Southwest, United Airlines Passengers

Passengers won’t be happy about this, but there’s nothing they can do about it.



Passengers won't be happy about this, but there's nothing they can do about it.

Airfare prices move up and down based on two major things -- passenger demand and the cost of actually flying the plane. In recent months, with covid rules and mask mandates a thing of the past, demand has been very heavy.

Domestic air travel traffic for 2022 rose 10.9% compared to the prior year. The nation's air traffic in 2022 was at 79.6% of the full-year 2019 level. December 2022 domestic traffic was up 2.6% over the year-earlier period and was at 79.9% of December 2019 traffic, according to The International Air Transport Association (IATA).

“The industry left 2022 in far stronger shape than it entered, as most governments lifted COVID-19 travel restrictions during the year and people took advantage of the restoration of their freedom to travel. This momentum is expected to continue in the New Year,” said IATA Director General Willie Walsh.

And, while that's not a full recovery to 2019 levels, overall capacity has also not recovered. Total airline seats available actually sits "around 18% below the 2019 level," according to a report from industry analyst OAG.

So, basically, the drop in passengers equals the drop in capacity meaning that planes are flying full. That's one half of the equation that keeps airfare prices high and the second one looks bad for anyone planning to fly in the coming years.

Image source: Getty Images.

Airlines Face One Key Rising Cost

While airlines face some variable costs like fuel, they also must account for fixed costs when setting airfares. Personnel are a major piece of that and the pandemic has accelerated a pilot shortage. That has given the unions that represent pilots the upper hand when it comes to making deals with the airlines.

The first domino in that process fell when Delta Airlines (DAL) - Get Free Report pilots agreed to a contract in early March that gave them an immediate 18% increase with a total of a 34% raise over the four-year term of the deal.

"The Delta contract is now the industry standard, and we expect United to also offer their pilots a similar contract," investment analyst Helane Becker of Cowen wrote in a March 10 commentary, Travel Weekly reported.

US airfare prices have been climbing. They were 8.3% above pre-pandemic levels in February, according to Consumer Price Index, but they're actually below historical highs.

Southwest and United Airlines Pilots Are Next

Airlines have very little negotiating power when it comes to pilots. You can't fly a plane without pilots and the overall shortage of qualified people to fill those roles means that, within reason, United (UAL) - Get Free Report and Southwest Airlines  (LUV) - Get Free Report, both of which are negotiating new deals with their pilot unions, more or less have to equal (or improve on) the Delta deal.

The actual specifics don't matter much to consumers, but the takeaway is that the cost of hiring pilots is about to go up in a very meaningful way at both United and Southwest. That will create a situation where all major U.S. airlines have a higher cost basis going forward.

Lower fuel prices could offset that somewhat, but raises are not going to be unique to pilots. Southwest also has to make a deal with its flight attendants and, although they don't have the same leverage as the pilots, they have taken a hard line.   

The union, which represents Southwest’s 18,000 flight attendants, has been working without a contract for four years. It shared a statement on its Facebook page detailing its position Feb. 20.

"TWU Local 556 believes strongly in making this airline successful and is working to ensure this company we love isn’t run into the ground by leadership more concerned about shareholders than about workers and customers. Management’s methodology of choosing profits at the expense of the operation and its workforce has to change, because the flying public is also tired of the empty apologies that flight attendants have endured for years."

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