Is this really your patient adherence curve?

Written by Al Kenney on 09 May 2016. Posted in Co-Pay Program Optimization


We have many clients who misinterpret reports and data from their copay program vendors. One of the most misinterpreted reports we see is this one showing copay card usage which is sent to clients by their copay vendors each month.

When asked about their adherence curve, many times clients send us this graph. They may also complain that their adherence curve doesn’t look as good as it should and they conclude that there must be something wrong with their copay program. We explain to them that the copay card usage information shown in this graph is not their adherence curve…at least not yet.

This report tracks how many times patients have been utilizing their copay offer on a program to date basis. It is important to remember that patients are entering the program each month while the program is still in effect. Each new patient using the copay card will be recorded in “Use 1” regardless of when they entered during the program’s effective dates. That patient will be recorded in the “Use 2” grouping if and when they use the card a second time. The counts of claims are actually laid on top of each other regardless of when the use actually occurred and that causes the confusion. For example: you have thirty three new patients come into the program this month counted as script #1, another twenty two who have filled twice (started last month) and then groups of patients that have filled three, four, five and six times.

Put them all together in one report and what do you get? You get a bunch of mush that is hard to interpret! A high first use number and low second use number may indicate that new patients have dropped therapy. Or, alternatively, those new patients may not yet have reached the point of needing a second or third fill (they may still be on their first script). Looking at this graph as a representation of the average patient’s adherence over time will cause you much anxiety!

Once the program is closed down and all of the patients have cycled through (6 months after the program is over), then the final version of this chart will give you a much better indication of what your adherence rates really look like. Until then, this report has very little value as a proxy for a brand’s adherence curve.