The Best Drugs in the World Can’t Work Without Persistence

When the very programs designed to keep patients on therapy become obstacles, the downstream result is entirely predictable: patients simply stop.

There’s a long tail of friction that patients face after prescriptions are written, limiting the full effect of their medication. Because most patient support infrastructure was created to get patients to start — not stay on — therapy, patients encounter everything from barriers at access and confusion about financial assistance to impersonal or redundant outreach from disconnected sources. When this combines with the burden of self-managing medications (which includes overcoming low motivation and navigating complex regimens), the outcome is the erosion of persistence. Not only is persistence critical for optimal real-world patient outcomes, but it’s also vital for pharma companies to demonstrate the full value of their therapies.

The net effect of non-persistence

Staying on therapy is what produces the durable effect. This fragmented pharma patient journey and the lack of persistence harm everyone in terms of outcomes. Common challenges include:

• Complex dosing or administration
• Side effect burden or silent disease
• Patient financial barriers
• RWD/REW collection
• Low or no patient support

Studies have shown that poor persistence is associated with higher healthcare costs and poorer health outcomes, as well as increased disease prevalence and relapse.¹ Among patients with type-2 diabetes (T2D), a one-month increase in medication duration was associated with reduced risk of hospitalization due to stroke by 0.54%, acute myocardial infarction by 0.51%, and all-cause hospitalization by 0.36%.² The percentages look small, but when scaled across millions of people with lifelong T2D, they represent thousands of catastrophic event reductions per month of therapy.

For pharma companies specifically, poor persistence means real-world effectiveness data underperforms clinical trial results, refill revenues are lost, and brand reputation suffers — all while payers and policymakers question the value of treatments that aren't being taken correctly. Persistence in chronic conditions also provides pharma companies with a stable revenue source, as acute prescriptions are subject to outside forces. Over the five years following the start of the pandemic, acute prescriptions experienced significant disruptions, dropping 16% in 2020. In comparison, prescriptions for chronic conditions remained largely stable since 2019, with annual growth of about 1%, reaching 3% above baseline in 2024.³

The core problem: patients suffer within the gaps

Patients interact with multiple healthcare touchpoints, each adding complexity to the treatment process. From the patient's perspective, these aren't separate systems — they're supposed to be one seamless experience. Unfortunately, the inherent challenges of self-management are compounded by outdated technologies, siloed data, and manual processes that fail to meet today's patients' needs, driving gaps into the patient journey. Research has shown that low fill rates and lower persistence for new medicines are likely a result of significant barriers for patients to treatment through payer controls and often high costs.

To remedy the problem, companies stitch together hub, CRM, and copay programs, hoping the patchwork of point solutions will generate a cohesive, seamless experience. Unfortunately, the result resembles more of a “Franken-stack” than a connected infrastructure.

No one entity owns the patient relationship

When a separate hub handles access, a CRM handles outreach, and a third-party vendor handles copay, with no single entity providing a holistic view of where the patient is in their journey, it’s impossible for a manufacturer to identify patients at risk of abandoning therapy — let alone what they need next. The consequences include more than just drop-offs; they also bring delayed starts, frustrated patients and prescribers, and reputational and revenue impacts for manufacturers.

The ability to intervene at the right moment

Getting access to the right patient data at the right time is a game-changer — and it's the only way to stay competitive. It enables internal teams to make predictive recommendations or provide relevant information to help patients stay on treatment. To do this, pharma companies must discard their “Frankenstacks” in favor of an integrated blend of real-time data analytics, patient-centric support, and proactive, technology-driven interventions.