Two forum entries by patients in the multiple sclerosis section of the BrainTalk Communities Online Patient Support Groups for Neurology indicate that mistrust of a company that produces medications for the treatment of multiple sclerosis can “significantly affect drug adherence.”
The thread begins with a forum member’s posting of what appears to be the Biogen Idec press release describing the Global Adherence Project, a large-scale, international study of patient compliance with multiple sclerosis treatments. The press release included this quotation from the study’s lead investigator, Elliot Frohman, MD, PhD:
“Our analysis of adherence patterns thus far tells us that certain drug-related issues can significantly affect adherence in MS, including frequency of drug administration, medication side effects, as well as how effective the patient perceives their treatment to be.”
In response, another member of the forum lists “Other drug related issues that can significantly affect drug adherence in MS,” including
- A pharmaceutical company’s surreptitious recall of “tainted lots” of medications for the treatment of multiple sclerosis
- A pharmaceutical company misleading patients, pharmacists, and physicians about the reasons for a recall of “tainted lots” of medications for the treatment of multiple sclerosis
- The production and marketing of a new version of a medication for the treatment of multiple sclerosis without thorough research and, in effect, using patients who then took the medication as test subjects to evaluate side-effects
- Executives of a pharmaceutical company selling their privately owned stock in the company just prior to publicly announcing that a new medication has caused patients’ deaths
In the next posting in the thread, another participant in the forum extends the list of possible causes of “distrust of the medical community” to include
- Pharmaceutical companies charging “unwarranted” prices for essential medications.
- The prescription of the same medication to all multiple sclerosis patients in the face of the observation that these medications do not work for every patient
- The influence a physician’s “affiliations” [apparently with pharmaceutical companies] on the choice of medications prescribed
- The failure of the medical community to endorse a trial of alternative therapies for multiple sclerosis
- The suspect motives of Biogen’s support for the Global Adherence Project.
These are not the first, nor will they be the last, criticisms leveled against pharmaceutical manufacturers and their affiliated physicians, and I have no independent data supporting or refuting the particular allegations made by these forum participants.
I am, however, struck by the direct link specified by the forum members between mistrust of a pharmaceutical manufacturer and effect on adherence to medication produced by that manufacturer. While there is, of course, a plethora of literature relating compliance to a trusting patient-physician relationship, a good deal of advertising paying homage to the notion of the public nonspecifically trusting one or another company in the abstract, and there have been several cases of public concerns about the dangers of a specific drug decreasing its use, I cannot recall or, in a hasty search, find evidence of research exploring the direct impact of a pharmaceutical manufacturer’s corporate reputation among patients on those patients’ compliance with that corporation’s medications in a non-crisis situation..
It would be easy to dismiss this as simply a case of unhappy patients using adherence as a handy soapbox on which to rage against a pharmaceutical company being blamed for a portion of his or her suffering, and I doubt that most patients prescribed a medication for an acute condition (e.g., a patient prescribed an antibiotic for a urinary tract infection) would routinely consider the identity, let alone the reputation, of the corporation that produces and markets the drug. On the other hand, it does not seem incredible that a subset of patients, those suffering from a chronic, severe disorder who assiduously seek and follow medical research and other news pertinent to that disease, are aware of and react to the perceived trustworthiness of a company responsible for a medication that could greatly improve or gravely endanger their outcomes.
In any case, it would seem both foolish and dangerous for pharmaceutical companies to casually discount the possibility that their perceived integrity among these patients directly affects how these patients use the manufacturer’s medications, and research checking for correlations between shifts in a patient’s esteem for a pharmaceutical manufacturer and the patient’s adherence with the manufacturer’s medications might prove interesting.
