Understanding non-adherence
50%
of patients with chronic illness do not take their medication as prescribed
31%
of patients never fill
their first prescription
1/3
of patients stop their treatment earlier than recommended
€125bn
is Europe’s annual cost
of excess healthcare services
due to non-adherence
$637bn
in lost revenue for the pharma industry due to non-adherence
200k
of patients with treatable ailments are estimated to die each year in Europe as a result of poor adherence
10-25%
of all hospital and nursing home admissions are a result of non-adherence
50%
of patients with chronic illness do not take their medication as prescribed
31%
of patients never fill
their first prescription
1/3
of patients stop their treatment earlier than recommended
€125bn
is Europe’s annual cost
of excess healthcare services
due to non-adherence
$637bn
200k
of patients with treatable ailments are estimated to die each year in Europe as a result of poor adherence
10-25%
of all hospital and nursing home admissions are a result of non-adherence
Why adherence matters
Adherence, commonly defined as a combination of compliance (% of medication taken as prescribed) and persistence (duration of time the medication is taken for), and it is a critical determinant of treatment effectiveness.
But they confirm that a problem has occurred. They rarely explain why it occurred or when the behavioural shift began.
Healthcare system
Medication non-adherence increases the burden on the healthcare delivery system. It can lead to reoccurring hospitalisations and higher per-patient expenditure, increased morbidity as well as higher pay-outs by insurance companies to the insurer.
Patients
Forgetting or skipping medication is common amongst patients, putting them at an increased risk of morbidity and mortality. A decrease in treatment effectiveness due to non-adherence can lead to longterm adverse effects and financial consequences.
Pharmaceutical industry
Medication non-adherence has a significant impact on drug sales and has been estimated to globally bring an annual loss of $500 billion to pharmaceutical companies. It can influence the perceived brand value of drug manufacturers as therapy effectiveness is called into question with poor outcomes in non-adherent patients.
What drives medication non-adherence?
Medication non-adherence is not random. It emerges from interacting psychological, practicaland systematic factors.
Beliefs shift and motivation is not linear. Cognitive load accumulates over time, side-effect tolerance changes (usually diminishes) and life context evolves. These are dynamic behavioural states and most healthcare systems are unable to observe how these states change over time.
Please select a card to learn more.
FEAR
Patients may become apprehensive about side effects. Fear alters engagement behaviour gradually. Early hesitation can evolve into skipped doses or even complete discontinuation if not detected and addressed early on.
COST
Financial burden can create a silent barrier to adherence. Patients may reduce dosage frequency or delay refills long before complete discontinuation becomes visible.
MISUNDERSTANDING
When patients do not fully understand the purpose of medication, expected timelines and side effects, motivation can weaken.
Confusion does not always result in immediate non-adherence but it can gradually erode behavioural consistency.
TOO MANY MEDICATIONS
As the number of prescribed medications and dosing frequencies increases, behavioural complexity rises. Cognitive load increases over time and routines become harder to maintain.
LACK OF SYMPTOMS
When patients do not feel immediate improvement or don’t experience symptoms at all, the perceived necessity of treatment may decline. Over time, reduced perceived benefit can destabilise engagement.
WORRY
Patients may have concerns about dependency, long-term effects and even lifestyle impact when on therapy. These factors may influence decision-making and as concerns often fluctuate, adherence behaviour may also change over time.
DEPRESSION
Depression and emotional distress can reduce energy and routine consistency. Even patients with initial adherence intentions may struggle to maintain stable engagement.
MISTRUST
Patients may be skeptical towards a doctor’s prescribing decision or even the healthcare systemas a whole. Mistrust may not appear immediately but progressively over time and weaken adherence.