"When patients do not take medicines as they should, there is a primary cost to their health of the illness not being properly treated. But there is also a secondary health cost when the original problem worsens and gets more expensive or even impossible to treat effectively," says Paul Anley, CEO of South African generics manufacturer, Pharma Dynamics.
Anley says the South African healthcare system could lose substantial millions of Rands unless the matter of patient compliance is addressed. "There are many reasons for non-compliance. Clinical trials have shown that side-effects and a complicated dosage regimen, such as having to take various different medicines at different times of the day, play a large role. However the cost of medicine is increasingly becoming a factor in the local context, where poor people are already straining and the cost of living spirals out of control for many."
Anley cites the example of the high cost of cardiovascular treatments to illustrate the multiple toll of non-compliance. The Heart and Stroke Foundation of South Africa estimates that premature deaths caused by heart and blood vessel diseases in people between the ages of 35 and 64 are expected to increase by 41% between now and 2030.
"Cardiovascular medication is often very expensive, and usually patients need to take more than one drug, especially when related conditions such as hypertension and high cholesterol, the so-called silent killers, are also present. When patients do not feel a physical manifestation of their illness, they are likely to cherry-pick which of their prescribed medication to take if cost becomes an issue," says Anley.
Anley says that the high cost of some cardiovascular drugs is the main factor behind non-compliance with treatment for this specific condition - a blow which the company has sought to soften by way of its patient assist programme, which, in line with international best practice, absorbs part of the dispensing cost for non-medical aid patients.
"It is essential that patients are able to access cost-effective treatment. Not only to assist the individual to maintain optimal health and make a productive contribution to society, but also to ensure that the public financial burden does not become unbearable," Anley concludes.
