Nearly half of patients with chronic conditions discontinue therapy within months, with the steepest adherence decline occurs in the first 90 days. This single challenge costs the U.S. health system over $300 billion annually in avoidable hospitalizations and complications. It is not because patients don’t care or can’t remember, but the system and barriers around them makes staying on therapy harder than it should be.
No two patients struggle for the same reasons, yet brands often respond with the same solution: more reminders and more education. But generic information alone doesn’t fix friction or the emotional weight of treatment. In moments of uncertainty, patients need a steady hand to hold and walk them through treatment.
Critical Barriers Driving Both Early and Long-Term Drop Off
Each of these barrier’s chips away at adherence in the short term and undermines persistence over the long term.
- Financial Friction: Even with assistance, unpredictable costs undermine persistence.
- Onboarding Gaps: The first 30–60 days often lack structured support to build confidence.
- Education Deficits: Patients who don’t understand “why” the therapy matters disengage early.
- Side Effect Concerns: Anticipated or experienced effects can cause rapid drop-off without proactive outreach.
- System Complexity: Prior authorizations, pharmacy delays, and refill hurdles create frustration.
Why the First 90 Days Are the Deciding Factor
Research shows that long-term persistence is largely set within the first three months⁴. This is a make-or-break moment of vulnerability for patients. It’s a fragile period when patients are learning how to integrate treatment into their lives, and where uncertainty can quickly turn into disengagement. Patients quietly decide whether therapy is compatible with their real life.
Pharma should treat onboarding as a distinct stage of the patient’s journey: offering staged pathways, predictive check-ins, and proactive affordability or side-effect interventions that catch risks before disengagement occurs. Supporting patients in the early weeks not only improves adherence but establishes the habits and confidence that sustain persistence over time.
Data Activation in Real Time
Waiting months to identify a lapsed patient is too late. Real-time signals matter. If a co-pay card is downloaded but unused, affordability support should be triggered immediately. If refill gaps appear, outreach must be personalized, not a generic reminder. This is the difference between communication and support. Brands must map the entire patient journey (inflection points, motivators, constraints) and uncover the root of emotional and psychological drivers that shape behavior. This deep dive reveals unseen forces that influence patients’ behaviors.
Understanding a patient’s individual concerns and condition-specific needs allows brands to deliver relevant interventions. Real-time data makes it possible to know where each patient is in their journey and respond with humanized marketing that reflects their emotional and logistical reality. Pharma must shift from being an information provider to being a journey partner: guiding, grounding, and reassuring patients at every friction point. Real-time intelligence is what makes this kind of hand-holding possible.
Shifting from Communication to Care
Driving persistence requires moving from product-centric messaging to service-oriented support experiences. Patient support programs should reduce barriers and simplify workflows, meeting patients where they are rather than forcing them deeper into the healthcare system.
For many patients, even the basics of care including getting an appointment, navigating insurance, waiting hours in a clinic, managing financial strain, create constant friction. Support programs must counter that friction with clarity, personalization, and simplicity. Trust and transparency, especially around cost, are essential.
The Payoff
- For Patients: Greater confidence, fewer setbacks, and the consistency needed to stay on therapy long enough to see meaningful results.
- For providers: Increased prescribing confidence backed by patients who follow through, report fewer challenges, and experience more stable outcomes.
- For pharma brands: Stronger real-world results, higher adherence and persistence, and long-term growth rooted in trust, not just acquisition.
At Response Media, we build adherence and persistence strategies that anticipate friction, intervene in real time, and meet patients at the moments that matter most. Real adherence is won before it is lost, and it starts by going beyond the prescription.
References: AHA (2024), IMS (2023), McKinsey (2024)
