Breakthroughs in enhancing compliance

Journal of Family Practice, August, 2006 by Jeff Susman

It was my third phone call after registering and re-registering to no avail at the "customer-friendly" web site. There was the usual 15 minutes on hold and the transfers to endless voice mail options, none of which applied to my situation. Was I trying to secure a rebate coupon on my latest purchase? Upgrade my Windows software? Validate that lifetime rust-proofing on my car? Nope. Simply trying to refill my prescriptions.

Like many of you, I prefer to renew my prescriptions online, by phone, or by mail. And as I get older, I acquire chronic problems--minor conditions like diabetes and hypertension--that necessitate regular prescription renewals.

Well into the third hour of investigation, I was hot on the trail of my medication renewals. Now, if I could only remember which pet's name I gave (Gabby? Mouser? Rasha?) and the unique combination of at least 5 numbers, 3 letters, and a punctuation mark (not including "-'s"), I'd be all set. Let's see, I wrote those double-super-secret passwords on that file card and placed it on my desk somewhere ...

Finally, success--well, almost. There was the obligatory physician reauthorization, even though he had renewed this script only 4 months ago. And of course, that Humalog is a second-tier medication (maybe I should use purified pork insulin?).

OK, you get the picture.

It is no wonder many patients fail to renew their medications even once. It is no surprise our patients fail to achieve goals for the treatment of diabetes and hypertension. Instead of enabling health, we continue to assure patients have countless barriers placed in their paths. It is almost as if insurers and pharmacy benefit managers are making sure we don't use our benefits.

So here are a few simple practical suggestions for purveyors of medications. When your web site changes, why don't you notify your users of the new web address? Why not assure that the phone number on the back of our insurance cards gets us a live person who can provide useful information? How about allowing physicians to determine the length of renewal rather than making arbitrary decisions; and, after receiving initial approval, assume medications are needed on an ongoing basis. And at your web site, in addition to posting arcane prescription numbers, why don't you make it possible to simply check a straight-forward description of medications for renewal?

It's time physicians and other health professionals take a stand against such chicanery.

Jeff Susman, MD

Editor, JFP