Rethinking Medication Adherence: A Stakeholder Blueprint

Published May 12, 2025

ISPOR Report Showcases Key Stakeholder Views on Solving the 50% Medication Nonadherence Challenge

Lawrenceville, NJ, USA—May 12, 2025—Value in Health, the official journal of ISPOR—The Professional Society for Health Economics and Outcomes Research, announced today the publication of a report from its Medication Adherence and Persistence Special Interest Group that provides valuable insights into the perspectives of key stakeholders on interventions to improve medication adherence. The report, “Stakeholders’ Perspectives on Medication Adherence Enhancing Interventions: An ISPOR Report,” was published in the May 2025 issue of Value in Health.

"The prevalence of nonadherence to prescription medication can be as high as 50%," said author Bijan Borah, PhD, Professor of Health Services Research, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, and the current Chair of the ISPOR Special Interest Group on Medication Adherence and Persistence. "Besides being highly correlated with adverse health outcomes, medication nonadherence often leads to potentially avoidable healthcare utilizations, with associated annual adjusted costs per person ranging from $949 to $44,190 (2015 US$)."

Supplementing the findings from a recent systematic literature review that evaluated measures used in assessing medication adherence enhancing interventions, this Special Interest Group report summarizes the perspectives of stakeholders representing patients, manufacturers, providers, health technology assessment agencies, and payers. Each stakeholder is a key opinion leader in their respective field and is active in both research and practice.

Patient Perspective:
Patients emphasize that nonadherence may signal ineffective treatment rather than noncompliance. They advocate for personalized approaches based on individual socioeconomic factors and healthcare barriers instead of one-size-fits-all adherence interventions.

Manufacturer Perspective:
Manufacturers see improved adherence as critical for patient outcomes and regulatory approval. They invest in support programs and are increasingly using artificial intelligence to develop targeted, personalized interventions that address individual adherence barriers.

Provider Perspective:
Providers implement innovative adherence interventions guided by patient-centered approaches. They integrate health equity training, screen for social determinants, and participate in value-based contracts that reward improved adherence outcomes.

Health Technology Assessment (HTA) Perspective:
HTA evaluates how adherence interventions impact clinical outcomes and quality of life. Better evidence linking improved adherence to patient outcomes and cost-effectiveness is needed for informed funding decisions.

Payer Perspective:
Payers focus on reducing costs by improving adherence to common medications. They use data analytics to identify social determinants affecting adherence and implement performance incentives for providers based on adherence metrics.

While stakeholder interviews provide valuable insights, these perspectives may be limited to just one person representing the stakeholder group and therefore may not be representative of the broader group. However, the disparate nature of the different stakeholder perspectives underscores the need for medication adherence enhancing interventions to go beyond solely improving adherence rates but such improvement has to also demonstrate improved clinical outcomes, health-related quality of life, and potential cost savings.

The authors conclude that despite differences in what various stakeholders want to see in medication adherence enhancing interventions, “one thing we all agree on is that future studies should focus on quantifying the costs associated with medication adherence enhancing interventions’ implementation and how such costs are borne by different stakeholders; such studies will be crucial for large scale adoption and sustainability of medication adherence enhancing interventions."

About ISPOR’s Medication Adherence and Persistence Special Interest Group

Mission:
To stimulate research and evaluation on issues related to medication adherence, treatment persistence, and implications for health outcomes.

Background:
Medication nonadherence has a significant impact on patients’ morbidity and mortality. Behavioral interventions have been developed to improve medication adherence. Adherence research requires an understanding about the best methodology to conduct studies especially when assessing interventions. Adherence studies include various designs such as: randomized controlled clinical trials, observational, and quasi-experimental studies. Click here to learn more.

Further Reading

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ABOUT ISPOR
ISPOR
—The Professional Society for Health Economics and Outcomes Research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.
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ABOUT VALUE IN HEALTH
Value in Health
(ISSN 1098-3015) is an international, indexed journal that publishes original research and health policy articles that advance the field of health economics and outcomes research to help healthcare leaders make evidence-based decisions. The journal’s current impact factor score is 4.9 and its 5-year impact factor score is 5.6. Value in Health is ranked 5th of 118 journals in Health Policy and Services, 15th of 174 journals in Health Care Sciences and Services, and 56th of 597 journals in Economics. Value in Health is a monthly publication that circulates to more than 55,000 readers around the world.
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