A patient support programme (PSP) is a service, usually funded by a drug maker, that helps patients start and stay on a treatment. It can include nurse calls, injection training, reminders, help with insurance paperwork and financial assistance. PSPs are now common for biologics, cancer drugs, rare disease treatments and other complex or costly medicines.
The adherence problem
WHO reported that adherence to long-term therapy for chronic diseases averages only 50% in developed countries, and is lower in developing countries [1]. WHO called this a "massive, world-wide problem" and said better adherence could do more for health than many new treatments [1].
In the United States, a 2012 review in the Annals of Internal Medicine found that 20% to 30% of prescriptions are never filled, and about 50% of medicines for chronic disease are not taken as prescribed [2]. The authors cited estimates that non-adherence causes about 125,000 deaths and at least 10% of hospital stays each year, at a cost of $100 billion to $289 billion a year [2][3].
Why patients stop
- Cost: high co-payments lead people to skip or ration doses.
- Side effects: early side effects often cause people to stop without telling their doctor.
- Complex routines: injections, many pills or strict timing are hard to keep up.
- Feeling well: people with silent conditions, like high blood pressure, may not see the point.
- Doubts: patients may not understand why the medicine matters.
- Access: insurance approvals and pharmacy delays interrupt supply.
Silent conditions show the gap
High blood pressure is a clear example. WHO says about 1.4 billion adults had hypertension in 2024, and only about 23% had it under control [4]. Treatment works, but only if people keep taking it. Poor adherence is one of the reasons control rates stay low.
What a support programme offers
- Onboarding: a welcome call, an explanation of the treatment and what to expect.
- Access help: benefits checks, prior authorization support and appeals.
- Financial help: co-pay cards or free drug for eligible patients.
- Nurse support: injection training at home or by video, and help with side effects.
- Reminders: texts, apps or calls before doses and refills.
- Logistics: home delivery and cold-chain shipping for injectables.
What works
The 2012 review looked at 62 trials of patient, provider and system interventions [2]. It found that lowering patient costs improved adherence, and that case management and education helped for several conditions, including high blood pressure, heart failure, depression and asthma [2]. No single tool worked everywhere. Programmes that combine practical help with regular human contact tend to do better than reminders alone.
Concerns and rules
Because drug makers fund most PSPs, there are rules to keep them from steering prescribing. Programmes should not give medical advice that replaces the doctor, and patient data must be protected under privacy law. Side effects reported to PSP staff must be passed on to drug safety teams. Co-pay help can also raise questions about overall drug costs. Good programmes are open about who funds them and what data they collect.
Digital support
Many programmes now add apps, smart pill bottles, connected injectors and remote check-ins. These tools can flag a missed dose quickly. But they work best for people who are comfortable with technology. A phone call is still the most important tool for many older patients.
Key numbers at a glance
- Average adherence to long-term therapy: 50% in developed countries.
- 20% to 30% of US prescriptions are never filled.
- About 125,000 US deaths a year linked to non-adherence.
- Estimated US cost: $100 billion to $289 billion a year.
- Only about 23% of adults with hypertension have it controlled.
Questions to ask about a support programme
- Who funds it, and what data does it collect?
- Does it include a named nurse or case manager?
- What help is there with cost and insurance?
- How are side effects reported to my doctor?
- Can I leave the programme at any time?
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Common myths
- "Patients who stop are careless." Most stop because of cost, side effects or confusion, which support can fix.
- "Reminders alone are enough." Reviews show combined help with cost, education and follow-up works better [2].
- "Support is only for expensive drugs." Pharmacists and clinics can offer simple adherence help for any long-term medicine.
What this means
A medicine only works if people take it. Patient support programmes address cost, access and confidence, which are the main reasons people stop. The best programmes are transparent, patient-led and closely linked to the patient's own care team.
Where to read more
All figures in this article come from public sources listed below. For more detail, start with the WHO adherence report and the 2012 Annals of Internal Medicine review. Each is free to read online. If anything here raises a question about your own health, take this article to your doctor or pharmacist and talk it through together. Buyers, investors and policy makers can also use these sources to check claims in sales materials and compare options on the same public evidence. Where public sources disagree or update their figures, we note the year of each number so readers can see how the picture changes over time.
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Topics: Biologics and biosimilars · Digital health · Oncology
Sources
- WHO news (2003): Failure to take prescribed medicine for chronic diseases is a massive, world-wide problem
- Viswanathan M et al. Interventions to improve adherence to self-administered medications for chronic diseases in the United States (Annals of Internal Medicine, 2012)
- Brown MT, Bussell JK. Medication adherence: WHO cares? (Mayo Clinic Proceedings, 2011)
- WHO fact sheet: Hypertension
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The data behind this story
Topics: Biologics and biosimilars · Digital health · Oncology
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