Why has patient adherence to Pfizer's Eliquis anticoagulant declined by 8% among US patients aged 65+ in the last 6 months?

Introduction

The decline in patient adherence to Pfizer's Eliquis anticoagulant among US patients aged 65+ by 8% over the last 6 months is a critical issue that demands immediate attention. This analysis will systematically identify, validate, and address the root cause while considering both short-term and long-term implications for patient health and product success.

I'll approach this problem by first clarifying key details, ruling out external factors, and then diving deep into product understanding, metric breakdown, and data analysis. From there, I'll form hypotheses, conduct root cause analysis, and propose validation methods and solutions.

Step 1

Clarifying Questions (3 minutes)

• Looking at the timing, I'm thinking there might be seasonal factors at play. Have we seen similar declines in adherence during this time of year in previous years?

Why it matters: Seasonal patterns could indicate external factors rather than product issues. Expected answer: No significant seasonal patterns observed in previous years. Impact on approach: If seasonal, we'd focus on supporting patients during specific times; if not, we'd look deeper into product or market changes.

• Considering the age group affected, I'm wondering about changes in Medicare coverage. Has there been any shift in Medicare policies or reimbursement rates for Eliquis in the past year?

Why it matters: Changes in coverage could directly impact adherence for this age group. Expected answer: No major changes in Medicare policies affecting Eliquis. Impact on approach: If policy changes exist, we'd need to address affordability; if not, we'd focus on other potential barriers.

• Given the specific 8% decline, I'm curious about our data collection methods. Has there been any change in how we measure or define adherence in the last 6 months?

Why it matters: Ensures we're comparing apples to apples and not facing a data anomaly. Expected answer: No changes in adherence measurement methodology. Impact on approach: If measurement changed, we'd need to reassess our data; if not, we can trust the decline is real.

• Thinking about product changes, have there been any modifications to Eliquis formulation, packaging, or dosing instructions in the past year?

Why it matters: Product changes could affect patient experience and adherence. Expected answer: No significant changes to the product itself. Impact on approach: If changes occurred, we'd investigate their impact; if not, we'd look at external factors or patient perceptions.