Coping with chronic diseases and compliance to treatment has been crucial for managing chronic illnesses and achieving better health outcomes, yet it continues to remain a significant challenge. According to the World Health Organization (WHO), less than 50 percent of patients adhere to their medication regimens as prescribed. This has resulted in substantial clinical and economic burdens, including increased hospital admissions, higher morbidity and mortality rates, escalated healthcare costs, and reducing patient health outcome and quality of life.
A science-based, personalized, customized methodology builds need-based adherence interventions, as reminders alone are insufficient for ensuring long-term adherence. By studying real-world insights and data early on, Axios’ experts design and implement successful interventions that are tailored to individual needs with elements of personalization and customization. These interventions typically integrate reminders within a broader ecosystem of support, including but not limited to educational, motivational, and behavioral strategies in patient support programs.
Studies have shown that multifaceted interventions, which address various dimensions of adherence, are more effective than single component interventions. A key to the success of these interventions is building a caring relationship and understanding the patient’s situation and needs through validated methodology – a unique approach adopted by Axios International. Axios’ experts and patient care team provide care based on personalized adherence support plan, often empowering individuals to take responsibility in managing their condition and adopting positive behavior toward their health.
Stock image: A caring approach influences individuals to take responsibility in managing their condition
Adherence is influenced by multiple dimensions, key among which are those related to specialized healthcare professional and system that seamlessly connects this care to patients no matter where they are, access to the full course of treatment, socioeconomic, and other condition factors surrounding the patient.
“These diverse elements require comprehensive and science-based strategies and methodology to design adherence interventions that are tailored and need-based,” says Dr. Anas Nofal, Chief Business Officer at Axios International. “It isn’t enough to simply know what is required for proper adherence; one must also thoroughly understand and address all major factors that directly impact the decisions for long-term adherence. Hence, a 360-degree approach to patient care is important,” he adds.
After diagnosis, patients often lapse in adhering to treatment regimens. By providing access to maximized adherence solutions through the Patient Support Programs (PSPs) we manage, Axios always aims to create an integrated ecosystem of care and treatment by looking at the patient journey holistically. Patients receive 360-degree support from the Axios Program team, who engage and enable them through interventions like education, awareness, and the enablement of coping mechanisms for their condition with shared decision making. Axios’ agile and multi-disciplinary experts ensure the much-need care is delivered through these personalized interventions.
Stock image: Studies show personalized approach helps in implementing successful adherence interventions
Once patients are referred to a patient support program managed by Axios, the patient care team at the CareLine hub ensures that patients’ needs are met individually. Using Axios’ validated and proprietary tool, the Patient Needs Assessment Tool (PNAT), the specialized patient care team then customizes a tailored service solution for patients and develops a personalized adherence support plan.
The success of Axios’ adherence interventions is measured and reflected through an increase in treatment compliance rate, decrease in patient dropout rates, and increased stay on treatment which ultimately improves health outcomes.
Access to healthcare is not just a need—it’s a matter of survival. Yet, in many parts of the world, millions of people are unable to access their treatment due to affordability challenges. From Latin America to Asia to the Middle East and Eastern European regions to Sub-Saharan Africa, treatment affordability is shaped by a complex web of factors, including economic disparities, healthcare systems, governance structures, and geographic barriers.
To make some innovative and high-cost treatment more accessible for patients, Axios International takes a systemic and novel approach – from strategy to implementation – to design impact-driven creative access strategies that outline market access decisions.
But what are the primary barriers that prevent people from accessing treatment globally?
“The first point is the cost of treatment. There will always be a level of new innovative treatment that, regardless of the affordability of the person, will be challenging to complete the full cost,” says Omer Karfis, Global Head Access Solutions at Axios International.
“Secondly, when you look at the average income or GDP of almost 70 percent countries in the world, you will find that people cannot afford medication especially for chronic diseases. Lastly, not all countries have a health coverage that can bear the costs for high-cost treatment,” he adds.
In many parts of the world, including dynamic economies, the challenge of treatment affordability is compounded by vast geographic distances, infrastructure, shortage of healthcare funding, and the evolving cost of new and innovative treatment which reflects in the high cost of that treatments ultimately leading to disparity in access to care.
Using the Affordability and Economic models, Axios evaluates the development and implementation of a sustainable access strategy based on the country needs, country landscape, and other factors that contribute in choosing the most suitable model to be implemented.
The Affordability Model is used to measure the patient’s ability to share part of the cost for their treatment plan. The model is real demonstration for a contribution of different stakeholders with one goal which is supporting patient, in that each stakeholder participate based on their ability even patient who share part of their treatment cost based on their affordability.
Stock image:Everyone talks about equality, but we talk about affordability and equity
Axios has addressed the problem by designing innovative cost-sharing affordability models based on geographic and economic indicators. “Implementation of affordability models in high-income countries is not suitable for a low-income population. For instance, in some countries where the average affordability is around $500 per year, the models must be designed to accommodate such financial constraints. This requires a strong collaboration among multiple stakeholders, including charities to ensure that the support system remains sustainable and effective,” he explains.
“Everyone talks about equality, but we talk about affordability and equity. We usually say one size doesn’t fit all but with an experience of 27 years designing such solutions, you will find that the most successful model was the cost sharing model based on affordability solution,” says Omer.
Stock image:The global challenges of treatment affordability are vast and multifaceted, but they are not insurmountable
Meticulous process of designing an access model
The practical application of these models involves a meticulous process of design, evaluation, and continuous improvement. It begins with a thorough study to ensure the model aligns with the specific needs of a region to be sustainable. Once implemented, the model is continuously monitored and updated to reflect changes in economic conditions, healthcare systems, and patient needs. Feedback from patients, healthcare providers, and other stakeholders is vital in this process, allowing for necessary adjustments to maintain the model’s relevance and effectiveness.
The core of these affordability models lies in patient-centric design and execution, ensuring that the system is not only sustainable but also compassionate and responsive to the needs of all stakeholders involved in a compliant manner.
“When Axios introduced the novel concept of making treatment more financially accessible by having patients pay what they can afford while pharmaceutical companies and other stakeholders cover the rest, it marked a significant shift in access to healthcare. The approach centered on collaborating with pharmaceutical companies to ensure their medicines reached patients regardless of affordability issues,” adds Omer.
As healthcare budgets become tighter globally, many countries are increasingly relying on innovative financial models and tailored cost-sharing initiatives to ensure that patients can access the treatments they need.
Studying a diverse approach
The global challenges of treatment affordability are vast and multifaceted, but not insurmountable. By studying the diverse approaches taken by countries around the world through Real World Insights (RWI), we can learn valuable lessons about what works—and what doesn’t. Axios utilizes RWI through its programs when they are implemented which helps improve and optimize the programs to better address the evolving patient needs.
“The traditional access models e.g. buy X get Y free are not effective as they leave a lot of patients behind and may be perceived as a marketing tool rather than access strategies by key stakeholders,” says Valeriia Mykolaienko, Senior Consultant at Axios International.
She adds: “We create solutions that work and fully address the local context and business priorities, ensuring patient needs are met.”
Axios CEO Joseph Saba will join healthcare business leaders from around the world next week in Shanghai, China, to discuss the “Challenges and Opportunities of Global Market Access for Pharmaceuticals,” including emerging and developed markets.
Location: To join the discussion, email axios@axiosint.com to request your invitation and join via Weblink.
What will be discussed? Organized by the China Europe International Business School (CEIBS), Dr. Saba will share his insights from 30+ years of experience designing and implementing access programs in low- and middle-income countries during a panel on access challenges in emerging markets. Panelists will explore innovative access to treatment models – including patient assistance programs and differential pricing – as well as China’s access experience, learnings and opportunities to date.
Panelists include:
Paola Barbarino, CEO, Alzheimer Disease International, London, UK
Prof. Ding Jinxi, Executive Deputy Dean of Graduate School of Chinese Pharmaceutical University, Nanjing, China
Jon Fairest, Head of Global Health Unit, Sanofi, Paris, France
Dr. Joseph Saba, CEO, Axios International, Paris, France
Dr. Wu Xiaobin, President and COO, BeiGene, Shanghai, China
Moderator:Eric Bouteiller, Adjunct Professor, China Europe International Business School, Shanghai, China
In addition, a separate panel will be held to discuss how to access the latest innovations in developed markets, including access challenges in precision medicine, diagnostic and digital tools to improve outcomes and the role of patient organizations
Panelists include:
Christoph Glaetzer, Chief Global Value and Access Officer, Johnson & Johnson Innovative Medicine, New Brunswick, NJ, USA
Francois Houÿez, Information & Access to Therapies Director & Health Policy Advisor, EURORDIS, Brussels Belgium
Professor Hiroshi Nakamura, Dean, Keio Business School, Tokyo, Japan
Moderator:Annie Chicoye, Senior Lecturer, Sciences Po Paris, France
Why this matters: Pharmaceutical innovation is accelerating, but effective access to these innovations is not following the same pace. While issues in emerging markets and more developed countries may differ, both face significant treatment challenges. Shanghai, the world’s second-largest pharmaceutical market, is an ideal place to discuss these issues, thanks to China’s rapid progress in pharmaceutical innovation and economic development.
CEIBS is a business school co-founded in 1994 by the Chinese government and European Union, with campuses in China, Europe and Africa; its Global EMBA program was recently ranked #1 in the Financial Times’ 2024 EMBA rankings.
Healthcare services are rapidly evolving and moving to digital formats when it comes to services outside the physical environment. A popular part of this growth is the rise of mobile health (mHealth) apps which play a key role in healthcare automation. However, as the world digitalizes, a pertinent question arises: do patients truly want these apps to track their healthcare?
Recent trends suggest that the answer is a resounding yes, especially when these apps are designed to meet specific patient needs and concerns. Mobile health applications, electronic health records, telehealth, telemedicine, and wearable devices enable patients to monitor their health, allowing physicians to detect potential health issues early, and develop personalized treatment plans based on the patients’ own data and health history.
Jean-Noel Saba, Digital Health Manager for Axios+ at Axios International says that digital health tools have truly transformed the way we manage our health. “By tracking our health data, we can become more proactive about our well-being, making informed decisions that can lead to better health outcomes. It’s not just about improving efficiency or cutting costs; it’s about giving patients the power to take charge of their health journey. This patient centered approach – upon which Axios+ is built – is key to making a difference in our patients’ day-to-day lives and long-term health,” he says.
Stock Image:While interest in health apps is high, patients are increasingly particular about the apps they use and how those apps, in turn, use their data
Increased usage and interest
Concurrently, the use of mHealth apps to access medical records and manage health is rising. In the US alone, the HealthIT.gov reports an increase in app usage to access medical records, with 51 percent of individuals doing so in 2022, up from 38 percent in 2020. The growing reliance on digital tools for health management is clear in daily life, with patients finding these apps convenient for frequent access to their health information.
While the interest in health apps is high, patients are increasingly particular about the apps they use and how those apps, in turn, use their data. Nishapa Leeleartkij from Thailand is an ulcerative colitis patient who is enrolled in the Axios International’s Patient Support Programs (PSPs). Since her diagnosis a few years ago, the 45-year-old has been using digital apps to monitor her condition, “I use different apps for different purposes. Some help me to understand the patterns of my medical condition, so I can better manage my lifestyle and treatments to prevent or minimize flare-ups. So many apps are available for patients to choose from, so the key is to find the best one that suits your needs.”
Patients worry about data breaches
Concern is paramount for patients when it comes to digital healthcare tracking, data privacy, and security. Despite healthcare institutions and data owners implementing stringent security measures when storing and managing data, patients worry about data breaches and unauthorized access to sensitive health information, thus preventing some from embracing digital health trackers.
Additionally, patients can easily experience information overload with social media and internet search engines providing health information on demand. So, it is crucial for physicians and other healthcare providers to not only present data in a format that patients can easily understand but also anticipate questions about their condition and debunk untruths patients may encounter online. Those who are less comfortable with technology might find digital health tracking intimidating or cumbersome to navigate without training or support from health tech providers.
Nishapa shares, “I have struggled with some of the more complicated app usage and data upload instructions in the past, which has prevented me from utilizing digital health tracking apps more effectively. I tend to shy away from those that do not have adequate, clear instructions on how to upload my health data.” With apps and ease of access to digital services now second nature, a significant majority of patients strongly desire to manage their health digitally. According to PYMNTS.com, a digital data platform, 76 percent of patients show interest in using digital methods, including apps, to track their health. This interest is particularly pronounced in younger generations, given their propensity to receive healthcare insight and education from social media applications on the go and who are even willing to switch healthcare providers for better digital health management options. The convenience of digital interactions for appointment reminders, test results, and communication with providers is highly sought after, reflecting a shift towards a more tech-savvy patient demographic.
In Mexico, patients’ perspectives on using mobile apps for health care monitoring are mixed. A study conducted in 2023 by the specialized portal Doctoralia revealed that 65 percent of respondents use some type of mobile technology to manage aspects of their health, such as medication reminders or virtual consultations. However, only 42 percent of them were completely satisfied with current applications due to concerns about data privacy and the accuracy of the information provided.
Graciela M., a patient with type 2 diabetes from Mexico City, says: “The apps help me to monitor my glucose levels, but I am always afraid that my data could be used without my consent, and I feel that the data about my disease is only of interest to me, my family and my doctor.” This feeling is common among users, who fear that their personal data could be shared with third parties without their knowledge. On the other hand, other patients value the convenience and access to these apps’ real-time information, allowing them to better manage their health.
Stock Image: Concern is paramount for patients when it comes to digital healthcare tracking, data privacy, and security
Consumers driving future of healthcare
Dr. Karen DeSalvo, Chief Health Officer at Google Health, emphasizes that “the future of health is consumer driven. People will expect a mobile-first experience with more personalized insights, services, and care.” However, the success of these apps hinges on their ability to align with consumer expectations and provide a seamless user experience. Jean-Noel adds, “While the benefits of digital health tracking are clear, there’s still room for improvement. Health tech providers need to focus on making their solutions user-friendly, offer solid tech support, and prioritize stronger data security and privacy. By addressing these areas, we can help more patients feel comfortable and confident in embracing digital health solutions as a whole.”
The potential benefits of these tools are immense, empowering patients to take charge of their health. However, for digital health tracking to be widely embraced, healthcare providers and tech companies must address issues like data security and ease of use. By doing so, they can create a future where digital health tools are not only.
When it comes to healthcare communication between doctors and patients in a digitally saturated world, phone calls continue to play a critical role and offer that very special touch. Despite advancements in telemedicine and digital health platforms, the healthcare industry and healthcare providers are the last to adopt the technological advancements of digitalization. Hence, in urgent cases, direct phone communication is still the preferred method for doctors when contacting patients. This preference is rooted in several practical, cultural, and logistical factors, making phone calls indispensable to patient care despite the digital surge that offers 24/7 connectivity.
Phone calls in healthcare settings offer practical advantages over many forms of communication we now take for granted. They provide immediacy and directness, which can be crucial in medical situations. For example, post-discharge, personalized follow-up calls help ensure that patients and caregivers understand their care instructions and medication regimens and, in the process, reduce the risk of complications and readmissions.
Preference for phone could be based on regional preferences too. For example, the Middle East caters to more than 100 languages and cultures in a smaller area due to migration and expatriate working populations, sometimes making it difficult for relevant communications to reach all. In such cases, direct phone calls facilitate clearer communication and understanding as compared to written messages which may not be able to convey the emotion or the personal touch that a phone conversation does. Doctors speaking in a way that the patient understands provides two-way communication, allowing for a personal check-in and a more personalized approach. Phone calls provide a personal touch that can help build trust and rapport between doctors and patients, especially for managing chronic conditions and ensuring compliance with treatment plans. For example, doctors and healthcare staff regularly use phone calls to follow up with patients, especially those in remote areas. This practice helps monitor the patient’s health status and address any immediate concerns without the need for a physical visit. That said, being digitally connected in healthcare is of paramount importance as the world moves on to Artificial Intelligence and beyond.
Stock Image: Axios International believes in redefining healthcare by striking the perfect balance between cutting-edge digital access and the warmth of human interaction
How Axios International provides the human touch
Axios International believes in redefining healthcare by striking the perfect balance between cutting-edge digital access and the warmth of human interaction. While Axios’ digital health ecosystem, Axios+ enables patients to connect to the healthcare and treatment they need at every step of their treatment journey, where patients enrolled in the Axios-managed Patient Support Programs (PSPs), prefer us getting in touch with them on a personalized phone call via Axios CareLine, or through our home care visits, our commitment to providing healthcare with warmth and familiarity sets us apart in the industry.
A study by Axios International and published in the Journal of Comparative Effectiveness Research shows that the potential benefit of phone-based programs to support patients with chronic disease treatments should be explored in less developed countries. Titled “Phone contacts and treatment discontinuation predict survival cancer patients in a subsidized drug access program,” the study includes 460 patients from Egypt, Malaysia, Mexico, Peru, Philippines, Thailand and Ukraine. The study shows that patients who were contacted by telephone as compared to email, during their treatment were more likely to stay alive at the end of the study. Results also show that of the total patients included in the study, phone-based patient support had a protective effect and lowered the mortality risk by 11 percent as compared to other messaging methods and emails. According to the study, reaching out to patients by phone helped them stay on their cancer medication by making sure they were supported in managing side effects or scheduling appointments which helped them live longer as compared to those who were contacted via emails.
While digital solutions play a vital role in improving healthcare outcomes, Axios recognizes that the essence of healthcare lies in the human touch, compassion, and empathy that define the patient-caregiver relationship.
Logistical convenience
The logistical convenience of phone calls cannot be overstated. The calls are immediate and do not require the same level of technological infrastructure as video calls or digital consultations. Almost everyone has access to a telecommunication device with a personal number. This is particularly relevant in areas with limited internet connectivity or populations less comfortable with digital technology, including the more medically vulnerable, such as the elderly and special needs population.
Stock Image: While phone calls remain a traditional method of communication, they are increasingly being integrated with modern technology to enhance their effectiveness
Modern technological advancements are now integrated
While phone calls remain a traditional method of communication, they are increasingly being integrated with modern technology to enhance their effectiveness. Many healthcare providers now use apps that provide a secondary phone line for patient interactions, maintaining boundaries, and managing calls efficiently without compromising personal privacy. These tools support text messaging and voicemail, making communication more convenient and streamlined. An upcoming trend is that, if not most, major healthcare organizations now integrate their direct dialing within Google search results, instantly connecting with the hospital, clinic, or doctor instead.
In a place where direct communication is highly valued, phone calls offer a personal and reliable way to connect doctors and patients. Harmonizing two crucial elements – digital and the human touch – is the way forward to reshaping the future of healthcare.
There was a time when access to healthcare was not a priority on the global public health agenda. In fact, until the late 20th century, the idea of “access” was historically understood as a strictly physical issue – like the access you need to get into a special exhibit at your local museum. What changed and what does it mean for the future of patient health?
The HIV/AIDS epidemic opened the world’s eyes to the consequences of access inequities.
In the 1980s and 1990s, the HIV/AIDS epidemic devastated communities worldwide, with sub-Saharan Africa bearing the brunt. The epidemic exposed severe inadequacies in healthcare systems, particularly in resource-limited settings. Life-saving antiretroviral treatments (ART) were available, but only to a privileged few in more developed countries. For millions in Africa and other developing regions, these treatments were out of reach due to high costs, limited distribution networks, and at times, a lack of political will to address the crisis comprehensively.
No previous health crises highlighted the disparities in healthcare access more starkly than the HIV/AIDS epidemic. The HIV/AIDS crisis underscored the devastating impact of inadequate access to healthcare, sparking a global awakening that forever changed public health.
Stock image: The HIV/AIDS crisis highlighted the urgent need for equitable healthcare access, transforming public health forever.
Early pilot access programs showed that treatment access was feasible around the world.
At a time when the healthcare access debate was in its infancy, Axios International recognized that equitable access to quality medicines and services was crucial for combating the HIV/AIDS epidemic, and future health crises to come. For that reason, Axios was founded in 1997 with a mission to improve access to healthcare for underserved populations. That same year, in collaboration with UNAIDS, we designed what would become the first access to treatment program for low- and middle-income countries (LMICs) called the Drug Access Initiative (DAI). Working in close collaboration with pharmaceutical companies, DAI offered ARTs at discounted prices and facilitated their distribution in regions hardest hit by HIV/AIDS, enabling both treatment availability and accessibility.
The DAI pilots weren’t just small-scale studies of ARV introductions in LMICs. They were proof-of-concept for an idea that had never been tried before. DAI increased access to treatment at a critical time. Importantly, it also showed the world that it was possible to make quality medications accessible in LMICs. DAI was the first time access was used in the context of medicine.
These early efforts were instrumental in shifting the public health agenda towards a focus on healthcare access. The success of these initiatives demonstrated that with the right strategies, it was possible to deliver life-saving treatments to even the most marginalized populations. This paradigm shift laid the groundwork for subsequent global health campaigns and policies, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and many other public and private initiatives for HIV/AIDS and other diseases.
Skyrocketing chronic disease rates put a significant burden on existing healthcare delivery mechanisms, growing the need for access to healthcare solutions.
Fast forward to the 21st century, chronic and non-communicable diseases have surpassed infectious diseases as a leading cause of death around the world. As rates of these diseases increase quickly, the burden on the healthcare system is significant. Whether it’s governments struggling to cover the cost of new specialty medications for chronic disease patients, overworked healthcare providers, or overcrowded hospitals, the chronic disease epidemic is resurfacing many of the same issues first faced during the HIV/AIDS epidemic.
As a result, healthcare stakeholders are being forced to prioritize alternative mechanisms to improve access to quality care and treatment, such as innovative treatment financing models and adherence support models to address affordability issues and minimize the burden on providers and health facilities.
Stock image: surge of chronic diseases strains healthcare delivery and demands for better access to healthcare.
Why It Matters
As we reflect on the journey from a time when healthcare access was not on the public health agenda to today’s more holistic approach, it is clear that the work initiated during the height of the HIV/AIDS epidemic was transformative. The evolution of healthcare access from a neglected issue to a central tenet of the global health agenda showed us:
The importance of thinking outside the box. When DAI first launched, few thought it was possible – but today, that one program inspired a much bigger access to healthcare movement.
The need to think ahead. When it comes to healthcare, we can’t afford to act only once the issue is already out of control (as was done during the HIV/AIDS epidemic). We need to look around corners and be proactive with our solutions.
The importance of collaboration. Much of what we were able to accomplish during the HIV/AIDS pandemic resulted from a shared sense of urgency, and a willingness to collaborate to find solutions fast. No one person or group can overcome today’s access challenges alone. We must be willing to collaborate cross-sector and cross-industries to achieve real change.
The fight for healthcare equity is far from over, and it’s important that we keep these reflections in mind as we continue to innovate and advocate for equitable healthcare, and move closer to a world where access to quality healthcare is a reality for all.
According to the World Health Organization (WHO), adherence is ‘the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes – corresponds with agreed recommendations from a healthcare provider.’
Patients’ adherence to prescribed treatments can positively influence their illness’ long-term outcomes and prognosis. Conversely, non-adherence can lead to repeated hospitalization incidents or physician consultations, lower quality of life, medication waste, and increased healthcare costs. In most cases, non-adherence may lead to disease progression.
Low adherence is a leading problem worldwide, especially in patients with chronic diseases that require long-term management, such as diabetes mellitus, hypertension, cardiovascular disease, and cancer in low-and middle-income countries (LMICs), adherence among patients suffering from chronic diseases averages about 50 percent, with even lower numbers reported in developing countries.
Barriers to adherence to treatment
Various factors contribute to non-adherence, broadly divided into five domains or dimensions, as defined by WHO: socio-economic, health system or systemic, therapy-related, condition—or illness-related, and patient-related. “Socio-economic factors, such as the high cost of medications, lack of social support, and living far away from hospitals are some of the key challenges patients face, which can contribute to low adherence in patients. These are further compounded by other factors that may be unique to specific illnesses or individual circumstances in different regions,” says Dr Joseph Saba, the Chief Executive Officer and Co-Founder of Axios International.
Let’s look at cardiovascular disease (CVD) as an example. The leading cause of morbidity and mortality globally, CVD accounts for about 17 million (30 percent) deaths annually and is expected to increase to over 23.3 million by 2030. Although the CVD epidemic has begun to recede in some high-income countries (HICs), CVD mortality rates in LMICs continue to rise to about 300 to 600 CVD deaths per 100,000 population every year. A key factor driving these rates is sub-optimal adherence to medications for the prevention and treatment of CVD. Adherence to CVD medications in emerging economies is challenged primarily by limited health resources, socioeconomic barriers, and inequities in access to healthcare.
Dr Navin Sukilan, consultant cardiologist from Subang Jaya Medical Centre (SJMC) in Malaysia, says, “Adherence is a big issue in hypertensive patients. In younger patients who are pre-hypertensive or in Stage 1 of hypertension, we usually prescribe lifestyle modifications and regular monitoring of blood pressure. However, patients who present with Stage 3 hypertension or blood pressure reading of more than 160, have a higher risk of organ damage and complications such as heart attack or stroke, where we prescribe medications immediately.”
“To control their blood pressure effectively, hypertensive patients must take a few different medicines over a prolonged period. The increased pill burden is a significant challenge in medicine adherence. Other factors include low tolerance to side effects of the medicines and misinformation. They often obtain false information regarding the adverse effects of taking certain medicines for the long term through social media and chat apps such as WhatsApp, despite scientific data proving otherwise. Even highly educated working professionals believe these messages make adherence to medication even more challenging,” adds Dr Navin.
Stock Image: Improving adherence is a complex issue that involves different factors and multiple stakeholders
Improving medication adherence
One American study found that if patients took their drugs as directed, it could avoid up to 23 percent of nursing home admissions, 10 percent of hospital admissions, physician visits, diagnostic tests, and unnecessary treatments.
Although interventions to improve medication adherence have been introduced in high-income countries for patients with CVD, a 2021 study found that they are still at a nascent stage in LMICs. Strategies such as patient education, medication regimen management, fixed-dose combination medications, consultation with clinical pharmacists, and team-based care have been shown to have some success, but due to their cost, may be unsuitable for the health systems of many LMICs.
“Fixed-dose combinations have recently become available to hypertensive patients in Malaysia. These medicines consolidate two or three drugs into just one pill, which reduces the number of medicines patients must consume and improves adherence. However, the drug is available only in limited supplies outside of private hospitals here and is quite expensive, which impacts the ability of some patients to stay on long-term treatment. When a patient visits a government clinic or hospital for follow-ups and refills, they are usually unable to obtain the fixed-dose combination and have no choice but to revert to their former three-pill treatment regimen,” explains Dr Navin.
Strategies such as cognitive-behavioral therapies and electronic pill monitoring with text messages, automated refill tracking of in-patient electronic records or email alerts to a provider for missed refills, although widely used in HICs, have not been sufficiently adapted for use in LMICs, often due to cost limitations. Reminders to take medication via phone calls, text messages, Short Message Services (SMS), or in-phone calendars were some of the most common adherence interventions in LMICs. The study also found that reminders were more effective when they were personalized or interactive rather than generic.
“Improving adherence is a complex issue that involves different factors and multiple stakeholders. While we, as physicians, should take certain proactive steps to remind patients or reiterate the importance of adhering to their treatments, it is usually factors such as the high cost of medication and limited availability of less costly options that would ultimately determine if the patient continued to adhere to their treatment. This is especially true in managing chronic conditions such as hypertension and cardiovascular disease, which require long-term management,” says Dr Navin.
Importance of personalized adherence solutions
Thanks to decades of work by researchers worldwide, adherence is now understood and addressed as a behavioral issue that requires more than consistent reminders. Much of that research supports the theory that behavior is mediated by cognition, where knowledge of a person’s condition, treatment, and attitude affects their actions. Cognitive-behavioral theories recognize knowledge alone as insufficient to produce behavioral change. A person’s perception, motivation, skills, and social environment influence behavioral change.
As a result, adherence programs and apps must prompt patients to take their medication and promote well-being through goal setting and tracking. Ideally, they should also consider their patients’ needs and barriers to adherence. This allows for more tailored support to meet the needs of individual patients.
Patient Support Programs (PSPs), such as those provided by Axios International, benefit from approaching adherence as a behavioral issue and play a key role in providing 360-degree support to patients to maximize their health outcomes.
“Adherence is rooted in creating an environment where patients can cope with their disease throughout their treatment journey. At Axios International, we believe there is no ‘one size fits all’ when it comes to designing access solutions. Every patient’s journey is unique, so to help patients stay on treatment, we must utilize a multi-layered approach to effectively address the five dimensions of adherence through a versatile approach with a broad range of Maximized Adherence Solutions,” explains Dr. Saba.
“The PSPs we manage are designed to create an integrated ecosystem of care and treatment. Using our proprietary Patient Needs Assessment Tool (PNAT), we identify the risk factors that may lead patients to discontinue their treatment and tailor programs to best meet those unique requirements. By adopting an evidence-based approach, PNAT customizes services for each patient, thereby maximizing adherence to treatment, engagement, and program cost-efficiency,” adds Dr. Saba.
Our partnered-access programs yield improved medical outcomes and reduce the burden on hospitals and healthcare professionals by following through with patients outside the hospital environment. Through the programs we manage, we also foster trust with patients and their caregivers, thus ensuring sustained program outcomes. PNAT is currently used in five countries, including the UAE, Kuwait, Kingdom of Saudi Arabia, Iraq, and Egypt, for disease areas such as Dermatology, Rheumatology, Immunology, Neuroscience, Asthma, Cardiology, and Oncology.
Stock Image: Digital support programs facilitate stronger adherence to treatment
Using digital to support adherence
In recent years, many positive advances have been made in developing digital support programs that facilitate stronger adherence to treatment.
Axios’ digital health ecosystem, Axios+, intuitive tools to enhance the patient experience and medical outcomes while facilitating the delivery of Axios-managed Patient Access Programs (PAPs and PSPs). Axios+ offers intuitive tools to enhance the patient experience and medical outcomes while facilitating the delivery of Axios-managed Patient Access Programs (PAPs and PSPs). The MyPatients app helps physicians stay in touch with their patients, allowing them to check their progress in a personalized way to help them stay on treatment and get the most out of their medication.
To improve patients’ medical outcomes, barriers to treatment adherence must be considered as seriously as patients’ ability to afford treatment. To encourage and sustain behavior that leads to medication adherence, patient’s personal needs and motivations to use digital tools must be considered and incorporated into the design and implementation of healthcare solutions.
Flexibility is crucial in today’s market. Over the past 25 years, we have adjusted our resources based on current needs and embraced different work models to connect with our global teams
In today’s fast-changing business landscape, cost efficiency and adaptability are more than just buzzwords; they are essential for staying competitive. In my 15 years with Axios International, I have seen first-hand how a commitment to cost-effective strategies has put us at the forefront of the healthcare industry.
So, here is how we do it.
At Axios, we believe in doing more with less. Streamlining processes, optimizing resource allocation, and maintaining a lean structure are key to our operational efficiency. We focus on being financially conscious while investing in improving our operations, learning, and development. This approach has been crucial in ensuring that Axios delivers high-quality services without unnecessary overheads.
Outsourcing and on-demand resources
Flexibility is critical in today’s market. Over the past 25 years, we have adjusted our resources based on current needs and embraced different work models, including remote work, to connect with our global teams. By outsourcing non-core functions and using on-demand resources, including IT support, we keep costs down without sacrificing quality. This strategy allows us to remain agile and responsive to changing demands.
Being cost-efficient also means keeping a close eye on expenses and maintaining transparency. Axios has clear checks and balances in place, especially regarding quality and compliance, and good governance. Everyone, from a new joiner to the leadership team across the functions, has defined roles and responsibilities to ensure alignment with Axios’ goals.
We also have tight budgeting processes, with annual resource planning and metrics that keep us on track. This mindful use of resources enhances profitability and supports morale. The resulting cost savings enable us to invest in incentive schemes and training programs for employees, promoting a culture of continuous learning and improvement.
A tech-driven culture that complements the human touch in workplace relationships is essential for any company’s growth. Embracing automation and systems in our core business support services and operations has streamlined administrative tasks, reduced errors, and improved overall efficiency.
Our digital ecosystem, Axios+, allows us to deliver 360-degree patient care efficiently while effectively connecting with our stakeholders, clients, and partners. These technology-driven measures ensure effective cost control while improving patient and stakeholder satisfaction while ensuring optimal health outcomes. By integrating advanced technologies, Axios is now able to focus more on core activities that drive growth and innovation.
Integrating technology also enables us to serve patients, clients, and partners more effectively. Since our digital health ecosystem, Axios+ has been optimized, it has enhanced the experience for patients enrolled in our programs. It has also streamlined the effective delivery of Axios-managed Patient Access Programs. This tech-driven culture ensures that Axios stays ahead of the curve and continuously improves our services.
In the healthcare industry, lean and agile operations are critical. That’s why Axios prioritizes Identifying, onboarding, and empowering a pool of access experts and healthcare specialists to maintain high standards while controlling costs. Our recruitment process is managed internally through a standardized selection process. Axios employees follow a customized learning path with Axios-centric modules based on a 90-day onboarding plan, ensuring continuous learning and assessment.
Our cost-efficient practices are also reflected in our patient-centric work. Serving patients, healthcare professionals, clients, and partners in over 28+ countries, Axios understands the importance of localized expertise. All staff on the ground are crucial, and we ensure that we hire professionals with local experience and specialized backgrounds in all project locations. This approach helps us understand and meet the unique needs of patients in different regions.
The way forward
Reflecting on the past 25 years, Axios has grown steadily because we care for our patients and how we serve them. By taking the 360-degree approach to patient support, maintaining a lean operation, expanding meaningful client engagement, and optimizing resource allocation, which secures revenue growth year on year, our processes and systems are set up to empower people within Axios.
As we look to the future, Axios is well prepared to embrace emerging trends and technologies such as automation and data analytics. These advancements will shape sustainable best practices and strategies. Moving towards digitization will further enhance our ability to stay ahead and better serve our patients, healthcare professionals, clients, and partners.
Driving financial efficiency isn’t just about cutting costs; it’s about making smart, strategic decisions that enhance productivity, boost morale, and ensure sustainable growth. These strategies are integral to Axios’ success and future readiness.
Healthcare in Mexico is an evolving topic of discussion, especially considering the challenges and opportunities patients face regarding access to health services. Mexico’s fragmented health system complicates the patient’s journey, especially in the case of chronic conditions, such as oncology.
In recent years, the reorganization of the Mexican health system, with the change of the Seguro Popular in January 2020 to the Institute of Health for Welfare (Insabi) and its subsequent replacement by the IMSS Bienestar in 2023, has introduced both significant opportunities and challenges, as this system serves more than 60 million people. It seeks to provide universal access to health services, especially for those not covered by Social Security.
However, the transition has been complicated, as highlighted by Laura Suchil, clinical researcher and former Director General of Research at Instituto Nacional de Cancerología (INCAN): “The lack of clarity and communication about the transition process has created confusion among patients. In addition, maintaining the drug supply chain and retaining healthcare professionals are ongoing challenges.”
Laura, who has extensive experience in supporting patient programs and is a member of the Asociación Mexicana para el Estudio de la Hematología, said, “It is essential to work with civil society organizations (CSOs) to compensate for resource constraints in public institutions.” She also said that CSOs not only provide additional support to patients but also help cover critical aspects such as housing, transportation, and adequate information. “This collaborative approach has become essential, allowing the creation of targeted patient support programs that strengthen the health system’s responsiveness and improve the patient experience,” she added while speaking at a webinar organized by Axios International on ‘There is no health without access: Navigating a patient’s journey in Mexico.’
Stock Image: Organizations must work together to provide comprehensive support
Civil society perspective
Organizations must adapt to the diverse circumstances of the patient’s journey, from lack of care to specialist shortages, and work together to provide comprehensive support.
“It is crucial for organizations to collect and systemize information to facilitate the decision-making process. The fragmentation of the health system and information complicates the picture, but through networks and alliances, we can offer better support to patients,” said Leticia Aguiar, General Manager of ConAcción Salud and an expert consultant in civil society organizations.
It is also very important to prepare patients to participate in healthcare reform. The new architecture for social engagement in healthcare offers spaces for patients to contribute their expertise and knowledge, which can lead to a more patient-centered system. Education and empowerment in this context benefit the individual, strengthen the patient community, and improve the overall healthcare system.
A comprehensive and collaborative approach
The patient journey in Mexico is marked by several challenges, from economic conditions to lack of access to information and appropriate treatment. However, it is possible to improve access to quality healthcare through innovative and collaborative approaches, such as thosedesigned and managed by Axios International in partnership with the program sponsors and supported by various CSOs.
A patient-centered approach, such as that taken by Axios International, an access to healthcare company with over two decades of experience designing and implementing access solutions, prioritizing their unique needs and experiences, is essential to move towards a more inclusive and efficient healthcare system in Mexico.
Valeriia Mykolaienko, Regional Operations Lead at Axios International, speaking at the webinar, said: “One of the key opportunities is to continue to put the patient at the center, addressing accessibility challenges in a sustainable way by working together as partners with various stakeholders in the market. However, one of the biggest opportunities we see is having a more holistic approach to supporting patients because most of the patient journey happens outside the hospital setting.” It should be emphasized that one of the main challenges of the health system in Mexico is access to quality healthcare and affordability of innovative medicines. Collaboration with multiple stakeholders is crucial to addressing these issues in a sustainable way. In addition, a holistic approach that considers patient support outside of the hospital setting is needed, which is essential to ease the burden on the health system and improve treatment outcomes.
Stock Image: A more holistic approach, and a shared vision can make access a reality for more people
Patient empowerment and continuing education
Another crucial aspect is patient empowerment. Patient education about their disease, treatment management, and support from family members and caregivers is critical to improving health outcomes.
Implementing digital solutions in health is urgent, especially for remote communities. Such digital tools enable efficient healthcare delivery and more robust data collection, essential for planning and developing effective health policies and access to healthcare strategies.
Digital apps such as Axios+ provide intuitive tools to enhance patients’ experiences and medical outcomes while facilitating the delivery of Axios-managed Patient Access Programs (PAPs and PSPs).
Effectively navigating the patient journey in Mexico, from the fragmentation of the health system to the accessibility of innovative treatments, is more critical than ever before. This is why scaling and seizing opportunities for improvement through collaboration with like-minded partners is significant. Collaboration between institutions, CSOs, and other stakeholders, along with holistic patient empowerment, education, and implementation of digital technologies, can transform the Mexican healthcare system to benefit more patients.
It is possible to build a more resilient and patient-centered healthcare system that improves health outcomes and promotes patients’ holistic well-being anywhere in the world. The patient journey in Mexico can be arduous, but with collaborative efforts, a more holistic approach, and a shared vision to make access a reality for more people, the path to equitable and efficient health care is achievable.
Healthcare professionals cannot alone achieve the shift to patient-centered medicine
More and more patients are increasingly spending more time of their journey outside the hospital. However, there is a lack of adequate patient support and services that offer them assistance where and when they need it most.
Shifting to a patient-centered healthcare model means a necessary and urgent change in the healthcare system. As we know, the hospital model has remained practically unchanged for the last 100 years. This underscores a troubling reality. Despite technological and scientific advances, hospitals’ structure and approach remain anchored in an outdated paradigm that prioritizes disease over the well-being of the whole patient.
Historically, hospitals have focused on treating specific diseases with a fragmented, intervention-oriented approach rather than prevention. This model has effectively addressed medical emergencies and acute conditions, but in a world where chronic diseases are on the rise and personalized care is becoming more relevant, this approach falls frankly short.
“This is happening worldwide,” said Dr. Armando Garduño, Palliative Care and Quality of Life Support Area Head from the Instituto Nacional de Pediatría (INP) in Mexico City. “Healthcare is very mechanized; it focuses on the disease of the patient. There is still a lot of progress to be made all over the world.”
The traditional hospital model is often rigid and lacks adaptability. Standardized rooms, strict and inviolable schedules, and an inscrutable medical hierarchy often exclude patients from important decisions. Although these aspects have worked in the past, they are inadequate to meet today’s public health challenges.
“The health system must be strengthened, with more support for primary care, more prevention, and more resources to treat chronic diseases such as cancer; nothing should be missing. Patient and family-centered care is a strategy to ensure that care is comprehensive and that the patient is seen as a person, subject to rights, as a human being, not just as a disease, and naturally in the family, especially in pediatrics,” said Dr. Armando.
Stock Image: There is a greater need for specialized healthcare with personalized access to care and treatment
Need for change: Patient-centered medicine
The aging population and increased incidence and prevalence of chronic and non-communicable diseases have increased the need for lifelong and/or costly specialty medications, leading to a greater need for specialized healthcare with personalized access to care and treatment, as a significant portion of the patient journey happens outside the hospitals.
For the past 25 years, Axios International has been working to build a sustainable access ecosystem to fill these gaps in the space outside the hospital and improve patient health and medical outcomes. Using sustainable access solutions carefully curated around patient journeys, the Axios team leverages a broad, trusted network of stakeholder relationships.
Valeriia Mykolaienko, Regional Operations Lead at Axios International, said: “At Axios, we put the patient at the center of everything we do, and that is why our access solutions go beyond the hospitals to reach patients where they are. We work with local stakeholders in the market and bring global expertise to ensure that patients get the right medication at the right time without having to make huge sacrifices to pay for this type of treatment that their treating clinic has prescribed. Our focus is on end-to-end access to treatment. Otherwise, the patient will not be able to get the full medical benefit from their treatment.”
“This approach improves the quality of care, increases patient satisfaction, and improves long-term health outcomes. Patient-centered medicine promotes collaboration between patients and healthcare professionals, ensuring that medical decisions are informed and shared.
And we do this by creating personalized treatment plans that consider everyone’s unique needs, preferences, and circumstances. This comprehensive approach considers the patient’s medical condition in social, emotional, and economic contexts. In this way, it seeks to offer more holistic and effective care”, she said. According to a study published in the Journal of Participatory Medicine, patients actively involved in their health care have better health outcomes and, therefore, greater satisfaction during their day. Axios provides 360-degree patient support in all partnered access programs we set up and manage, from access to diagnosis to treatment and maximized adherence solutions.
This holistic approach improves the quality of care, increases patient satisfaction, and improves long-term health outcomes. Most importantly, patient-centered medicine is achieved through successful collaboration between patients and healthcare professionals, ensuring that medical decisions are informed and shared.
Stock Image: Investing in technologies facilitating communication and information access is crucial
Investments needed for transformation
Investing in technologies facilitating communication and information access is crucial to achieving this transformation. Digital platforms that allow patients to access their medical records, communicate with their doctors, and manage their appointments contribute to greater patient empowerment.
It is also essential to train health professionals in interpersonal skills and empathy, which are often the “Achilles heel” of many doctors. However, healthcare providers must be knowledgeable in technical skills and the ability to listen to and understand patients’ concerns and wishes. Empathy and effective communication are key components to establishing a trusting and collaborative relationship with the patient. Keeping these factors in mind, Axios has developed Axios+, which provides integrated patient support with an all-in-one digital health solution. Axios+ is designed to enable and complement such physician-patient, patient-caregiver, and patient-pharmacist relationships. It is the first and only full suite of digital solutions designed to improve patient access and adherence to treatment.
Technologies like Axios+ are enablers. Public policies should support this transition by financing health technologies, promoting continuing education for health professionals, and implementing standards encouraging patient-centered care.
Stock Image:It is important to recognize and emphasize that patient well-being does not depend only on medical treatments but on holistic care
Towards a future of holistic care
The transition to patient-centered medicine is more than a trend; it is imperative for adapting the health system to the demands of the 21st century.
The care of the future must be comprehensive, considering all aspects of the patient’s life and not just their illness. Such change requires a concerted effort and a long-term vision.
Therefore, it is important to recognize and emphasize that patient well-being does not depend only on medical treatments but on holistic care that includes prevention, education, and emotional support. Patient-centered medicine is an imperative in healthcare and a move towards a more equitable and compassionate society where everyone receives the care they need and deserve.
Modern medicine must evolve towards a model that puts the patient at the center of all decisions and processes and facilitates the management of patients with chronic diseases outside the hospitals to relieve the burden on patients and their families, providers, and payers. All stakeholders in the health system should work together to bring about this change. The healthcare system can move toward a healthier, more humane future for all with a renewed, patient-centered approach.
