MCCs had previously been discussed in the Teva-sponsored Digital Transformation Zone at the Expo. It was acknowledged that the growing burden of MCCs present a significant challenge for the NHS: more than 15 million people in England live with a long-term condition and that number is rising.

During her presentation, Amalia discussed a behaviour change programme that Teva is developing to help empower patients with MCCs through support for caregivers and patients delivered by healthcare professionals such as pharmacists.

As many of Teva’s medicines are used by patients for MCCs, in 2017, the company did some initial consultations in the UK to learn about the scale and complexity of MCCs. The finding that there is a considerably high prevalence of MCCs, especially in older adults, and that the prevalence is set to double by 2035, prompted further global research.

A number of key observations have emerged from this research:2

  • MCCs reduce a patient’s quality of life: new conditions bring additional emotional distress and out of pocket expenses, further reducing quality of life
  • Health systems can make considerable saving if they deal with MCCs in an agile manner
  • MCCs can cluster according to prevalence, association and cost
  • The major challenge of adherence and polypharmacy is ubiquitous in patients with MCCs and with every new medicine the adherence to the medication regimen reduces
  • MCCs increase healthcare expenditure in a staggering way: evidence indicates that with every additional condition, healthcare costs double.

Amalia noted that against these somewhat negative learnings, there are multiple touch points that offer opportunities to engage with patients. She noted that patients navigate an extremely complex health system. They turn to patient organisations for information, education and resources. In addition, there is a lot of burden on their caregivers and their loved ones.

Of note, patients visit multiple doctors and they take a lot of medications, resulting in a significant issue with polypharmacy. Pharmacists therefore have a critical role to play in the healthcare system, as almost a quarter of adults take three or more prescribed medicines and nearly half of people with MCCs in the UK take eight or more medicines.

In this regard, Amalia highlighted the NHS Long Term Plan, in particular the components that are intended to promote community pharmacists’ clinical skills, which will allow them to support the integration of care in a system where the majority of care components are not yet interconnected.

Amalia went on to discuss the behaviour change programme that Teva has developed and is piloting in conjunction with Mount Sinai Hospital in New York. This peer-to-peer programme is intended to empower patients by targeting education and communication for patients and healthcare providers.

For instance, patients are being given support to help them communicate effectively with their pharmacist about medication adherence or side effects. Similarly, pharmacists are being supported to provide appropriate guidance for patients to help them manage and cope with their emotions and stress, their diet and nutrition and to promote smoking cessation.

As part of this initiative, Teva in Canada partnered with an organisation called Huddle, which offers an online peer professional network for healthcare professionals. Through this collaboration, a toolkit was developed that included an online training course for pharmacists, training them to impart information to patients’ caregivers to help them effectively navigate the healthcare system.

Looking further afield, Teva’s partners at Mount Sinai Hospital are working in rural areas of Ghana to evaluate whether common interventions can be scaled, even though healthcare systems may be very different. To this end, the same behaviour change programme that is being tested in New York is being applied in Ghana, through work with community volunteers, caregivers and nurses.

Integrated care can help optimise health outcomes for patients with MCCs, especially by improving coordination within primary care and providing preventative community care.

Teva is committed to supporting pharmacies to leverage NHS funded services and to develop new assets to empower patients to self-manage their health. The aim is to reduce the cost burden on the health system, reduce doctor visits and hospital utilisation through innovation.