The most expensive pill in the world

...is the one people don't take



Only 50% of pharmaceutical doses are taken as prescribed


Between 30% and 60% of all medication-related hospital admissions in the US are due to poor adherence


Poor adherence in the US is estimated to cost approximately

US$100 billion annually

Poor adherence cost DKK 4-6 billion (Mia DKK) annually in Denmark



A multi-dimensional problem


No single intervention strategy can improve the adherence of all patients


Physician–patient partnerships are essential when choosing amongst various therapeutic options to maximize adherence.


Mutual collaboration fosters greater patient satisfaction, reduces the risks of nonadherence, and improves patients’ healthcare outcomes.




Based on learnings from compliant patients, we at PLUMBAGO have developed a ”checklist” for physicians, called "PICASSO", to guide physician-patient relationships.


The PICASSO checklist and dialogue tool was developed


1. to build on the patient-doctor alliance,


2. to quantify all known factors which effect adherence


3. to address all barriers to adherence


Patients are provided with better understanding, enhanced involvement, and better management – all essential to adherence.


PICASSO can assist the doctor in examining barriers to adherence in an effective, methodical and structured manner


The PICASSO is in many ways similar to “checklists”

used by other professionals; e.g. airline pilots


Integrate individually-reported patient health outcomes & clinical data for better healthcare management


Why PICASSO works:


1. Patient-Reported-Outcomes


2.Physician-Patient Relationship


3. Patient involvement in treatment decision (Concordance)


are pathways to better understanding, enhanced involvement,

and better disease management


Value for doctors


By using PICASSO, the doctors can identify patient’s barriers to medication adherence within a short time-frame


Repeated use of PICASSO can improve monitoring of their patients, regardless of changes in the patients’ life


The PICASSO concept provides a systematic “checklists”, which can be used regardless of the number of patient visits

Value for patients


Reduced complications

Improved quality of life

Increased capacity to work

Avoiding early death





Value for healthcare system


Fewer unneccessary consultations

Fewer hospitalisation

Fewer re-admissions

Reduced healthcare costs

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