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On face value it may seem obvious, whether we’re talking about pills, pessaries or pre-filled syringes, that efficacy must always come first, right?  But in reality this is a question that comes up time and time again when we’re discussing new products and treatment choices with physicians and it can be hotly debated.

We thought it would be interesting to share some recent insights from the GPs in our eVillage to illustrate the range of opinion on the matter.  For some GPs, the issue is fairly black and white…

“If a patient cannot be bothered to comply - then they suffer the consequences.”

“If the patient doesn’t take the drug you can forget about the efficacy.”

While others seemed to have a slightly more pragmatic viewpoint, placing emphasis on the role compliance has to play…

“If convenience improves patient compliance then you can afford to take the efficacy hit.”

“Inhalers may only be used correctly by 25% of patients- yet they contain costly drugs and a cheaper inhaler that’s easier take correctly would probably be more efficacious and have less side effects!”

When considering treatments where there is no obvious immediate benefit to the patient e.g. preventative asthma inhalers, compliance is often the first hurdle to overcome.  A convenient medication facilitates compliance, which ultimately leads to better efficacy; which is the line that many of our GPs take. 

In addition, convenience will often be considered more important to those on multiple medications and the elderly, where it’s a case of the easier, the better!  There are however always going to be scenarios where there simply aren’t that many options and therefore efficacy has to rule e.g. in chemotherapy, anti TB etc…

So what does all this tell us?  Well if you look at the figures from our eVillage quick poll, it might appear that efficacy will always top the bill with 91% of GPs saying they felt it was most important, but as we know from experience it’s never black and white.  I personally suspect that the argument for convenience leading to compliance leading to efficacy is a pretty strong one, but the debate is far from simple.

Next time I might go for the simpler question of “Which came first, the chicken or the egg?”  In the meantime post a comment and let me know what you think - efficacy or convenience??