Sohail Kasmani. Brand and marketing strategist in London: pharma brand management at Cipla and Alembic, now marketing strategy and AI adoption at ACTAsia. MBA, Brunel University London.
Pharma patient engagement: what works for chronic conditions in the UK
Pharma companies improve patient engagement by working on the specific reasons people go undiagnosed or stop taking their medicines. In the UK that means three lawful routes: unbranded disease awareness for the public, support programmes for patients already prescribed a medicine, and genuine partnerships with patient organisations. The line you cannot cross is anything likely to make the public ask for a specific prescription-only medicine.
NICE guideline CG76 on medicines adherence states that between a third and a half of all medicines prescribed for long-term conditions are not taken as recommended, and the World Health Organization’s report Adherence to long-term therapies puts average adherence among people with chronic diseases in developed countries at 50%.
What does patient engagement actually mean for a UK pharma marketer?
UK pharma cannot talk to patients about prescription medicines the way a consumer brand would, so the word covers three jobs with separate rulebooks.
- Disease awareness: information for the public about a condition, its symptoms and why it is worth seeing a health professional, with no product in sight.
- Patient support: materials and services for people already prescribed your medicine, usually reached through the prescriber, a nurse service or a pharmacist.
- Partnership: working with patient organisations, with the relationship declared and the charity’s independence intact.
The health professional sits in the middle of all three, so if your HCP channels are weak a patient programme has nowhere to be recommended from. It is worth reading this alongside my piece on how pharma engages HCPs digitally in the UK.
Where is the line between disease awareness and promotion?
The legal floor is regulation 284 of the Human Medicines Regulations 2012. The MHRA’s Blue Guide on advertising and promotion of medicines (third edition, revised November 2020) summarises it as a ban on any advertisement wholly or mainly directed to the general public which is likely to lead to the use of a prescription-only medicine. The government’s Advertise your medicines guidance reminds us that breaches are criminal offences, with fines and up to two years’ imprisonment, which tends to focus the mind of the brand team faster than any training module.
The self-regulatory layer is the ABPI Code of Practice, run by the PMCPA. Clause 26 of the 2024 Code says prescription-only medicines must not be advertised to the public, and that statements must not be made for the purpose of encouraging members of the public to ask their health professional to prescribe a specific prescription-only medicine. Its supplementary information allows disease awareness campaigns whose purpose is to encourage people to seek treatment for their symptoms “while in no way promoting the use of a specific medicine”, warns that brand or non-proprietary names, or a restricted range of treatments, might lead to the use of a specific medicine, and asks for particular care where the company’s product, even unnamed, is the only relevant medicine.
The MHRA’s Disease Awareness Campaign Guidelines (Blue Guide Appendix 7) adds the practical standard: campaigns may mention treatment options, but not in a way that would encourage an individual to approach a prescriber to request a particular medicinal option. Campaigns can point to helplines, charities and patient groups. The wider rules are in my explainer on UK pharma advertising rules.
| Campaign element | Usually fine | Where it goes wrong |
|---|---|---|
| Treatment information | All options described with equal prominence, including non-drug options | Only the class your product sits in, or your mechanism described in loving detail |
| Single-product categories | Symptoms, diagnosis, “talk to your GP or pharmacist” | Any hint of “a new treatment is available”, which in practice names your product |
| Visual identity | Campaign look designed for the condition | Colours, typography or imagery borrowed from the brand’s packaging or HCP detail aid |
| Calls to action | Symptom checker, questions to ask your doctor, charity signposting | “Ask your doctor about…” followed by anything specific |
| Company involvement | Clearly declared sponsor | Vague phrases such as “in association with” a charity |
Four cases worth reading before you brief the agency
In CASE/0443/01/25, Complainant v Organon (completed 4 July 2025), a health professional said a leaflet called “What are my contraceptive options?” promoted Organon’s vaginal ring, NuvaRing. The Panel found no breach because the ring was one of 12 methods in the same format, unbranded, with no extra prominence and a steer to talk to a health professional.
In AUTH/3394/10/20, Anonymous health professional v Novartis (completed March 2021), a melanoma booklet encouraging BRAF gene testing was found balanced, partly because only two of seven targeted treatments were from Novartis. But it said it was produced “in association with Melanoma UK” when the charity had only reviewed and endorsed it, and the Panel ruled that phrase misleading, a breach of the patient organisation clause then in force.
In the MHRA’s June 2024 investigation into Vertex Pharmaceuticals, it upheld a complaint that a LinkedIn post announcing a new GB marketing authorisation was an unlawful advertisement to the public. Vertex said the post was aimed at global investors, but the MHRA pointed to open access and emotive language. By contrast, AUTH/3874/02/24, Ex Employee v Sanofi found no breach where a LinkedIn job announcement included three product brand names but no indications or benefits. My reading is that emotive benefit language, more than the brand name itself, is what tips a post into promotion.
How can pharma companies improve patient engagement through marketing campaigns?
The campaigns that work start with a behaviour problem in a defined patient group and build backwards, and this is the process I would use.
- Name the behaviour gap. Late diagnosis, never starting after a prescription, dropping off at month three and poor inhaler technique each need a different channel and legal route, so “raise engagement” is not a brief.
- Find out whether the barrier is practical or a belief. NICE CG76 separates unintentional non-adherence (forgetting, device trouble, cost) from intentional non-adherence (the patient decides not to). A reminder app only helps with the first.
- Choose the lawful route. Pre-diagnosis problems belong to unbranded disease awareness, post-prescription problems to patient support reached through HCPs and pharmacists, and anything in between needs medical and compliance input before the creative brief.
- Build it with patients, through a patient organisation or panel under a written agreement and a declared involvement. The ABPI and Patient Information Forum’s 2025 handbook, Working together, covers how to set that up.
- Design the safety plumbing early. Clause 26.4 requires material for patients taking a specific medicine to carry the Yellow Card side effect statement, and any patient interaction creates pharmacovigilance duties.
- Certify, then launch in the channels HCPs will actually recommend. A support programme that no nurse or pharmacist mentions is, in practice, a very well certified PDF.
- Measure the behaviour you named in step one: if the gap was drop-off at month three, the metric is persistence at month three.
What are effective patient engagement strategies for chronic conditions?
A study of NHS England data led by Professor Jonathan Valabhji of Imperial College London, published in the Journal of the Royal Society of Medicine, found nearly 15% of the English population living with multiple long-term conditions. So a patient on your cardiovascular medicine may also be managing diabetes, arthritis and a stack of other tablets, which rather changes how excited they will be about your branded pill diary.
The WHO report lists five dimensions that drive adherence: social and economic factors, the health care team and system, the condition, the therapy, and the patient. Only one of those is the patient, which is awkward for our habit of treating non-adherence as a character flaw we can message away.
| Barrier (NICE type) | What it looks like | Engagement response | Route and compliance note |
|---|---|---|---|
| Forgetting (unintentional) | Missed doses, gaps in refills | Reminders, simpler regimens, multi-compartment packs as NICE CG76 suggests | Support programme for prescribed patients; certified; Yellow Card statement |
| Device or technique (unintentional) | Poor inhaler or injection technique | Video demonstrations, nurse training, pharmacist checks | Unlisted video links shared by HCPs rather than public search |
| Side effects (intentional) | Stopping because they feel worse | Set expectations early and route patients back to their prescriber; NICE 1.2.9 covers dose changes or switching | Clause 26.5: personal medical advice must be referred to the patient’s own doctor |
| Doubt about need (intentional) | “I feel fine, why take it?” | Condition education explaining what the medicine prevents, not what it is called | Can be unbranded disease information if balanced |
| Undiagnosed condition | Symptoms ignored or normalised | Disease awareness, symptom checkers, charity partnerships | Clause 26.2 and Blue Guide Appendix 7; extra care in single-product categories |
What the evidence says actually works
The best UK evidence for post-prescription support comes from the NHS. The New Medicine Service, where community pharmacists follow up people starting a new medicine for conditions such as hypertension, asthma and type 2 diabetes, was tested in a trial of 504 patients in 46 pharmacies led by Professor Rachel Elliott at the University of Manchester. According to the NIHR’s summary, the service resulted in 10% more patients taking their medicines as prescribed at 10 weeks, saved £21 per person after its own costs, and was estimated to have saved the NHS £558 million since it began in 2011. What worries me is how many brand plans build a parallel programme without asking how it plugs into this.
For company-run programmes, the most cited review is by Ganguli, Clewell and Shillington in Patient Preference and Adherence (2016), which included 64 studies of support programmes across chronic conditions. 64.1% reported at least one significantly positive clinical outcome, and adherence was the outcome most often improved. Two details matter for marketers: 75% of the programmes offered face-to-face support in clinic, and 85.9% were overseen by allied health professionals. So the evidence base is mostly nurses and pharmacists talking to people, and an app with a streak counter is borrowing credibility it has not earned.
A worked example: type 2 diabetes
Diabetes UK’s February 2025 figures estimate 4.6 million people with diagnosed diabetes in the UK, a further 1.3 million with undiagnosed type 2, and 6.3 million with prediabetes. If you market a type 2 therapy, the undiagnosed 1.3 million are a disease awareness problem: symptoms, risk factors, a risk check and a push towards a GP or pharmacist, with no mention of drug classes, least of all the new one your product belongs to.
The patients already prescribed your medicine are a support problem. Here I would fund nurse and pharmacist time and materials on the side effects people most often quit over, shared through HCPs, certified and carrying the Yellow Card wording. Keep the two workstreams on separate creative and separate URLs, because once the awareness site links into the product support hub you have built the bridge the Code is looking for.
How should pharma work with patient organisations?
Carefully, and with some humility. PatientView’s UK survey of 117 patient groups, released May 2025, found 46% rated the industry’s corporate reputation as excellent or good in 2024, down from 55% in 2023. Groups credited pharma with products that benefit patients and with protecting safety, and rated it fair or poor at most other things. So we have good medicines and a reputation for being hard to work with, which is a very pharma combination.
The practical rules sit in Clause 27 of the ABPI Code: written agreements, declared involvement, and no attempt to steer the charity’s independent voice. The Novartis case shows how literally “declared involvement” is read. I would bring the patient organisation in at problem definition, when they can still change what you build, instead of at review, when all they can do is check the tone.
Where do digital channels and AI fit?
The PMCPA refreshed its social media guidance in February 2026 (its pages read “Last revised: 2 February 2026”), and Morgan Lewis’s summary covers what patient teams need. Companies remain responsible for paid influencers, and “#ad” may not be enough disclosure. Patient support content should sit in places like non-public YouTube sections reached through a URL shared with patients. And if you allow comments, you need community guidelines and monitoring, because a comment describing a side effect is a potential adverse event.
This bites hardest on support programmes. The MHRA Inspectorate’s guidance on patient support programmes says adverse events from organised programmes are treated as solicited reports needing causality assessment, and expects vendor contracts, staff training and periodic reconciliation. If the agency running your WhatsApp support line has never heard the phrase “reconciliation”, that is a conversation to have before launch.
The NHS is also moving onto this ground. The King’s Fund’s analysis of the 10 Year Health Plan (published July 2025) describes the plan’s ambition for the NHS App as a “doctor in your pocket”, which makes a standalone branded adherence app harder to justify.
AI earns its place in research and production, since a patient-facing chatbot would run straight into Clause 26.5 on personal medical advice. It is good at sorting barrier themes out of qualitative research and at pre-checking drafts against a disease awareness checklist before medical review, with a prompt along these lines:
You are reviewing draft UK disease awareness copy for [condition]. Flag every sentence that: names or implies a specific medicine or drug class; describes some treatments more fully than others; tells the reader to ask for a particular treatment; or uses visual or verbal cues from [brand] materials (listed below). For each flag, quote the sentence and explain the risk against ABPI Code Clause 26.2 and MHRA Blue Guide Appendix 7. Do not rewrite the copy. Do not decide compliance; list issues for the medical signatory.
The last line matters, because the medical signatory is a legal role and a model cannot hold it. If you are setting this up across a team, my guide to building an AI marketing workflow covers where human review sits, and my ACTAsia case study covers AI adoption in a marketing team.
How do you measure patient engagement properly?
Pick metrics that match the behaviour gap and agree them with medical and market access before launch. Otherwise, when the programme underperforms, we blame the channel, the agency, the NHS, and probably the weather.
- Disease awareness: symptom checker completions, click-throughs to NHS or charity resources, and aggregate uptake of relevant checks where a partner can share it.
- Patient support: enrolment among prescribed patients, persistence at 3, 6 and 12 months, and reasons given for leaving.
- HCP pull-through: how many prescribers or pharmacists actually refer patients.
- Safety operations: adverse events captured and reconciled on time, the metric an inspector will ask about.
Companies often get patchy persistence data in the UK, so plan the data source at design stage. What I would like to see more UK teams test is simple: fund pharmacist-led follow-up for your patients through existing NHS services, measure persistence against a matched group, and see whether it beats this year’s app budget.
FAQs
Can pharma companies advertise prescription medicines to patients in the UK?
No. Regulation 284 of the Human Medicines Regulations 2012 and Clause 26.1 of the ABPI Code ban advertising prescription-only medicines to the public, apart from health-minister approved campaigns such as vaccination. Companies can run unbranded disease awareness and give factual, balanced information, but nothing that encourages people to ask for a specific medicine.
What makes a disease awareness campaign compliant?
Its purpose must be to encourage people to seek advice about symptoms. Under the ABPI Code and the MHRA’s Blue Guide Appendix 7, it should avoid brand and generic names, describe treatment options in a balanced way, signpost to health professionals or charities, and take particular care where the company’s product is the only treatment.
Do patient support programmes improve adherence?
Often, yes. A 2016 systematic review by Ganguli, Clewell and Shillington of 64 studies found 64.1% reported at least one significantly positive clinical outcome, and adherence was the outcome most often improved. Most programmes in the review involved face-to-face support overseen by allied health professionals such as nurses and pharmacists, rather than purely digital tools.
What is the difference between intentional and unintentional non-adherence?
NICE guideline CG76 defines unintentional non-adherence as a patient wanting to follow treatment but being prevented by practical barriers, such as forgetting or cost. Intentional non-adherence is when the patient decides not to follow the recommendation, often because of beliefs about the medicine or side effects. Each needs a different engagement approach, so find out which you are dealing with first.
Can pharma use influencers or social media to reach patients?
Yes, within limits. The PMCPA’s February 2026 social media guidance says companies are responsible for paid influencers, need clearer disclosure than a bare “#ad”, and must monitor comments for adverse events. Patient support content for a specific medicine should be shared through non-public links rather than open search.
Sources
- NICE, Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence (CG76), Introduction, 2009 (accessed September 2026)
- NICE, CG76 Recommendations, 2009 (accessed September 2026)
- World Health Organization, Adherence to long-term therapies: evidence for action, 2003
- MHRA, The Blue Guide: Advertising and Promotion of Medicines in the UK, third edition, November 2020
- MHRA, Blue Guide Appendix 7: Disease Awareness Campaign Guidelines, November 2020
- GOV.UK (MHRA), Advertise your medicines, updated 11 April 2025
- PMCPA, ABPI Code of Practice 2024, Clause 26: Relations with the public, including patients and journalists, 2024
- PMCPA, ABPI Code of Practice 2024, Clause 27: Relationships with patient organisations, 2024
- PMCPA, CASE/0443/01/25 Complainant v Organon, completed 4 July 2025
- PMCPA, AUTH/3394/10/20 Anonymous health professional v Novartis, completed March 2021
- PMCPA, AUTH/3874/02/24 Ex Employee v Sanofi, completed 9 January 2025
- MHRA via GOV.UK, Promotion of a prescription only medicine by Vertex Pharmaceuticals Incorporated, June 2024, published 20 August 2024
- Morgan Lewis (As Prescribed blog), UK PMCPA Refreshes Social Media Guidance: What In-House Teams Should Know, February 2026
- MHRA Inspectorate, Patient Support Programmes, 7 May 2020
- NIHR, Supporting patients to take their new drugs correctly, 2 July 2021
- Ganguli A, Clewell J, Shillington AC, Patient Preference and Adherence, The impact of patient support programs on adherence, clinical, humanistic, and economic patient outcomes: a targeted systematic review, 2016
- Imperial College London, Multiple long-term conditions affect more than 14 per cent of English population, 2023
- Diabetes UK, One in five adults now live with diabetes or prediabetes in the UK, 6 February 2025
- PatientView, What 117 UK patient groups say about pharma (Corporate Reputation of Pharma, UK edition 2024), 26 May 2025
- ABPI and Patient Information Forum, Working together: a handbook for industry and patient organisation partnerships 2025, May 2025
- The King’s Fund, Truly fit for the future? The 10 Year Health Plan explained, July 2025