Medical nonadherence is a $500 billion a year problem1. So why don’t patients comply with their medication dosing schedule for COPD when the benefits are so clear?



There are many factors that affect inhaled medication adherence, such as age, education or knowledge, communication with medical provider, cost and ease of use. The Global Initiative for Asthma (GINA) these factors as follows:

Factors associated with poor adherence (adapted from GINA report)

Drug factors

Non-drug factors

Difficulties with inhaler devices

Misunderstanding or lack of instruction

Complex regimens

Dissatisfaction with healthcare professionals

Side effects

Unexpressed/undiscussed fears or concerns

Medication costs

Inappropriate expectations

Dislike of medications

Poor supervision, training or follow-up

Distant pharmacies

Anger about condition or treatment

Fears about side effects

Underestimation of disease severity


Cultural or religious issues






Attitude toward ill health

GINA, Global Initiative for Asthma.2

With all these factors working against treatment adherence, it’s no wonder that the number of non-compliant patients is so high. A study published by the World Health Organization (WHO) estimated 50% adherence or less for patients on long-term pharmacotherapy like bronchodilators and inhaled corticosteroids.3

Why it Matters: The True Costs of COPD

Chronic obstructive pulmonary disease (COPD) ranks as one of the deadliest diseases in the world, responsible for an estimated 3.17 million deaths in 2015, or 5% of deaths globally. By 2030, it is expected to become the 3rd leading cause of mortality. On average, COPD kills a person every 10 seconds.4

According to the World Health Organization (WHO), 65 million people are affected by moderate-to-severe COPD. The physical costs are high for the patient, who faces a progressive, diminished capacity for breathing, breathlessness, a chronic cough, fatigue, and the production of excess mucus or phlegm.5

By 2010, the cost of COPD in the USA was estimated at approximately US$50 billion, which includes $20 billion in indirect costs and $30 billion in direct health care expenditures. As COPD is a progressive disease, these costs are expected to continue to rise.6

With the costs of COPD so high, adherence technology holds the promise of shifting the paradigm in the favor of better health outcomes and reduced healthcare costs.

A New Approach to Adherence 

Attention is now focused on the design of the administration of these therapies, with the goal of increased adherence and improved clinical outcomes. Inhaler devices are being sold for ease of use and convenience with the goal of increasing utilization.

 Perhaps the most dramatic advancement in this effort is the development of Hailie™ technology. Clinically proven to improve medication management in chronic respiratory disease, the Hailie™ platform empowers patients, caregivers, researchers and physicians through objective and accurate medication monitoring and reminders.

The Hailie™ sensors attach to inhaler devices such as metered dose inhalers or dry powder inhalers. They collect usage data and connect to patient’s smartphone, monitoring inhaler usage, reminding patients of dosing times, and communicating wirelessly to the cloud.


How it Works

The Hailie™ technology empowers patients, caregivers, researchers and physicians by improving medication management.

  • Tracking Medication Use: Hailie sensors track every time the preventer and reliever medications are taken. 
  • Medication Reminders: If the user forgets to take the medication as prescribed, the Hailie™ sensor provides a discreet alert to the user.
  • Bluetooth® Communications: Bluetooth allows automatic wireless transmission of medication use and adherence data to apps and the cloud.

Beyond simply improving patient health outcomes, the Hailie™ platform can help reduce the significant financial costs associated with suboptimal medication management. As the costs of  COPD rises over time, the Hailie™ solution may well help many patients adhere to their medication schedules.


  1. World Health Organization. Evidence for action.Geneva: World Health Organization; 2003. Adherence to long-term therapies.

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