Decoding the Hidden Burden That Shapes Long-Term Treatment Persistence in Early-Stage Oncology

The Challenge

With a new adjuvant therapy approaching launch in a category requiring five or more years of daily treatment, the brand team faced a question existing data couldn’t answer: what actually drives a patient to stay on therapy, and where does the standard of care fall short?

The team recognized that persistence was not primarily a clinical problem. It was behavioral, emotional, and logistical. Understanding it required access to the lived experience of long-term prevention — what motivated patients, what eroded their commitment, and at which specific moments that commitment was most at risk.

CONTEXT

01
Multi-year daily therapy creates an adherence burden that conventional launch planning frameworks underestimate.
02
Existing research mapped clinical endpoints, not the behavioral and emotional calculus of long-term treatment.
03
Patient support had been built around initiation, not maintenance, leaving the majority of the treatment arc underserved.
04
Brand, medical affairs, and market access teams held different assumptions about why patients stopped therapy.
05
A crowded category required differentiation on livability and patient experience, not clinical profile alone.

Our Approach

RESEARCH OBJECTIVES

01
Map the full emotional, behavioral, and logistical arc of the patient experience from treatment initiation through year five.
02
Identify the high-leverage moments where persistence is most at risk and intervention could have the greatest impact.
03
Define patient subgroups with meaningfully distinct persistence dynamics to inform differentiated communications and support design.

We fielded a mixed-methods study combining 60-minute in-depth interviews (IDIs) with a 5-day digital ethnography on an asynchronous platform allowing participants to document their daily experience in their own words, unprompted, over five days. This gave us access to the ordinary texture of life on treatment that no interview alone can capture.

IDIs included n=25 patients sampled across multiple treatment classes, three time-on-treatment cohorts (within 12 months, 13–36 months, 37–60 months), and clinically relevant patient subgroups. The digital ethnography included n=20 patients with overlapping criteria. A social listening layer — drawing on approximately 17,000 patient posts — served as a population-level check on recruited-sample findings.

Analysis synthesized findings across methods using a behavioral persistence framework mapping the forces driving and eroding therapy engagement across the full treatment arc.

Insights Delivered

KEY FINDINGS

Persistence in long-term adjuvant therapy is an ongoing negotiation between the abstract future benefit of prevention and the concrete daily cost of side effects, identity disruption, access friction, and a timeline so long that ‘done’ can feel permanently out of reach.
Patients commit before they understand what treatment will cost them. The lived reality only becomes clear once they’re in it, and those without a personally meaningful rationale are far more vulnerable when challenges mount.
Three moments carry disproportionate risk: the initiation conversation, the first-fill and onboarding experience, and the long-tail maintenance phase — which represents the majority of total treatment duration but receives the least proactive support.
Persistence dynamics differ meaningfully across patient subgroups, requiring differentiated support strategies rather than a single intervention model.

Strategic Impact

The patient journey framework and persistence model became a shared analytical language across brand, medical affairs, and market access — the first time the three functions operated from a common picture of why patients stopped therapy.

The ‘Moments That Matter’ framework directly shaped Patient Support Services design: onboarding architecture, first-fill protocols, and long-tail adherence programming. Segment profiles drove DTC strategy, advocacy activation, and life-stage-specific support resources, addressing a gap patients named directly: existing materials failed to reflect the full range of life circumstances patients were managing alongside treatment.

KEY DELIVERABLES

Patient Journey Framework across the full adjuvant treatment arc
Behavioral Persistence Model mapping drivers and barriers to long-term engagement
Moments That Matter’ Framework with three high-leverage intervention points
Segment Profiles with distinct persistence dynamics by patient subgroup
Launch Opportunity Map informing PSS design, DTC strategy, and advocacy activation

We understood the clinical profile well. What we didn’t understand was what it actually feels like to take a pill every day for five years while the rest of your life keeps going. This research changed how we think about what we’re asking patients to do — and what we owe them in return.

When persistence is the product, understanding the lived patient experience isn’t optional. Let’s talk about how patient journey research can shape your launch strategy.