In the US, medical non-adherence accounts for 30-50% percent of chronic disease treatment failures and close to 125,000 preventable deaths each year, representing losses of $637 billion for the pharmaceutical industry.

The COVID-19 pandemic has created additional strain as healthcare utilization dropped significantly .  82% of healthcare providers surveyed indicated a significant decline in appointments and prescription dispensing.  This impact is particularly strong in Latino communities where language, cultural barriers to information, and new telehealth services made pursuing treatment even more difficult.

Before the pandemic, many of the big pharmaceutical players were already investing in marketing strategies that focused on messages tapping into relevant cultural values. There is a growing recognition that multicultural influences are at the root of the demand for personalized medicine and other upcoming trends for pharmaceuticals.

To reach more diverse segments, marketers need to re-evaluate their messaging in the context of the pandemic to re-engage diverse audiences and promote adherence.

Cultural Influences on Adherence

According to the US Census, 63% of surveyed hospitals encountered Limited English Proficient (LEP) patients on a daily or weekly basis. A similar study found that adverse events among LEP patients were more likely due to errors in communication (52.4%) than for English speaking patients, resulting in health complications and lengthy hospital stays. These negative experiences within the healthcare system, and hesitation surrounding prescribed therapeutics following adverse events have been shown to directly contribute to patient non-adherence.

Adherence is the degree to which a patient follows medical advice correctly, such as compliance with a medication regimen or dosage, or turning up to follow-up appointments.

Evidence suggests that those with LEP and diverse cultural backgrounds are at heightened risk of non-adherence.  For example, a study conducted among patients with Type 2 Diabetes found 60% of LEP patients had inadequate adherence, compared with 51.7% among English-speaking Latino patients, and 37.5% among non-Hispanic white patients. These rates of non-adherence can lead to a worsened condition, increased likelihood for comorbidities, and drive healthcare costs further.

To prevent these outcomes, we need to alleviate the factors that contribute to patient disengagement, namely the cultural disconnection that usually interferes with communication between pharmaceutical companies and their target audiences.

Re-engaging adherence during COVID-19

The public health crisis caused by the COVID-19 pandemic has uncovered huge disparities, taking a serious toll on individual lives and the healthcare system.

A report from the CDC revealed that minorities are twice as likely to become severely ill and die from the virus than non-Hispanic white Americans. Socioeconomic factors, employment insecurity, and low health literacy have contributed to higher vulnerability to infection, affecting individuals, families, and the wider community.

The disproportionate impact of COVID-19 on minority populations must be emphasized when considering pharmaceutical marketing recovery.

To drive better adherence, companies must evaluate the main pain points that prevent patients from making informed choices about their treatment regimens and assess how to resolve them. This includes acknowledging socioeconomic burdens on patients who have lost their healthcare due to unemployment, distrust of a particular therapeutic due to fear of cross-contamination or side effects, or perceived cultural discrimination arising from political frictions. Understanding the cultural dimensions which drive adherence is crucial to pharmaceutical marketing, especially when challenges to public health are making headlines on a daily basis.

Cultural diversity in clinical research and marketing

Minority patient groups are actively looking for healthcare solutions, but the key information is not always readily available, nor is it connecting in a culturally sensitive manner.

For example, running a dubbed pharmaceutical advertisement intended for non-Hispanic, English speaking viewers onto a Spanish-speaking television network is neither going to resonate with your audience nor have the same impact.

Conveying medical concepts and care instructions for patients from different cultures requires crossing cultural knowledge bases with medical standards. Each culture has its own set of customs that need to be factored in when determining marketing strategies. By expanding market outreach and recruiting for diversity in clinical research, pharmaceutical companies can get more accurate data and increase patient adherence.

This is where a language and cultural adaptation services provider can help, ensuring an intersection between patients’ expectations about their care and pharmaceutical companies’ offerings. A language service provider with the right expertise can implement best practices for recruiting for diversity, provide linguistic validation for clinical research documents, as well as optimize the cultural relevance of marketing materials through translation and transcreation. This not only ensures medical accuracy but delivers effective communication which resonates on a personal level.


Research has shown that diverse communities lack trust and harbor ill-perceptions of the US healthcare system, mainly because the differences in patient journeys are not adequately represented in pharmaceutical research and marketing.  In the wake of COVID-19, additional barriers to care have deepened this divide.

Failing to identify the pain points of diverse audiences and understand where they are going to find information about healthcare puts everyone at a disadvantage.

‘Diverse’ consumers are now the fastest-growing market segment in the US, meaning cultural awareness is no longer a study in innovation for the pharmaceutical industry – it is a necessity for driving success.