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The widening medication adherence gap

Journal content Created on 04 Sep 2026 PLOS Medicine

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PLOS Medicine, Public Library of Science

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by Zachary A. Marcum

The gap between medication efficacy in trials and real-world effectiveness is widening, and with it the opportunity cost of medication nonadherence. Closing this gap requires more than individual behavior change; it requires system-level solutions, including coverage and funding design, pharmacist-led programs, and health information technology. In this Perspective, Zachary Marcum argues that the gap between medication efficacy in trials and real-world effectiveness is widening, and with it the opportunity cost of medication nonadherence. He discusses why closing this gap requires not just individual behavior change, but system-level solutions.

Zachary A. Marcum

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