In Aging-Patient Categories, the Caregiver Is the Consumer

For a meaningful share of prescriptions written for older patients, the person deciding whether the drug gets filled, kept, or swapped out for something else isn't the patient, it's the adult child, spouse, or family member managing their care, and that has implications for who a go-to-market plan for certain medications should be built around.

The research on aging-patient caregivers backs this up well. For example, in dementia patients, caregiver perception already decides which drugs get called effective. Rexulti¹ (brexpiprazole), the first FDA-approved drug for Alzheimer's agitation, won approval on the strength of a 31% greater reduction in agitation frequency versus placebo, measured on a caregiver-rated symptom scale, rather than a lab test or an independent physician exam.² A study of medication transitions in dementia patients found that caregiver-reported issues are typically what triggers a regimen change.³ On the adherence side, caregiver presence significantly improved medication adherence among older home care clients with heart failure, and cardiac patients with a caregiver in the picture were 40-50% less likely to go non-adherent than those without one.⁴ ⁵ Across these conditions, the caregiver is the one reporting the symptom, understanding the side effects, and researching alternative medications.

Every one of those caregiver-mediated changes or lapses represents a patient lost to a competitor or a patient falling off therapy altogether, and this shows up as real, measurable revenue. Industry-wide, non-adherence costs global pharma manufacturers an estimated $188 billion in 2012⁸. No study isolates exactly how much of that is caregiver-driven, but in conditions such as dementia, Alzheimer's, and heart failure, where caregivers are the ones reporting symptoms and side effects and making the switch call, a meaningful share of that revenue pool is effectively decided by the caregiver, not the patient.

The challenge is that most pharma manufacturers' DTC (direct-to-consumer) campaigns, creative and media plans alike, are still built entirely around the patient, and the caregiver is missing from the media equation in exactly the categories where they're critical to the decision. For an aging patient with dementia, heart failure, or another condition managed day to day by a family member, patient intent alone is missing a large part of the picture.

There's also a media-fit argument here that's specific to TV. Caregivers for older adults are themselves a middle-aged to older audience, averaging 51 years old, and roughly two-thirds are 50 or older.⁶ That maps closely onto where linear TV viewing actually concentrates: adults 55+ account for 60% of all time spent with linear TV.⁷ The audience pharma needs to reach for these conditions and the audience TV already reaches at scale are, to a large degree, the same people, which makes TV (linear and CTV) a more efficient way to find this segment than digital channels built around younger, patient-first intent signals.

Proximity strengthens the case further. About 4 in 10 caregivers (roughly 40%) live in the same household as the person they care for, and zooming out from co-residence to proximity, 74% of caregivers either live with their care recipient or within 20 minutes of them.⁶ ⁹ In other words, the caregiver usually isn't a separate, dispersed audience to chase down, they're in the same home or the same local market as the patient, which is exactly the level at which TV and CTV targeting already operates.

Given that, we believe pharma marketers should focus effort in three places, for the conditions where this evidence is strongest:

1. Build creative that speaks to caregivers directly.
2. Treat caregiver status as its own targetable audience within TV and CTV audience planning, rather than folding it into the patient audience.
3. Add caregiver engagement as a leading indicator of sales.

None of this requires rebuilding the pharma GTM model from scratch. It's a case for adding a caregiver lens in the aging-patient categories where the evidence is strongest and the TV audience overlap is real.

Sources

1. PubMed, "A critical review of brexpiprazole oral tablets as the first drug approved to treat agitation symptoms associated with dementia due to Alzheimer's disease."
2. NeurologyLive / Otsuka, "FDA Approves Brexpiprazole as First Therapy for Alzheimer Agitation."
3. PMC, "Transitions in Medication Management Among Patients With Dementia: Patient-Caregiver Perspectives."
4. PubMed, "Caregiver status affects medication adherence among older home care clients with heart failure," 2012.
5. Patient Preference and Adherence, "Medication Adherence Is Associated with Having a Caregiver Among Cardiac Patients," 2013.
6. AARP/National Alliance for Caregiving, "Caregiving in the US 2025."
7. Nielsen, 2026 Upfront Planning Guide / linear TV viewership data.
8. Estimated Annual Pharmaceutical Revenue Loss Due to Medication Non-Adherence (2012); Capgemini Consulting
9. PMC, "Long-Distance Caregivers' Use of Supportive Services."