Michael Oleksiw on Fixing Pharma’s “One-and-Done” Adherence Problem

In the second and final part of our video interview with Pleio CEO Michael Oleksiw, the conversation moves from identifying hidden barriers to unpacking how they play out in real-world patient behavior—and what the industry often gets wrong in trying to solve them. While adherence is frequently framed as a matter of access or affordability, Oleksiw makes the case that a quieter, more human factor—loneliness—can be just as determinative in whether patients stay on therapy or fall off entirely.

Drawing from both research and frontline patient interactions, Oleksiw describes loneliness not as an abstract concept, but as something tangible and observable in everyday conversations. Patients who lack meaningful support often drift into isolation, where anxiety, confusion, and mistrust can take hold. These emotional and psychological barriers don’t just exist alongside the treatment journey—they actively disrupt it, leading to missed doses, delayed pickups, and, in many cases, early discontinuation. For an industry focused on precision medicine, these imprecise, deeply human variables remain a persistent blind spot.

That blind spot becomes especially evident when examining the industry’s long-standing “one-and-done” problem—patients who start therapy but never continue. Oleksiw emphasizes that there is no quick fix, but rather a narrow window of opportunity. Early intervention, focused on building knowledge, confidence, and practical skills, is critical to shaping lasting behavior. Without that foundation, even the most well-designed therapies risk becoming part of the “leaky bucket” that has defined adherence challenges for decades.

At the same time, he notes concerns around the effectiveness of traditional patient support strategies, particularly those built around reminders, nudges, and information overload. While well-intentioned, these approaches can fail to create meaningful behavior change—and can even reinforce feelings of isolation. In the context of GLP-1 therapies and other chronic treatments, Oleksiw argues for a more personalized, journey-based model that meets patients where they are, rather than overwhelming them with tools they may not be ready or able to use.

Ultimately, this conversation reframes adherence as less of a logistical problem and more of a human one. It’s not just about getting patients the medication—it’s about ensuring they have the emotional support, understanding, and motivation to stay on it.

Access the first part of his interview series with PC:

1. Michael Oleksiw: Loneliness and the Hidden Barriers to Adherence