Adherence refers to the extent patient behavior matches advice from health care providers. Non-adherence should not be a reason to blame the patient

The reason why the Morisky scales are highly validated is because of the way the questions are phrased to avoid “yes saying” bias. The MMAS-8 was conceptualized to reduce victim blaming by reversing the direction of the question. The MMAS-8 never asks the patient "Do you always take your high blood pressure medication" because 90% of my patients will say "yes, doctor" because they don’t want to be blamed for not taking their medication. So, we ask in the negative direction, "Do you sometimes forget to take your high blood pressure medication"? Now about 50% will respond "yes".

​1. Corporate Background and Role
Q: What is the primary business focus of MMAR, LLC, and how does it generate revenue?
A: MMAR, LLC, operating as Adherence, focuses on providing the Morisky Medication Adherence Scales (MMAS-4 and MMAS-8), which are the gold standard for assessing medication adherence in various patient populations. Our primary revenue comes from licensing these validated tools to healthcare providers, researchers, pharmaceutical companies, and hospital systems for use in clinical trials, chronic care management, and research. A license is required for use, as outlined on our website, www.moriskyscale.com.

Q: Who are the key personnel involved in the development and management of the Morisky Medication Adherence Scales (MMAS)?
A: The MMAS scales were developed by Dr. Donald E. Morisky, whose work in adherence has influenced healthcare practices globally, as noted on www.moriskyscale.com. The CEO, oversees the management and licensing of these scales, supported by our team at MMAR, LLC, which ensures proper administration and enforcement of our intellectual property.

Q: Can you confirm MMAR, LLC’s ownership of the MMAS-4 and MMAS-8 trademarks and copyrights?
A: Yes, MMAR, LLC owns the trademarks and copyrights for the MMAS-4 and MMAS-8 scales, which are protected by U.S. copyright laws and registered with the U.S. Patent and Trademark Office. Permission from MMAR, LLC is required to use these copyrighted scales, and unauthorized use may lead to legal action.

Q: When and how were the MMAS-4 and MMAS-8 developed? Who were the key contributors, including Dr. Donald E. Morisky?
A: The MMAS scales were developed by Dr. Donald E. Morisky, starting with his research published in 1983 in the American Journal of Public Health, as noted on www.moriskyscale.com. The MMAS-4 and MMAS-8 were refined through extensive studies to assess medication adherence, focusing on intentional and unintentional non-adherence, and are now globally recognized for their validity and reliability.

Q: What is the process for licensing the MMAS-4 and MMAS-8 to third parties?
A: Licensees complete a questionnaire specifying the health condition and intended use, after which we provide an End-User License Agreement (EULA) outlining terms, such as administration limits and prohibitions on modification. Commercial licenses are required for over 1,000 administrations, and we offer a subscription package for unlimited use by entities like hospital systems or pharmaceutical companies.

Q: How widely are the MMAS scales used globally, and what is their market share in the medication adherence assessment industry?
A: As noted on www.moriskyscale.com, the MMAS-4 and MMAS-8 are the gold standard for assessing medication adherence, trusted by major pharmaceutical companies like Novartis, Pfizer, and AbbVie, and used globally in hospitals for chronic care management. They hold a significant market share due to their high sensitivity, specificity, and ease of use.

Q: What documents or records does MMAR maintain regarding the development, licensing, and enforcement of the MMAS scales?
A: MMAR maintains trademark and copyright registrations, licensing agreements, and correspondence with licensees, as referenced on www.moriskyscale.com. We also keep records of enforcement actions against unauthorized use, which will be provided in discovery as relevant.