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As patient centricity seems to be hitting a slump, Paul Tunnah lays out the key factors companies need to consider to deliver on its promises.
There has been a marked elevation of noise around ‘patient centricity’ in recent years, with most pharma companies featuring the word ‘patient’ in their mission statement, or even going further to say that everything is about the patient (which I think is impossible, as I’ll explain later).
It’s easy to get lost in the semantics, obsessing more about whether we should even be using the word patients (terms like ‘people living with a condition’ are favoured as they reflect the desire to minimise the impact of a disease, rather than focus on it) than actually doing anything.
There has been a lot of buzz, but has it delivered?
I wrote a piece back at the end of 2016 that speculated that patient centricity was about to enter the somewhat unflattering ‘trough of disillusionment’ on the Gartner Hype Cycle – and I think it has.
To my ears, the noise about patient centricity has deadened slightly. Dedicated patient centricity teams in some companies have been and gone (or at least marginalised), and everyone seems keener to shout about big data, digital health, artificial intelligence and other exciting technologies.
But despite that, I’m optimistic.
I’m optimistic because the next stage of the Hype Cycle is the ‘slope of enlightenment’, which I think we’re now in, leading to the ‘plateau of productivity’, which is on the horizon for some companies who are heading into patient centricity v2.0.
As the buzz subsides, what I see and hear from those working within the industry is a more considered approach and some key lessons learned. I also see a lot of analogies to ‘digital’ in pharma, where we’ve stopped throwing the term around like the latest trending hashtag and started to really explore how to define it, what it means and how to implement it.
So, here are the key things I see smart companies doing in order to successfully deliver on the promise of patient centricity.
Define the areas of win:win and success metrics
It sounds obvious, but be very clear on why patient engagement matters, where you should be incorporating it into business process and how you will measure its success.
The easy answers to those questions are “because we care”, “at every stage of medicines development and commercialisation” and “improved reputation”, but that’s too simple and, ultimately, won’t keep the programme going when the CFO’s gaze turns to it.
The reality is that it only matters in a sustainable way if it can deliver both positive results for patients and economic benefits for companies. This means a laser focus on the key points where it can be shown to support medicines positioning, market access and delivery of outcomes in the real world. That can’t be everywhere.
Understand the difference between advocacy, experience and engagement
I warned about the dangers of getting lost in terminology earlier, but it’s important to understand the different elements of patient centricity, each of which has its own value.
Patient advocacy, whether through advocacy groups or individual influencers, is all about working collaboratively to shape the environment, for example through disease awareness or policy change, to support better outcomes.
Patient experience is the focus on truly understanding every aspect of what it’s like to live with a specific condition – in terms of diagnosis, treatment, medical and emotional support, information and technology,
Patient engagement is about how and where you interact directly with the patient to improve that experience, often also necessitating advocacy, either through additional interventions beyond the pill or direct input/co-creation of solutions.
Patient centricity includes them all – and all have a role to play.
Listen to the patient voice, not just the data
In today’s world big data can provide the answer to everything, right? Well, maybe.
The amount of data now being generated in healthcare is staggering, from patient demographics and lifestyle, to vital signs, genetic make-up and longitudinal treatment and outcomes history, increasingly at the level of the individual.
Amongst all this, smart companies also know the value of engaging with a real patient, sample of n=1, to hear their personal story, hopes and frustrations. Many patients are increasingly well-informed and experts in their own condition, so their input should be valued as much as medical Key Opinion Leaders.
Reams of market research and data can provide insight, but so can one patient in the room, telling you what really matters to them.
Understand that not all patients are equal
As an industry, we spend enormous amounts of time segmenting prescribers into smaller and smaller groups. We classify them based on their potential to prescribe in a specific disease area, propensity to prescribe a brand, likelihood to embrace new treatments and channel preferences for receiving information. Then we devise tailored strategies for each segment, with different channel mix and messaging.
Alongside that we come up with a solution for patients and expect it to work for all of them.
Okay, so that’s a bit unfair, but you get my point. In addition to segmenting patients by stage of disease, we also need to consider demographics like age, health literacy and access to technology. Then we need to think about how to engage with different types of patients.
True personalised healthcare recognises that not all patients are highly empowered superheroes.
Don’t assume everyone is seeking the same outcome as patients
As mentioned earlier, the phrase ‘everything is about the patient’ is oft quoted by pharma. It’s a noble ambition but, in my view, impossible to consistently deliver against – and not just by pharma.
While 99% of people in healthcare work with the best intentions for the patient, each of them is often seeking a slightly different outcome. Doctors pursue the textbook clinical outcome, payers want the best cost-effectiveness, commercial companies seek to balance patient benefit with financial returns and patients may want something that doesn’t fit with any of those exactly.
Practically, good patient centricity is about trying to find the optimum route that gets as close to the best patient outcome as possible but keeps everyone else happy along the way. If others can be steered closer to the best patient outcome and away from their defaults then even better, but it’s not always possible.
Good patient centricity recognises you are trying to move everyone towards better patient outcomes while also balancing individual stakeholder needs.
Interact consistently, transparently and authentically
For successful engagement with patient groups and individual patients, these three factors are key,
Interacting consistently means maintaining constant dialogue, not just at times when it suits the pharma company such as a product launch or major event, but being there even when they don’t want something immediately in return.
Interacting transparently is about being brave enough to say “this is what’s in it for us” as well as “this is what’s in it for you”. It’s about not shying away from being a commercial company but showing there are ways both sides can benefit.
Interacting authentically is about the actions matching the words, doing what you say you will and sharing successes and failures in equal measure.
Make patient centricity part of the core business
Finally, the pharma companies that are most serious about patient centricity don’t see it as an add-on service, but a core part of the vision, mission and strategy, rather like some companies are starting to view sustainability. It’s part of the bottom line.
Investors and shareholders need to literally buy into it as an important outcome alongside financial return, but also understand the two are not mutually exclusive and that patient centricity, over time, leads to better products and outcomes on all sides.
Of course, I know that all of this is very easy to state when I’m not sat working in a pharma company myself with all the pressures that it brings, so I’m realistic that it takes time. However, all these points reflect the steady change I see happening in companies that are starting to really understand patient centricity.
For now, patient centricity – done the right way – remains a critical part of the evolution of pharma. But we’ll know when we’ve got it right because we won’t talk about it anymore. All of the above will just be business as usual.