Talk is cheap and in the pharma world, ‘patient engagement’ and ‘patient-centricity’ have many attributes of marketing success – everybody is talking about them. There are designated roles termed ‘chief patient officer’ or ‘Patient Advocate’. There even are awards for pharma’s patient engagement efforts. It is safe to say, that the pharmaceutical industry has been putting a lot of resources into patient engagement. Unfortunately, the output appears to not live up to the input.
How have the awarded initiatives impacted patients? How many patients did they reach? Did they improve the quality of life of these patients or their caregivers? Did they improve medication adherence or a medication’s safe and responsible use? The careful answer is: we don’t know. The awards of the pharma marketing world reward input, not output or performance. However, one channel where performance quickly becomes evident is apps. When looking at pharma’s attempts to engage patients through these digital channels, the picture that emerges is not particularly favourable: judging from the number of downloads and average score of user ratings, patient impact is very limited.
One may argue that this lack of patient effectiveness reflects pharma’s basically unchanged business priorities: despite all the buzz around patient-centricity, patients are a marketing prop at best. HCPs are still pharma’s only customer. Some marketers may consider storytelling around patient engagement to be a sufficient source of differentiation. This standpoint has always been questionable and is becoming increasingly flawed: with remuneration models starting to build on real-world outcomes, pharma’s engagement efforts need to achieve both differentiation towards prescribers and impact with patients.
Pharma’s structural barriers to successful patient engagement
More and more companies seem to have understood that their patient-centric efforts need to deliver both a higher share of voice with HCPs and real impact with patients. However, at least with respect to the latter, they continue to fail miserably. Does that mean that all the talking about patient engagement is just PR? I would argue otherwise: pharma’s patient engagement ambitions are more real than ever- it is in the delivery where things go wrong! Over years of working with pharma on engagement initiatives, I’ve encountered three major barriers that the industry faces in engaging patients.
Barrier 1: Stuck in a silo
Big pharma’s priorities and budgets typically stem from products and their life cycle: Patient engagement efforts are to support a specific product’s launch or growth phase. Hence, the resulting services and apps cater to one specific product or perhaps one disease. This approach confuses patient-centricity with disease-centricity and ignores the fact that many patients are living with more than one health condition. Frustratingly, knowledge on co-morbidity-driven patient needs is often available in other parts of the company but is not being considered.
Barrier 2: The innovator’s dilemma
Clayton M Christensen described this phenomenon in his book The Innovator’s Dilemma. While effectively engaging patients is strategically important for pharma today, in most cases it has yet to become a business case in itself. When it comes to budgeting decisions on a product level, patient engagement competes against long-established marketing measures like the yearly congress booth. With its short-term payoff appearing to be less certain, patient engagement is chronically underfunded. The same simple and compelling logic also explains why digital units are not delivering on the corporate level: the foreseeable return on investment simply does not stack up against the core business. With no clear monetary value attached to patient impact, these units are either systematically underfunded or need to focus on non-patient-impact KPIs such as PR or corporate brand building to deliver their value. Therefore they forgo tapping into the real potential patient impact could have (as opposed to creating talk, talk, talk).
Barrier 3: No quick rewards for the brave
Engaging patients requires the development of specific skills and technology. Starting from scratch takes considerable time and resource just to get a first product (service, patient offering) out of the door.
After all, today’s patients (users) have become used to a world-class user experience, whether using apps, on the web or with call centres. And it does not end with the launch. Retaining patients requires continuous efforts for operations and – more importantly – refinement of the service. Those in charge need to make bold decisions (and invest real money and time). Proving them right will take years rather than months.
In a world of frequent job rotation this requires extraordinarily brave agents of change for driving a patient engagement initiative: they have full exposure for the risks they take, but will have moved on by the time the benefits set in. In most large organisations, there are easier and less risky ways for climbing up the ladder.
Getting delivery right
Can pharma effectively engage patients despite the structural barriers? Definitely. But actively addressing them significantly improves the odds of success, for example, by using one of the following tactics:
Reap the launch opportunity: Product launches allow leveraging global resources for developing an effective and globally scalable engagement programme. Successfully reaping this opportunity requires leaders and/or partners that have a proven track record in patient engagement and think as much about later operations and refinement as about the initial launch
Accelerate and enable partnerships: Traditionally, pharma’s accelerator programmes focused on supporting early stage start-ups. While this is good for PR, hardly any of the accelerated start-ups gained traction with its host’s core business. Accelerator pioneers like Bayer’s Grants4Apps are therefore putting increasing focus on matching external start-ups with the needs of its core business through their new ‘dealmaker’ programme
Enter population health management: This goes along with payment for real-world outcomes. Integrated care models such as the ones Sanofi is establishing in diabetes elevate patient engagement to a key driver of service value and make it a direct contributor to pharma’s core business case.
Any of these tactics will fail without crystal-clear business objectives for patient engagement and continuous backing through top management. We rarely find all these pre-requisites in place, but it is happening. The resulting new generation of initiatives strictly focuses on actual engagement. And the pharma marketing talk? It will persist. And it should! However, I would suggest switching the topic of the engagement conversation from input to impact.
