The current social and economic landscape is shaped by social media, information overload and pressure on costs. In this environment, connecting with your ‘customer’ in a transparent and meaningful way is a must. Healthcare systems worldwide are increasingly defining and rewarding innovation as a composite of clinical efficacy, real-world effectiveness and improved patient experience with new treatments. Effectively demonstrating the patient value of a novel therapy is, therefore, key to convincing regulators, HCPs and the public of its place in the market. In addition, healthcare access authorities are increasingly requesting patient input in drug appraisals, making it critical for ensuring drug success in the real world.
While healthcare is moving rapidly away from physician-centred care and pharma companies are increasingly involving patients in R&D, medical communication plans lag behind. Many medical education initiatives still focus on the classic ‘opinion leader’-led model, expecting that a change in patient outcomes will automatically follow. Highly specialised physicians are still critical for development and education, but the patient perspective is significantly absent. From our recent consultations between healthcare providers and pharma companies, we strongly believe that patient involvement needs to be central to all planning, if greater value is to be delivered.
This article contains three practical steps that will enable you to shape your medical communication strategy to prioritise activities that deliver value for patients. We refer to this approach as Patient Value Planning.
1. Start with the patient
The challenge here is how to ‘adopt’ the patient perspective and prioritise patient-centric versus brand-centric activities.
There are no established rules defining how pharma companies should develop patient-centric strategies, but success stories are emerging. This issue has been discussed at a number of industry forums in recent years. Adelphi’s Renaissance Series is one example that provides a forum for multi-stakeholder debate worldwide on the why, how and what of patient-centricity. The meetings included 250 senior pharma executives, leading physicians, FDA representatives and patient advocates, underscoring the growing interest across the industry in patient-centricity. The consensus is that:
“A shift in the industry environment and patient empowerment is dictating a change in how healthcare solutions are designed. We recognise that patient expectations and needs can differ considerably from the aims and objectives of healthcare providers, at both the policy and delivery levels. In fact, to be accepted by patients, the patient experience should be the key driver for the development of solutions (eg medicines, devices, information, support programmes, apps).”
It is important, therefore, to establish a clear and robust methodology to design patient-value solutions. The ‘science of patient input’ is about engaging with patients and gaining insight into patient experiences and needs, with the goal of designing solutions that treat the patient and not just the disease. While approaches and processes vary in different companies, a good rule of thumb is to ask ‘what does the patient value’ at each point. This ‘patient value’ mindset is paramount to establish deeper understanding of the logistical and emotional patient journey. One approach is to adapt Design Thinking, a proven technique in addressing complex problems by centring on the human needs. In healthcare, Design Thinking can be the ideal framework to drive patient value planning. By means of centring on the human need, patient value planning can be applied in a scaleable fashion, from fully restructuring the medical plan to simply including a patient-value pillar in existing activities.
2. Select appropriate tactics
Medical communication plans are essential to successful launch, uptake and appropriate use of new drugs. We strongly believe patients should play a more prominent role in ensuring that the positioning of new drugs factors in the patient perspective and needs, and this perspective is captured by appropriate communications. There are two major types of activities we can consider in patient value planning, ie tactics relevant to either knowledge collection or knowledge dissemination.
From a knowledge collection perspective, medical plans can include direct engagement with and communication to patients, eg gathering patient input in needs assessments and medical strategies, from clinical trial design through to results interpretation and communication. Key insights can be gained from listening to patients directly through patient and caregiver online surveys, advisory panels, patient forums, virtual meetings, etc as well as HCPs closely involved in patient care, such as primary care physicians, consultants and nurses. This may also include a constellation of supporting specialists such as nutritionists and psychologists.
In terms of knowledge dissemination, we can also make efforts to align the information received by patients and HCPs, and to equip HCPs with the tools and skills to better understand patient needs and to communicate with patients effectively. More and more medical meetings are informing or challenging HCPs with the patient perspective. In addition, as patient organisations are increasingly attending medical congresses, this represents an opportunity for us to reach patients as an audience. If the goal is a patient-friendly presentation, appropriate graphical formats should be used such as infographics or clarification of risk figures. Trial results and conclusions should highlight the relevance to the patient, and patient-reported outcomes should also be included.
3.Give patients access to scientific information
Recent strides have been made to ensure clinical trial results are made available for the lay public, and guidelines are being made available to ensure that these are communicated clearly and unambiguously, but challenges remain. Nevertheless, we see that patients want to consume scientific information at source. Recent research presented at the 2017 Annual Meeting of the International Society of Medical Publication Professionals showed that a considerable proportion of patients (45%) read peer-reviewed medical publications and actively searched for them on the Internet (Figure 1). A larger proportion of patients (80%) appreciated the need for patient summaries of published data. Access to peer-reviewed medical information empowered patients: patients indicated that publications/patient summaries helped them discuss disease management and treatment options with their HCPs and feel in control of their disease. Respondents also stated that they would trust the publications more if they were reviewed by other patients. Although 53% of patients were relatively confident of their ability to understand the medical literature, there is still an unmet need to improve clarity and relevance of peer-reviewed publications to patients.
Publication of scientific data is already a core activity for pharma, so these insights are relevant and actionable. Is there a future role for patients as stakeholders in publication planning? Perhaps this remains some way off, but as patients are already reading the peer-reviewed literature, we argue that there is an obligation to make it clearer and more transparent to the lay audience to avoid the possibility of misinterpretation. The challenge will be achieving this in a compliant way, without reducing the academic credibility of publications or changing the meaning of the results. Patient publication summaries can be a first step in this process and medical journals seem an appropriate channel. However, few medical journals currently publish patient-level information, so alternative channels of similar credibility need to be considered.
The changing dynamics of healthcare conversations, with patients playing an active role in decision-making, call for the redesign of our communication strategies to integrate patients in the various stages of the process as stakeholders, authors, contributors and audience. Figure 2 shows that the patient value mindset can be applied throughout publication planning and execution.
In conclusion, the way value is defined in different diseases and patient groups will vary, and the best interventions for pharma will continue to evolve, but patient value planning provides a framework to guide medical and brand teams in the right direction. Insights into patient needs and how patients want to consume information give us the best chance to engage with patients, improve the patient experience and thus achieve the full potential of the drugs that take so much investment to bring to market.