In the present era characterised by a swiftly changing healthcare environment, it is important to take a step back, assess the stakeholders, and review their position of power in relation to disease management.
There was a time when innovative pharma companies could rely on their R&D, their pipeline filled with promising compounds, their salesforce and marketing machinery. Things have changed; companies are now facing major changes, not only in R&D, technology, and global and local markets, but also in a social, environmental and legal context.
In this challenging environment companies need to recognise changes and act cohesively within a group or network in order to respond to these challenges, strengthen their competitive edge and meet the needs of a wider group of stakeholders.
The internet has played a major part in shifting the balance of power in the doctor–patient relationship. The doctor is no longer the oracle. People are becoming more interested in lifestyle, in drugs, and they know where to access the information.
Power of the patient
A recent study in the UK, implemented by Van Dongen Research in collaboration with Opinion Health, showed the power of the patient in the GP's practice. A total of 150 GPs and 488 chronically ill patients completed a survey, which showed that patients are actively searching for information regarding their disease and will consult multiple sources.
Of the GPs surveyed, 99 per cent feel that they do involve the patient to some extent. Ideally, 94 per cent of the patients want to be involved in disease management decisions; 32 per cent of these want to be involved fully. The survey revealed that 81 per cent of patients do feel that they are involved in treatment decisions in some way.
When it comes to treatment choices patients are taking a stand; 34 per cent of the patients surveyed said they asked for an alternative drug to the one suggested by the GP. Some 60 per cent of this group said that after consultation with their GP they received the requested alternative. The findings also show the importance of providing accurate information with regard to both a specific drug and the disease management. As patients are actively searching for information, it is essential that the available information is well managed.
Providing accurate information to patients can increase adherence and ensure long-term sales. Estimates suggest that 15-25 per cent of all drugs prescribed are not collected by patients. This represents a huge loss for pharma companies.
A strategy is as strong as its foundation. Managers in pharma companies need to understand the key driving forces that affect their performance. In the contemporary healthcare environment marketers need to ask: "How patient intelligent am I?"
Patient-led treatment decisions
Have you ever asked your doctor to prescribe an alternative treatment for your condition based on information you have sourced elsewhere? (n=488)
Did your doctor agree to prescribe the alternative drug? (n=168)
The definition of patient intelligence (PI) describes the way in which we collect and use patient information. It encompasses the technologies, applications and means for collecting, integrating, analysing and presenting data related to their beliefs and understanding of health status. The research outcomes can be used to report past patient information, as well as predict future trends, threats, opportunities and patterns.
It is important that healthcare organisations begin to lay the foundations on which PI can be built so that through their chosen strategies they are able to reach the next level of sophistication. With an integrated understanding of the players and the dynamics of regional health economies, they will be positioned better for promotional innovation and managing long-term stakeholder relationships.
PI can be used to ensure accuracy of patient information provided by the pharma company. Also, common beliefs about how a patient reacts to drugs and/or how the disease is affecting his/her daily life can be validated or dismissed. For patients making decisions about disease management, quantitative research can guide feedback in a structured way.
Online fieldwork helps to cover certain disease dilemmas, especially the ailments that are considered as 'taboo' or include specific 'taboo' subjects that still do need to be discussed. There are many questions you could ask patients about the management of erectile dysfunction or incontinence, or even how to cope with the side effects of drugs.
PI applications can be used to improve compliance with, and quality of, healthcare. They can also contribute to guideline acceptance. Incorporating the thoughts and views Healthcare providers might accept guidelines more readily if they know that patients' thoughts and views are incorporated in a methodical way.
As patients continue to become more knowledgeable and powerful, PI will become increasingly important. Going forward, all stakeholders will challenge healthcare organisations to develop structured pathways through which patients' viewpoints can be integrated into every process.
What information sources do patients most often use to understand their treatment options? (please select up to three most frequently used sources)
Future implications of patient intelligence
Healthcare organisations will be challenged by all stakeholders to develop structured pathways with which to integrate the patients' viewpoints into every process. A start for developing such a pathway is to draw up a checklist on your patient.
• What does he/she read? Which newspapers, journals, websites?
• What happens on social networks and discussion forums on the topic of the disease?
• What does the GP or specialist tell the patients when diagnosed?
• How is the drug described by the healthcare professional?
• Are adherence and working mechanism explained properly?
• Are patient information leaflets you provide accurate? Is the information on your patient information website accurate?
• What is it that the patient needs in terms of additional information or services?
Companies often need to outsource patient intelligence research, regulations do not allow them to contact patients directly. Moreover, designing proper quantitative and/or qualitative research projects and implementing them requires statistical and empirical knowledge.
The patient voice
By using the patient's voice in research for numerous issues, healthcare organisations will be able to validate common beliefs regarding diseases. Additionally, they can provide accurate information, which the patients can use to be more compliant and/or improve quality of life. When approached in a structured way, the patient can be involved in the decision-making process related to his or her own disease management (within boundaries). This will help to improve quality in healthcare through improving quality standards.
Implementation of PI applications
Making patients' voices audible, in order to improve efficacy in healthcare, can be achieved through qualitative or quantitative research. Efficacy in healthcare can be increased by carrying out research aimed at finding out how to integrate the missing components of patient experience and their perceived value into quality standards within the healthcare environment.
In order to create a platform for patients and to ensure quantitative research is feasible, a specific 'Patient Intelligence Panel' (PIP) is formed where patients can register to participate in research. Having access, through the internet, to thousands of people around the world who are willing to participate in research on healthcare and specific indications, means questions can be asked and a wide range of feedback obtained. Through the aid of consumer marketing models, this feedback can then be integrated into a structured, defined path and into marketing campaigns, for every stage of a product's life cycle.
All stakeholders in the healthcare environment can utilise this PIP to gain access to their patients. Patients have been very committed to contributing their opinions through online questionnaires at the PIP platform and in focus group discussions with the PIP members. For the most part, patients were very excited about being able to contribute to broadening the views and perceptions of large pharmaceutical companies. When a PIP member fills in a questionnaire, an incentive is paid towards the patient organisation or charity of the member's choice.
Nadine van Dongen is the founder of Van Dongen Research
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