Not yet six months into his new role at Boehringer Ingelheim, new UK medical director Professor Klaus Dugi is keen to bring his global experience to the local level and help tackle the big picture issues that his company is grappling with.
The role is the first position at the company that Dugi has taken outside Boehringer’s homeland. Until now he had always worked in Germany, starting in the company’s research and development centre in southern Germany, where he focused on translating Boehringer’s pipeline candidates in diabetes through the preclinical stage and then on through clinical research.
After that he took up a role as therapeutic area head for metabolic diseases, before moving to Ingelheim and company headquarters to become Boehringer’s global head of medical affairs. From there he has spent the last five and a half years as global head of medicine, or chief medical officer.
“Then the feeling was that people should get experience of working in a country, so I moved to the UK, because the feeling was that maybe the country could benefit from someone who could bring global experience,” he says, adding: “It’s a good experience to see how we work cross-functionally to bring medicines to patients.”
The global pharmaceutical landscape is going through a lot of change at the moment, but since coming to the UK Dugi says that change may be occurring at a faster pace in that country than those around it. But, whatever the pace of change, some fundamental challenges remain for the industry to answer, both in the way companies work internally, as well as how they collaborate with external stakeholders.
“For me, it’s really important that medicine is an equal partner to the other functions, to marketing, sales and market access, to bring together and disseminate our scientific information and to bring our medicines to those patients who can benefit from them,” he says.
“We understand also that in the UK payers have an increasing role in making medicines available, so that’s an important customer for us too, to help them understand how our medicines are differentiated from others and why it would be good for them to add them on their formularies.”
We don’t necessarily measure, compare or benchmark ourselves with other companies
Patient-centricity
Near the top of the agenda for Dugi and his company is a desire to be more ‘patient-centric’, though he says Boehringer wants to tackle this on its own terms.
“We don’t necessarily measure or compare or benchmark ourselves with other companies. We say, ‘this is where we are today, and this is what we aspire to’. Then we measure in regular intervals to check whether we are on the right track to becoming more patient-centric.”
He adds: “We’re determined to ‘walk the talk’, because what we hear from patients is that they don’t really see it happening at the pace they would like to see.”
The company has worked hard to receive The Information Standard certification, last year becoming the first in the industry to be awarded England’s ‘Kitemark’ for information and materials.
Commissioned by NHS England and run by Capita, the Standard is intended to help people identify what health and care information is clear, accurate, balanced, evidence-based and up-to-date among the sea of content they have access to.
In signing up to The Information Standard, Boehringer joins the likes of the Alzheimer’s Society and the British Liver Trust, private healthcare provider Bupa and many NHS Trusts.
The Standard means that information and materials can be understood by patients, as judged by the patients themselves, rather than just being clinically accurate. Currently Boehringer is taking a phase rollout approach to bringing its materials in-line with the Standard, but its plan is that ultimately all of its patient-facing literature will conform.
Measuring what matters
Another of the ways Boehringer has prioritised ‘patient-centricity’ is through a pioneering scoring system that will enable it to measure its progress, and give patients, carer organisations and its own employees clearer idea of what the company stands for and where it is heading. It has an internal purpose too, with the aim of reflecting the NHS, as exemplified by the UK government’s vision of a health service where ‘no decision about me, without me’ can be said to be the norm.
At the heart of the scoring system will be a process of continuous engagement with patients and measurements of the quality of peoples’ interactions with the company. This process is starting with how Boehringer measures up in the eyes of patient groups.
Dugi explains: “It will not necessarily be based on simple numerical targets. For example, it could be that we look at how well we conform to The Information Standard, which is a measure of how useful, accurate and readable our information is, as judged by patients themselves.”
He adds: “By having clear benchmarks that are revisited year in, year out, we expect to be able to demonstrate internally and externally that the company is moving in the right direction allowing us to set new and ambitious goals.”
The scoring system is still a work-in-progress, with the exact system yet to be revealed, though Boehringer hopes to have it up and running before the end of this year.
We’re trying to build in patient-relevant endpoints with some of the available digital technology
Remaining relevant
Other areas where the company is looking to be more patient-centric include adding more patient-relevant endpoints in clinical trials. “If you run a study in chronic obstructive pulmonary disease, or COPD, often the primary endpoint is lung function. And the patient may be happy to hear that his lung function has improved, but he or she may be much more interested in whether they can walk up a flight of stairs, or play with their grandchild, or make it outside again to the corner shop to pick up a pint of milk, and so on.
“So we’re trying to build in some of these more patient-relevant endpoints with some of the available digital technology, so we can measure how mobile patients become with a new therapy, are they more active etc.”
This requires wearable technology, but of a kind a step or two future than currently available consumer tools. “Fitbit is great,” Dugi says, “but it also has its limitations. For instance, I dance the tango, my wife has a Fitbit device and she always gets upset when we dance the tango and it doesn’t count her steps. So there are more sophisticated devices being developed, which are more like a belt, for instance. Or there’s technology that puts detectors in garments that are a little bit more elaborate and probably provide more reliable data.”
The involvement of patients in their own health and the part that digital health technology plays has been one of the big healthcare shifts over the last five years. “Patients are becoming much more involved in their own health, getting much more information through the internet and become much more educated, which is a good thing,” Dugi notes.
“It’s very important for a pharmaceutical company to not miss digital health trends – we don’t want to be the next Kodak.”