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Patient centred

The rise of the 'professional' patient signifies a new era for pharma marketing

A group of doctors examining a patient on a pedestalFor years the pharma industry has focused all its attention and promotional budget on just one customer: the physician. But the healthcare landscape is dramatically different now compared with when the physician-centric model evolved. A new breed of customer is becoming increasingly informed, taking a more proactive approach to pharmaceuticals with a treatment choice almost equivalent to that of the physician in certain therapeutic areas. This customer group begins with P, but it's not the payers. I am talking about the patients themselves. While the role of the physician and payer is now widely accepted in the industry, we ignore the third P — the patient — at our peril.

Patients are educating themselves
So where do patients currently get their information? In a very short period of time, the adoption of the internet has changed beyond recognition the way people access information. Recent research in the US suggests that 8 out of 10 internet users have looked online for healthcare information, making this a significant source of information for patients.

As well as increased access to information, the internet has also provided a platform for interaction. Further research suggests that 82 per cent of internet users are involved with some form of social media. In the UK 68 per cent of patients report that they use social media for health-related discussions: interestingly, according to their responses, the most popular sites used for this purpose are not the social networks that are dedicated to health matters.

The reliability of health information presented through social media cannot be guaranteed: sometimes a little knowledge can be a dangerous thing, especially as most people place great trust in the information on social media forums, regardless of the source. More US research, for example, indicates that 70 per cent of consumers believe pharmaceutical information from peers is credible, even if these peers are not qualified experts.

Discussing health on social media sites may make it impossible for the average patient to gauge the difference between reliable and unreliable information. However, a significant proportion of web users — 85 per cent of physicians and 92 per cent of consumers — think that pharma companies have an obligation to correct misinformation on social media sites.

The unreliability of the information and the reliance from web users on pharma's involvement are among the many challenges social media presents to the industry. Regardless, whether you love it or hate it, social media is here to stay and will remain an important source of information for patients.

Truly professional patients
In niche therapeutic areas, particularly long-term and hereditary conditions, the importance of the patient has long been accepted. It was in such a therapeutic area that I first came across the term 'professional patient'. The term, introduced to me by a physician, refers not simply to a well-informed patient but to one who is so well educated about his disease, its treatments, the products available and dosage regimens, that the physician is happy for the patient to be fully in control of his own treatment. A professional patient tailors his treatment levels according to his own assessment of his needs without medical consultation. He may even ask for his medication to be changed to a particular brand and the physician will normally comply.

One piece of research in this particular therapeutic area suggested that if a patient requested a specific branded treatment there was a 70 per cent chance the physician would prescribe it, such was the level of faith the physician had in the patient's ability to manage the condition. This may be an extreme example, but as marketers working in these types of marketplaces have known for years that the patient is an important stakeholder it also reflects the levels of trusts and influence patients have already been able to achieve in certain markets.

If we take a moment to consider the role that patients currently play in healthcare we may even decide that 'professional' patients already exist in all therapeutic areas. For example, the National Institute for Health and Clinical Excellence (NICE) has a 'Citizens Council', which prepares reports to be presented to the board of NICE. The board then issues a formal response, explaining its reaction to the report. Conversely, the influence patients have on health technology assessments (HTAs) conducted by NICE is currently limited; however, the Government's vision (as laid out in Equity & Excellence: Liberating the NHS, July's NHS reforms White Paper) states that patients will have more 'clout and choice' in the modern NHS. This means that patient influence on HTAs may well grow in the future.

The impact of the reforms
The White Paper sets out a vision of patients able to make their own choices about treatment, with the view that involving patients in their care improves patient outcomes. The White Paper states that: 'In addition to NHS choices, third parties will be encouraged to provide information to support patient choice.' This will include a range of online services to provide more information and data on all aspects of healthcare. These services will be web-based resources and patients will be directed to them by search engines like Google.

Patients will also be given access to their records and will have the option to share these with patient groups and any other organisation they deem fit. The aim of this is to create 'informed patients exercising choice' with the aid of a new consumer champion, Health Watch England, located in the Care Quality Commission.

Ultimately patients will be able to vote with their feet: if they are not happy with the care they are receiving they will be able to register with another GP or go elsewhere for their care, regardless of where they live. As the 'money follows the patient' this could make informed patients very powerful, although the concept of giving patients personal budgets could limit what this means in real terms. We will find out more about personal budgets in 2012.

The holy trinity of decision makers
With industry pipelines shifting to secondary care markets and more specialised disease states, the rise in social media and the recent NHS White Paper, the 'professional' patient has never before been so important.

As an industry we must now interact with a triad of decision-makers: physician, payer and patient. As decision making is becoming multi-faceted, we need a multi-faceted approach. This has to start within the brand planning process, utilising processes that encompass all three customer groups. Each of these customers has different needs and different environmental pressures to be determined and considered. The identified stakeholders' influence and their potential alignment to the marketing objectives need to be taken into account when establishing how to influence the decision-making process.

In the 'liberated' NHS, understanding the ability of your brand to demonstrate an economical and health benefit is essential, with a clear understanding of the value your brand offers and (most importantly) how this value relates to each of your stakeholders. Each stakeholder type needs bespoke communication messages, delivered through relevant channels that will generate a response. In short, your brand planning process needs to carry each stakeholder right through the process to deliver a strategy that can be implemented in an aligned fashion.

With an aligned strategy, defined objectives and specific communication messages (within ABPI regulations), the pharma industry can help to ensure that patients receive accurate and balanced information. As an industry we have the ability to add real value to all of our stakeholders: by partnering with patient groups and physicians we can educate and add real value to the end user — the patient. After all, it is in everybody's interest to educate and inform patients and ultimately help make patients more 'professional'.

The Author
Craig Dixon is director and principle consultant at Marketing and Sales Solutions (MASS).

To comment on this article, email

18th August 2010


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