Patient outcomes in practice: delivering value that transforms lives

Over the next five years, the NHS needs to drive efficiencies of £22bn. Like all global healthcare systems, it faces the challenge of improving the health of larger and older populations, with less and less money. Value-based healthcare is targeted to fix the problem through achieving the best outcomes for patients at the lowest cost. Providers, payers and manufacturers all have a role in achieving value, with increasing ethical pressure on drug pricing and resultant innovative, outcomes-based pricing models.

More than ever, pharma must demonstrate its value contribution to healthcare. It is responding with patient-centric corporate missions, and patient outcomes-driven visions, and investing in laudable initiatives with the aim of improving patient outcomes. All of the top ten pharma companies have company-level partnerships and initiatives such as funding of patient self-management technology, novel software to measure patient-reported outcomes data, commitment to incorporating patient-reported outcomes measures in real-world data programmes, and patient advocacy support. Companies are then driving patient-centred strategies through organisations with prominent campaigns. And at the brand team level, we see above-brand/beyond the pill/value-added initiatives in cross-functional plans.

But the model for commercialising medicines is changing even further. It’s no longer good enough to prove a commitment to patient outcomes; we must demonstrate an impact. As a result, and despite the impressive programmes stated above, true translation needs to go further. Our mindset needs to change. In our planning meetings we need to discuss how we can change patients’ lives in a therapy area, what outcomes matter to patients, and how we can measure clinical practice change and improved patient care.

These questions are central to the premise of medicine optimisation: the ‘person-centric approach to safe and effective medicines use, to ensure people obtain the best possible outcomes from their medicines’. This should be the goal of pharma and the ‘value-add’ packages designed to optimise a medicine’s use to deliver the best outcomes. It means we have to think big in designing programmes. We must understand how we can affect the system and improve decision-making, information, access, monitoring and treatment transitions. It means that the medical education programmes, patient support programmes, risk management plans and service design initiatives that are incorporated into cross-functional plans need to align behind the same desired outcomes - so that we can then measure the impact. We will think more strategically; we will create broader, more impactful programmes and our measurements will change from reach and breadth to value-based metrics. The organisations that do this first will lead the industry.

As an agency, we partner with our clients in transforming lives: making medicines work in the real world through improved decision-making, information, access, monitoring and treatment transitions. And we want to partner with our clients in ensuring they then demonstrate the impact of the value they deliver.

This means bringing the best measurement capability to each client solution: measuring barriers to behaviour change, clinical practice change metrics, clinical audit measures, patient throughput and service cost-saving metrics, and patient reported measures.

With this vision in mind, we have built an outcomes-led approach to initiative planning. This allows us to think differently with clients. To start with the outcomes that matter and work backwards to define what programmes, initiatives and interventions we need to effect if we are to demonstrate a difference. These outcomes should then inform not only the value story and trial endpoints, but also the target measures of value-add packages and medical education. This requires strategic planning support to ensure coordinated outcomes-led design of cross-functional plans and that this approach defines how tactics are implemented.

The vision for improving patient outcomes is there. But for this to be more than lip service requires translation of the vision to execution of outcomes-led strategic planning, cross-functional alignment and metrics collection capability that transcends annual key performance indicator cycles.

Dennis O’Brien is Lucid co-founder and CEO; Louise Verrall is managing director, Lucid Partners