It seems the whole healthcare industry is buzzing with the phrase ‘patient-centric’ these days. From GP surgeries to hospitals, therapists to pharmacists, everyone wants to demonstrate how in touch they are.
But what about pharmaceutical companies? In a world where the focus has long been about getting patients to comply with their medication regimes, how would a change in that mindset pay for itself? And how would we recognise its existence in a drug company’s behaviour?
For a start, we might hear a different language. One of the early lessons I learnt in understanding patients was from the Executive Director of Alzheimer Europe, Jean Georges. I was about to embark on a research project with Alzheimer’s Disease patients and carers at the time, and wanted to know from his existing studies how to handle early interactions in my interviews.
“These are people living with Alzheimer’s”, he told me, “both the person with the disease, and those caring for them. They are defined by their life, not their condition. It’s only the clinicians who always refer to them as patients.”
That realization points to how pharmaceutical companies will need to research health conditions in the future, if they want to genuinely gain a ‘customer’ perspective. That means exploring beyond the boundaries of their world – of drug pipelines and Loss Of Exclusivity (LOE) dates – and seeking to understand the lived experience, as well as the clinical impact, of those they treat. How might that happen in practice?
Personal priorities – for example, in the case of a person being treated for rheumatoid arthritis, a clinical goal may be to slow the progression of the disease, using disease-modifying anti-rheumatic drugs (DMARDs). But the individual patient may frame that same goal in terms of maintained mobility or even personal independence. And from a regime adherence perspective, it may be that the patient considers effective pain relief to be their number one priority, feeling unable to engage in a meaningful discussion about longer-term treatment until such pain is under control. Only through understanding such personal life priorities can the wider health outcome of the individual be framed and measured in a ‘patient-centric’ way.
Broader horizons – similarly, in order for individuals to understand and make choices about their medication, healthcare information needs to be made clear, accessible and relevant. Such communication success may not always be achieved through mechanisms such as patient information leaflets. Patient-centric pharmaceutical companies will look beyond their legal and code of practice requirements, and embrace broader communication routes with family, friends, carers and communities. Such environments may be less familiar to drug firms, but will be more accessible, natural and friendly to the wider public.
Patients for life – in its Progressions Global Life Sciences Report 2012 (Ernst & Young), Sanjeev Wadhwa describes a future where the bond between ‘patient’ and ‘pharmaceutical company’, is more holistic, where lifelong relationships might exist, rather than population treatment histories. Such an approach might provide for more personalized healthcare for the individual, whilst also enabling drug firms to see the life impact of their medication alongside its clinical effectiveness.
Why should the pharmaceutical industry invest in such patient-centric behaviours? Outside of brand reputation and CSR commitments, there are clear commercial opportunities here too. If pharmaceutical companies can demonstrate the social and community benefits of treating patient goals as seriously as clinical ones, the financial impact on government and insurance company decision-making could be significant. An example might be how the healthcare industry as a whole explores combatting depression. Of course drug firms already make an important contribution by offering existing medications to help this illness. But how might a patient-centric pharmaceutical company respond to research where individuals reported from their own experience that physical exercise (see ref. below) or meditation had positive benefits? What social benefits might accrue from an individual tackling their health condition in a park or a swimming pool, building confidence and friendships in the process? Could these informal health environments be more cost-effective for payers than clinical settings? And could a combination of drug and non-drug intervention become part of a broader assessment of patient outcomes?
In the traditional model, a patient-centric approach for pharmaceutical companies has the potential to impact its product research & development itself, by seeking to design medications and treatments, by being in tune with individuals’ needs and attitudes to healthcare. And in a more holistic model, patient-centricity may require a broader assessment from government, scientific bodies and investors in healthcare for how support provided by pharmaceutical firms are judged to benefit patients.
Ernst, C. et al. (2006) “Antidepressant effects of exercise: Evidence for an adult-neurogenesis hypothesis?” Journal of Psychiatry & Neuroscience 31(2): 84–92.