Customer-centric pharma is a challenging road, but it’s worth it

For many of us working in the pharmaceuticals industry, we are driven to make life better for people. To do that effectively you need to understand what people need, be they patients or other users of your products.

This is blatantly obvious, yet things get in the way. In my first year working in pharma, I have been stunned by how many companies are structured by product, paralysed by compliance fear, escalate decisions away from customers and up the hierarchy, and rely on blunt sales metrics. I’m sorry if that upsets you; it does me.

If we look outside of our industry, there are some fantastic examples of companies benefiting from going all in on customer-centricity. Take Haier, the world’s leading appliance manufacturer. During 2012-18, 12,000 managerial positions were abolished, and the 70,000 employees were put into thousands of 10-15 people companies. Each of them operates entrepreneurially in pursuit of ‘complete obedience to users’, with reward directly linked to user value creation.

Despite what I was seeing, I stubbornly refused to believe that in an industry that cares so much about the people it’s serving, that there weren’t instances of their needs being placed in greater focus. So, I went looking for them and – I am pleased to say – I found some compelling examples.

BioVentureHub (BVH) was set up by AstraZeneca in 2014 as “as an open innovation ecosystem in the life science industry”.

The scale of AstraZeneca enables huge investment in research, global reach and many other benefits. It also creates barriers. As Magnus Björsne, CEO of BioVentureHub, puts it: “We’re not in the pharma business, we’re in the trust business.”

He means that just as patients have to trust that the drugs they are prescribed are safe, collaboration partners have to trust that your interests are aligned and this can be challenging for a public company like AstraZeneca. That’s why, as a not-for-profit, there are no financial return expectations.

BVH exists solely to enable AstraZeneca’s values of following the science, putting the patient first and being entrepreneurial. It does that by enabling organisations to focus on customer needs, without the usual commercial constraints.

AstraZeneca, like many other big pharma companies, was sitting on thousands of discontinued development projects. The niche application products for instance, could suit a small, or start-up company. Small companies, however, lack the budget and competencies to take them on.

Consequently, AstraZeneca restructured the assets to suit niche players and sold them for 1 SKr – about 10 pence. One of the divested tech projects could supply variable and highly accurate dose sizes, normally managed by having different tablet sizes, which is costly and impractical.

Another notable application, which is delivering radically improved results, is within attention deficit hyperactivity disorder (ADHD) medication trials. This has allowed remote dosage adjustments and administration, meeting compliance requirements and using technology to prohibit user abuse in the process. This is a clear example of valuable innovation developed within the BVH ecosystem that can be expanded to other areas of medicine.

AstraZeneca is very skilled at understanding people at the molecular level. The Health Works entity was set up to complement the science with everything else that is needed to develop sustainable patient solutions.

Stefan Vlachos, Head of Health Works, offers me the example of people with heart failure that want to be more active in their own treatment. They need support that is tailored and continuous, which speaks to a digital monitoring solution. If patients get a warning, however, they worry and go to the emergency room. Primary and secondary aren’t set up to receive warnings either.

This is where Health Works steps in to bring together the technology, the education, the payment mechanism and redesign of the patient pathway. That involves building partnerships and whereas a large pharma company might typically contribute funding to an NGO or patient group, Stefan insists Health Work’s partnerships are on equal terms.

That means that the partners have equal rights to any nondrug intellectual property developed, another example of Health Work’s living its mission of working together to improve health.

Stefan is also keen to advocate how being open to the holistic patient experience, rather than being totally focused on product development, can lead to novel discoveries. When working on predicting deterioration in the heart failure patients, Health Works uncovered the significance of patient anxiety and knowledge limitation in patients’ ability to manage their condition.

He calls these ‘collateral insights’, which are shared across the organisation to enable new solutions to be developed.

It might be attractive to think about copying someone else’s approach or, conversely, to cross your arms and say that it could never work in your organisation. While the approaches can differ, there are common principles that any company can use to put customer needs front and centre.

Customer-centric organisations create opportunities where everyone, not just those in sales or support roles, have direct contact with end users. New Starbucks CEO Laxman Narasimhan recently spent four weeks training to be a barista, serving real customers. How could your leadership team spend a month in the field?

If you have field visits as part of your induction programme, repeat them every year. Make it easy for employees to visit or volunteer in relevant wards at their local hospital, on company time. Host patient-employee days.

Instead of measuring your account teams on their HCP call rate, how about valuing the quality of end-user insights? Complement the direct contact with photos, video interviews and cross-organisational sharing of customer insights, whether they reflect positively on the company or not.

There is much to learn from charities doing a particularly good job of sharing the often painful and unsightly realities of some conditions, like the striking photo exhibition at a Málaga train station by the Spanish Epidermolysis Bullosa organisation. AstraZeneca creates safe spaces for employees to discuss not just their customer interactions but also their own experiences of life with a medical condition.

Most importantly, support all individuals in your organisation to make use of their insights, to make decisions that put customer needs first and to bring those voices into the boardroom.

If you work in the short-acting insulin division, you are going to care about making the most effective, or stable or cheapest insulin you can ie, product-centric. If you work in the ‘stable blood sugar’ division or the ‘easier living with diabetes’ division, your job is now to think holistically about meeting that need.

“But we’re a pharmaceutical company” I hear you cry. That’s the product-centric stance. I don’t see myself as someone that uses insulin. I see myself as an athletic, concerned global citizen that has a second full-time job managing my diabetes. My insulin might perform well, but my insulin pens don’t fit in the little airport liquids bags without taking the lids off, and I’m frustrated by the mountains of waste my sterile, quality-controlled equipment leads to.

Netflix and Airbnb are two companies that succeeded by focusing on the need (viewing on demand and interesting accommodation) rather than the incumbent products (DVDs and hotels). The difference is tangible externally too. If the insulin representatives visit a large hospital, they are competing for attention with other brands.

If they are there to help patients stay in their target blood sugar range, there are a lot more opportunities for all parties. Instead of one rep for rapid insulin, one for long-acting insulin, one for tablets etc from the same company visiting the same specialist, and Medical and Commercial doing their compliance dance, what about developing a deeper partnership around the biggest hospital and patient needs?

By visiting hospitals, GE Healthcare discovered that children find MRI scans scary, so GE’s personnel decorated rooms and machines with adventure themes like pirate ships. They even walked around on their knees to get a child’s eye view. The product was meeting the hospital’s needs, but not the end users’. Creating better life outcomes is hard. It takes collaboration.

Decide the areas in which you want to collaborate and in which areas you do not. For AstraZeneca, the molecular science is its area, whereas drug delivery is open. To find collaboration opportunities, go see your customers in their world and go together to see their customers’ worlds. Invite them and your suppliers and competitors to discussions about how you can collaborate in ways that will make a difference on the things that matter to you.

Health Work’s journey began by asking NGOs and patient groups what their biggest needs were and then putting all their resources behind the projects with the greatest promise.

The idea of customer-centricity in pharma is decades old. If you’re ready to truly embrace it, the advice from Roche’s transformation is to forget about the model and start by shifting your mindset. In the BeLux region it set the target of delivering as much as five times more patient benefit at half the societal cost.

This is all about having the confidence to put customer benefit first. If you do that right, you’ll get the business returns in the longrun, and that represents a worthwhile investment for everyone.

Harry Malcolm is Principal Consultant at Rubica. Go to rubica.co.uk