14-15 - Prime Patient - Patient centricity

In 2012, health tech journalist, Kisch, predicted that “patient engagement is the next blockbuster drug”. A bold ambition. When Laura McKeaveney, Global Head of Patient Engagement, left Novartis at the end of 2020, she stated “patient centricity has a ‘transferable business value’ for a company”. Novartis has become the benchmark for excellent patient engagement practices with publication of measurable parameters that represent the ‘return on investment’ for a company infrastructure when patient engagement practices are approached as a business necessity and not just a ‘nice to’ concept.

The potential for patient engagement to become a therapy, a commodity and a catalyst to improve all aspects of pharma business and product development from that clarion call is coming to fruition. Laura and the team at Novartis recognised that getting patient engagement right – from the inside out – and creating a transferable business value from patient engagement was key to making sure that a patient-centric organisational mindset works – and pays. Payment is in the form of the ‘triple win’ – approaches, products, services and enduring policies that deliver benefits for patients, for pharma and for society.

Despite the intensity of patient-centricity projects and the plethora of branded patient engagement programmes run by pharma, we are still struggling to justify investment in approaching patient engagement as a strategic business essential for a company. The milestones of patient engagement are given in Figure 1, behind which are inputs from broader societal change and expectations from patient and advocacy groups which started more than three decades ago with the first ‘patient centric ward 4b’ opening for people being treated in 1984 for HIV infection.

There are parallels for patients living with rare conditions today to those early struggles and patient lobbying groups for people living with HIV. Both patient groups share the determination to be ‘heard’ within pharma – to disrupt, contribute to and challenge clinical trial protocols – to do whatever needs to be done to get new medicines to patients as soon as possible.

As such, it is evident that patient engagement impacts on every ‘department’ within pharma walls and the outcomes of patient engagement practices internally provide huge societal impact. Patient engagement therefore, must be strategically driven and recognised as requiring end-to-end practices from patient-focused drug development through to long-term patient support programmes.

Given that bottomless funding pockets do not exist and that pharma is increasingly scrutinised for the financial relationships it has with Patient Advocacy Groups, it is crucial that, internally and externally, a company has a transparent standard operating and reporting procedure for all investment in patient engagement activities. The return on investment must be demonstrated from all patient engagement projects.

Again, there is nothing sinister in this reporting when it is approached from the ‘triple win’ perspective. Figure 2 summarises the current academic ‘proof’ that this triple win is achievable – and acceptable to our different healthcare regulators and society itself.

Within a pharma company, the importance of, and needs for, patient engagement differs according to the department (Figure 3.). This serves to demonstrate that an overall patient-centric approach for an organisation is essential.
The pivotal ‘relationship vignettes’ that require a strategic approach to patient engagement are as follows:

Product development depends on clinical trial participation – clinical trial participation depends on engaged patients being recruited and staying in the trial – the clinical trial protocol needs to be practically and psychologically percipient of the patient’s needs and expectations and this relationship must be established as early as possible to build trust and collaboration
Patient advocacy and lobbying for early diagnosis and to truncate the patient journey can be assisted by pharma-sponsored awareness and patient educational programmes
•Regulatory approval routinely expects data from Patient Reported Outcome Measures and Patient Reported Experience Measures – PROMS and PREMS – to be part of clinical trial protocols by expert patients. Again, including patients in the creation of PROMS and PREMS requires early and enduring relationships
Access to treatment and care is competently improved and expedited when pharma and patient groups collaborate to highlight unmet medical needs
Long-term benefits of treatment – adherence and compliance and patients who are motivated in self-care contributions to their well-being have a measurable reduced use of other healthcare resources which is of great benefit to society.

Companies who ‘join the dots’ as described above, within their organisation and communicate, upskill and train employees to recognise their contribution within a patient-centric approach to patient engagement to deliver the ‘triple win’ are assured of more efficient and justifiable return on investment in patient engagement initiatives.

Companies who communicate this intent externally are able to improve measurement and validation of a strategic approach to patient engagement across the sector and to retain the current increased societal trust that is resulting from offering life-saving solutions in response to COVID-19 infection.

The time is right for pharma to be recognised for the incredible contributions made to improving and elongating human health. The triple win attitude amplifies the importance of pharma’s role in the global healthcare infrastructure. Importantly, it can be evidenced that patient engagement activities demonstrate excellent ROI in every desired outcome – from R&D through to global sustainability in healthcare initiatives (Figure 4).

Crucially, for pharma, patient centricity across the organisation – by investing in patient engagement activities in all areas of the business, ultimately has the potential to bring a product to market some two and a half years earlier and patient support programmes substantially reduce all disease related health costs. As a ‘blockbuster’ drug, therefore, it is little wonder that such invaluable return is establishing patient engagement initiatives as therapeutic/adjuvant products in their own right.

Accepting the need for a patient-centric organisational psyche and the impact on the business is one thing; implementing change and adjusting to the practicalities across huge organisations is perhaps the bigger challenge. Expert patient engagement agencies have a part to play in this transformation in three distinct ways:

Amplifying the patient voice in healthcare
Activating patient insights for pharma
Augmenting ‘normalisation’ of strategic patient engagement practices.

At Prime Patient, we have created bespoke ‘Patient Insight Positional Papers’ that employ specific ‘reach, relevance and impact’ assessment of patient activities and relationships with PAGs to identify where a company has gaps in its patient engagement strategy, which potentially leaves them vulnerable to missing a key relationship opportunity with patient leaders and policy makers.

Investing the time to audit internal success from existing patient programmes also identifies those ‘transferable skills’ that can be shared between departments and within different therapy franchises. Ultimately, recognising that patient centricity is no longer a ‘nice-to’ but a ‘must-do’ business essential is key to securing longer-term investment in patient centricity that delivers success for an increasingly patient-focused future, equipped to hear the patient voice and implement patient needs into pharma’s healthcare solutions.

Patient centricity that delivers the ‘triple win’ is a business essential for pharma