Reality sights

With the ever-increasing numbers of novel drugs and advanced treatments including cell and gene therapies coming to market, medical communications need to be adapted to help overcome instinctive resistance to change by prescribers and patients.

As novel therapies rise in profile in life sciences, behavioural science has a powerful role to play in overcoming potential barriers to new prescribing behaviour.

As treatments become more complex and ambitious, it follows that a more tailored approach to medical communications – guided by behavioural science, informed by evidence of what any barriers to change are – will be important.

This is so that HCPs don’t automatically default to their habitual choices of medical or treatments, but become more open to emerging options that may improve patient outcomes.

If they are not, patients may be unfairly deprived of opportunities to get better or to experience a better quality of life – something most healthcare stakeholders profess a keen interest in enabling.

It’s for this reason that the UK’s Medical Research Council is now advocating the use of behavioural science in the design of interventions such as medical communications campaigns, to ensure that important new biopharma innovation fulfils its potential for patients.

This isn’t simply a case of educating the market about the new product’s benefits, however. There are other factors that keep decision-makers coming back to habitual choices.

Behavioural science draws on psychological theory and the social sciences to understand why individuals follow or resist certain behaviours.

Equipped with those insights, drug companies can become smarter and more strategic in applying their communications resources.

In a public health or ‘responsible citizen’ context, behavioural science has been used successfully across a range of high-profile cases. These include encouraging people to follow COVID-19 guidelines, take up vaccines and make healthier lifestyle choices.

In the biopharma industry, the opportunity is to lower any identified resistance to supporting and offering novel therapies in place of entrenched drug prescription pathways.

While it’s possible to make an educated guess about healthcare providers’ reasons for sticking with tried and tested treatment choices (including officially recommended first-line treatments, budget restrictions and/or a lack of knowledge of the emerging options), the reality is usually more complex.

The COM-B model for behavioural science determines where barriers to behaviour change fall, based on the relative roles of capability, opportunity and motivation as determinants of current behaviour.

Armed with these insights, communications teams can combine the most appropriate of 93 different techniques (based on established devices such as the Theoretical Domains Framework and Behaviour Change Wheel), to ‘nudge’ new behaviour.

Drug approval and associated education/data represents only one-third (the Capability element) of the combined factors that may be needed to effect a change in behaviour. The other factors at play can be harder to predict.

It may be that the HCPs involved don’t have access to the right resources to see through a new treatment plan, for instance. Or perhaps prescribers are not being encouraged to try something new by the system they are in.

When it comes to rare diseases, HCPs and patients may have accepted as inevitable what many people would consider a gruelling regime if it is keeping the individual alive. A new therapy might be seen to disrupt the equilibrium that had been achieved, even where there is a promise of an improved quality of life, and it may be patients’ parents that are the main source of resistance.

Distilling the particular combination of ‘blockers’ to behaviour change is the first step in designing an effective medical communications campaign.

Ideally this needs to be guided by a structure, framework or methodology, to ensure that campaigns are evidence- rather than assumption based and have maximum impact across the target blend of channels.

Behaviour-change frameworks contain a set of instructions to guide the development of a behaviour-change strategy, in this case a medical communications campaign.

Drawing on the COM-B model, medical communications teams can start to determine what kind of campaigns might work best to drive change.

In a public health context, COVID-19 required a series of new behaviours, starting with fastidious hand-washing, face-covering and keeping a distance from others.

Getting the public on board required improving their knowledge of what to do and how (capability) – ensuring they had access to soap/hand gel or face coverings (opportunity); developing a clear plan of when they should do these things and align this with why they needed to do it or what they would get from it (motivation - e.g.  reduce the risk of negative outcomes/protect themselves and others).

At Amsterdam’s Schiphol Airport more than two decades ago, repeat issues with the cleanliness of the men’s toilets prompted alternative thinking.

Putting up signs did nothing to drive ‘a better aim’, but when the creative team designed a realistic ‘fly’ into the ceramic of the urinals, suddenly customers’ ‘targeting’ became more accurate.

The change was possible; it was a case of finding the right motivation. The impact was striking, too, reportedly an 80% reduction in urinal spillage and an 8% reduction in total WC cleaning costs at the airport.

With strong, evidence-based insights into the specific barriers that need to be overcome and the changes that are needed, it becomes easier to identify the right type of message and content, as well as the most effective combination of modes of delivery.

There is a commercially robust argument for doing all of this. In biopharma, applying behavioural science is about making sure more communications land effectively more of the time.

It is also about having greater ability to track the progress of communications campaigns, and establishing a method of tailoring the most effective messaging, making it possible finally to truly exploit omnichannel opportunities.

Managing biopharma marcomms to drive robust ROI is not rocket science. But involving behavioural science enables best practice in identifying barriers in prescribing behaviour – by removing the element of habit, or guesswork. Ultimately this will maximise communication channels.

William Hind is CEO at Alpharmaxim. Go to alpharmaxim.com