healthcare

Drug Delivery Partnerships

Patient-Centricity Shares the Stage

February 2, 2016
by Mike Dunkley

So I attended the Drug Delivery Partnerships conference at the PGA National Resort and Spa, in Palm Beach Gardens, Florida, last month.

The best (non-meteorological) part of the conference: it allowed me to join many rich conversations on hot industry topics, the chief takeaways of which I’ll share with you now.

Recalling the DDP sessions, two phrases vault to mind: “patient-centricity” and “patient journey.” The common usage of these terms at DDP was a clear sign that the pressures of driving revenues in pharma markets are influencing the thinking around the drug delivery experience and how to improve it from the patients’ perspective. A welcome development.

The gravitational pull of the drug-centric business model is strong.

But the scope of pharma’s current thinking around patients is narrow. Patient-centric considerations are mostly limited to the drug delivery device, and the associated patient journey starts only at device onboarding. The gravitational pull of the drug-centric business model is strong.

At the conference I heard scattered talk of trying to recognize patient needs sooner in the overall development process, to inform drug teams about formulation stability or viscosity and reduce dosage volumes through increased potency and availability. The current norm: drugs get developed with limited patient inputs, and drug delivery device teams focus in on safety and usability issues—and then move on to onboarding and adherence challenges.

This linear approach is understandable. Retire the risk of early stage drug development and layer on patient needs as the business model permits.

But patients are people, with different beliefs, attitudes, hopes and fears, mental models for their diseases, and economic realities. A truly patient-centric approach would consider them as individuals from the moment a first symptom or concern arrives, supporting them through diagnosis and their decision to treat, helping them recover from periods where they have become non-adherent, and guiding their lifestyles when not aligned with positive health outcomes. It would seek their inputs at the earliest stages of R&D. A truly patient-centric system, one that increases the chances of improved patient outcomes, must also provide meaningful value propositions for the array of stakeholders involved in their care.

A truly patient-centric approach would consider patients as individuals from the moment a first symptom or concern arrives

Here’s a patient story to illustrate the point. Dr. Brennan Spiegel‘s work at Cedars-Sinai Health System puts him on the frontline in testing technology with patients. One study involved measuring patient activity alongside patient-reported outcomes (PROs) for people undergoing treatment for rheumatoid arthritis. The first patient in the study surprised the team: her self-reported pain showed dramatic improvement during the study but, at the same time, her physical activity plummeted. The researchers were perplexed, so they decided to speak with the patient. Turned out, she loved to write and, without the usual stiffness and pain in her knees and ankles, she could enjoy extended periods of time at her desk fulfilling her passion. A patient-centric approach would seek out such stories as key inputs in the development progress. From the very beginning.

The first patient in the study surprised the team: her self-reported pain showed dramatic improvement during the study but, at the same time, her physical activity plummeted.

There are examples of pharma companies learning from on-line patient communities, or inviting patients to meet with their science teams, infusing the process with some empathy for the end customer. The trending new role these days is the Chief Patient Officer, but there is a long way to go. The industry and its development teams are still mostly siloed from each other, let alone the patients they ultimately serve.

Pharma may be anchored in its drug-centric business model, but the gravitational pull doesn’t preclude the industry from bringing patient needs into consideration. It just means that pharma companies will continue, first and foremost, to develop new drugs and get them to market. Once risk-sharing or outcome-based payments become the dominant business models, pharma will be compelled to think more broadly and holistically about the customers it serves, and patient-centricity will gain greater traction. In the meantime, the opportunity is here for industry leaders to gain an advantage.

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