The two questions currently baring down on senior pharma executives are:
(1.) How do you compete for market share?
(2.) How do you maintain premium pricing in order to continue to drive revenues and revenue growth to meet shareholder expectations?
To address these questions effectively, pharma needs to get serious about kicking its addiction to drug-centric business models, and look to patient experience as a possible cure. The future of innovation and reinvention belongs in the realm of patients. With strenuous competition in many therapeutic markets—and future payments linked to patient outcomes—the need to demonstrate value to the patient, and deliver ROI to health systems “beyond the pill,” is acute.
The MS Patient as a Model
Take multiple sclerosis. MS is a progressive, potentially debilitating and life-shortening disease that, although currently incurable, can be slowed by drugs. From a commercial perspective, it also represents an attractive market. There are currently 10—yes, 10—branded therapeutic products on the shelves in the U.S. And with the recent clearance from the FDA for Sandoz to market Momenta’s generic version of Teva’s Copaxone, the competitive dynamic is set to intensify.
For the most part, competition in the MS market has followed traditional lines. Companies huddle around IP protection and significant physician marketing budgets to increase market share. The main vectors of comparison? Safety and efficacy. Developments in drug formulation and delivery technology have created an improved injection experience for patients, and the recent appearance of numerous oral therapeutics has increased the weighting of delivery experience in the treatment-decision process.
Can pharma be brave enough, strategic enough, to reframe the problem and step back its drug-centric habits? Could it even temporarily set the drugs aside, and zoom in on unmet patient needs as the catalyst for innovation? I suspect that those companies that can will benefit enormously, and so will their patients.
What pharma needs is a successful patient experience strategy, one that will address the many MS challenges patients face. Treating the disease from initial diagnosis. Extending treatment through managing relapses. Switching therapies or recovering from poor adherence. It should also focus on areas such as reporting and alleviation of symptoms, care-coordination, patient education, financial assistance, and provide communities for support—and to exchange ideas and experience.
MS provides a rich opportunity for a patient-centric strategy, owing to the uncertainty of diagnosis, the unpredictability of its progression, and the complexity of the disease—including the significant challenges of managing a broad range of symptoms.
Early Pivots in the Direction of Patient Experience
Companies are beginning to think more about patient experience. Bayer, for instance, invested in the BETACONNECT autoinjector for the delivery of Betaseron. This novel delivery system uses Bluetooth or USB to allow for patient adjustment of injection speed and/or needle depth. The same connectivity is used to upload delivery logs to an app, for sharing with caregivers and incorporation within an electronic health record. The app also provides injection time reminders to patients, along with a record of injections and injection site history, and it connects directly to Bayer’s BETAPLUS patient support resources. However, despite the clear attempt to provide greater patient value, it feels like the result of thinking “drug out” rather than “patient in,” starting with technology as enabler, rather than patient unmet needs as the innovation catalyst. That said, Bayer is set about proving the value of its approach and is currently engaged in an observational study, not only to evaluate adherence to therapy, but also to evaluate key secondary endpoints such as anxiety, depression, and fatigue.
Moving beyond the drug-and-delivery experience, with the aim of providing greater patient value, Novartis has launched SymTrac, an app that allows for tracking and recall of symptoms, such as pins and needles in a specific area of the body, or mood and energy, in order to support productive discussions with care providers and to make the most of this essential interaction time. Although branded as a Novartis product, the app can be used independently of any specific therapeutic.
Traveling even further into patient-centric territory, Biogen Idec has recently launched a number of new initiatives, including a hackathon aimed at solutions for stress management, a recent patient trial using Fitbits in partnership with PatientsLikeMe, and a partnership with Google that employs Google’s data analysis expertise in order to provide insights into disease progression within patient populations. Sifting through the resulting insights will be challenging and will require considerable creative thinking but could provide significant competitive advantage, if patient value is seen as the key factor to guide development. The example being set by Biogen is less about the specific activities it’s pursuing and more about its bullish attitude of testing and learning. This willingness to try new things will prove a critical enabler as it seeks to embrace patients, rather than drugs alone, as the driver for innovation.
From Discreet to Complete: Next Steps for Pharma
While it’s encouraging to see pharma feeling its way toward the potential of patient-centric solutions, the greatest challenge is yet to come. Breaking out of the drug-centric model to become broader providers of services will necessitate transformative organizational change. Will pharma show a readiness to embrace market strategies based on patient value and outcomes, rather than volumes and premium pricing? Will it show a greater willingness to experiment and fail? Ever-increasing competition between branded products, generics, and the entry of biosimilars in U.S. markets will force the pace of this change.
In short: The moment to create a significant competitive advantage is now. Companies that can successfully deliver and differentiate on patient experience, and can demonstrate additional patient value as a result, have the opportunity to do so. The question is: Who will be bold enough to recognize this fact, and act?