Patient centricity is the new rallying call in healthcare with the potential to change the way pharma does business. It’s no longer just a talking point either; increasing numbers of companies are looking to incorporate the ethos into multiple aspects of their businesses with a concerted effort of putting the patient and their needs firmly at the centre. This is being seen in the new wave of patient education and disease awareness materials, as well as in drug development and innovative clinical trial designs. Indeed, the globalisation of the patient voice has prompted industry associations, such as the International Federation of Pharmaceutical Manufacturers and Associations, to provide guidance and education about ethical and effective patient involvement.
“Developing medicines for patients is not new but developing medicines with patients is,” explains Professor Karen Woolley, global lead, patient partnerships at Envision Pharma Group. “We are seeing more and more clients move beyond the ‘Why involve patients?’ to ‘How do we involve patients?’, and this shift is changing the way companies do business.” She believes the voice of the patient will get stronger, providing positive and transformational change for the industry. However, she adds, the science of ethical and effective patient involvement is still in its infancy.
Indeed, there are still gaps in the business model where some areas are less patent-centric, such as in peer-reviewed publications. These gaps tend to exist because patient involvement will not have been considered, research by Woolley and colleagues has found. The good news is awareness of these gaps is growing, along with motivation to change.
Pharma sales might have been considered one of the last bastions where patient centricity would be applied, given the quest for profits and the ‘no-no’ rules on direct sales to patients. But even here there is a sea change – and an accelerating one at that – where patient centricity is becoming synonymous with value and value-added services, explains Jan Cox, business development director at Apodi. And some companies have jumped full throttle into embracing value-added models.
“Over the last four years, pharma companies have become increasingly sophisticated and effective in how they promote their products in the market place, particularly those launching specialist medicines,” Cox says. “We are seeing more companies who are wanting to wrap additional value around their brands with programmes focused on delivering the best patient outcomes possible.”
With the reality that the current sales environment is something of a challenge – what with constrained NHS budgets, the demand for increased value and outcomes and the need for product differentiation – Cox says it has become an essential requirement for pharma to deliver services to patients, carers and healthcare professionals that offer unique value over the full cycle of care, “with a focus on care and not just the product”. It’s a logical step then for sales to become more patient-centric and, indeed, this approach would be particularly beneficial in the current sales environment, she says.
Examples of what this might look like include upskilling sales teams for a patient-centric-sales approach so they can operate in a specialised value-added account management structure, demonstrate an understanding of the care pathway and provide more of a consultation tailored to the individual preference and needs of the customer, Cox says. A patient-centric approach to sales could also mean the deployment of account teams or patient access teams, with a focus on value, and the introduction of customised flexible solutions to local health economies. There are already trends around technology use, data interrogation, robust market intelligence and enhanced remote customer engagement that are paving the way for a more focused approach to patient-centric sales, Cox adds. But Woolley stresses that while sales can be patient centric it is not a sales tactic – rather, “it is a strategic imperative that is honourable and valuable.” She adds: “The sales story has to be credible, compelling and patient-focused. Sales professionals have to convince buyers, using evidence and relevance-based information, rather than ‘this product does X’. They have to convince buyers that the product will make a valuable and sustainable difference to the patient and the healthcare system.”
But for sales to be truly patient centric it requires patient involvement right from the start of the product lifecycle and then all along the chain. In other words, to present a convincing rationale, sales teams need to know more than just their product, Woolley says. “They must also have a deep understanding of what is valued by patients and potential patients, what will be used by patients and what aspects of the product and/or any beyond-the-pill support will provide a cost-effective management solution.”
The benefit of this patient-centric approach is that products will be developed and sold that truly meet the needs of the patient, she says. “Pharma sales professionals need evidence-based information to share with their customers, but that evidence base will have greater resonance in the real world if it has been created with patients, not just for patients.”
From a sales perspective, that’s not just about having drugs and services that meet patient needs. It’s also about sales teams getting inside the heads of patients and understanding their experience. “Pharma sales professionals listen to and learn from many experts; their expert panels should include patients,” Woolley suggests. It’s a view, she says, that was broadly stressed at the Envision the Patient Forum in January this year. “Patients don’t want tokenistic involvement. They want to be involved as partners and respected for the unique and valuable contributions they can make.”
But Woolley cautions against rushing to be patient centric. It’s imperative that questions are asked that are relevant to that patient’s area of expertise and that the patients are representative of the patients who will use the product.
Healthcare professionals too are seeking to enhance their partnership with patients, Woolley adds, recommending that sales professionals should be looking to provide information that facilitates this, such as peer-reviewed publications that have been summarised in plain language for patients to understand. This makes sense when research by Woolley and colleagues that analysed publications in the Journal of the American Medical Association (JAMA) indicates that patients are more active than doctors in terms of raising awareness (via Twitter) about recent peer-reviewed publications. Woolley says addressing this is a matter of urgency based on the reality that patients share a lot of information from a variety of sources, not all of which is useful or safe. “Relying on plain language summaries would be much better than having to rely on Dr Google, which may not be reliable, or Dr Gobbledegook, which may not be understood.”
Tick all these boxes and Woolley believes pharma sales professionals may actually have an advantage over their industry peers when it comes to patient centricity. “The best sales professionals are always looking to solve the customer’s problem, rather than just sell a product,” Woolley explains. “In this increasingly patient-centric healthcare environment, where researchers, regulators and payers are listening more closely to the patient than ever before, sales professionals will be well positioned to use their skills to help not just their interim customers (that is, healthcare professionals) but also their ultimate customer, the patient.”
Of course, there is the issue of compliance. As Woolley notes: “conflating communication with promotion is easy to do”. But, she says, this is wrong. Take the example of plain language summaries of research abstracts, presentations and publications for patients. It’s easy to raise this as a compliance concern but according to the International Federation of Pharmaceutical Manufacturers and Associations’ Code of Practice, communication of research results to patients is allowed. “If healthcare professionals, the media, shareholders, and other investors can be informed – responsibly – about the latest research, why shouldn’t patients?” Woolley asks.
But even if the issue of compliance didn’t exist, sales teams still have the challenge of accessing face-time with their customers in order to showcase their patient-centric approach, Cox says. The need to highlight that the sales call has value and to position sales teams as the providers of patient-centric solutions couldn’t be more needed in the current healthcare environment, she says.
In many ways the sales team is the shop window of the pharma company; the customer-facing unit that has tended to influence, through its behaviour, how customers and the wider society view the industry. At this critical point in pharma’s evolution, and with the rise of patient centricity, the industry is being forced to change its current model. Pharma sales with a patient-centric twist is now well positioned to showcase the new paths the industry is taking and, indeed, Cox believes patient-centric sales will play a significant part in the success of pharma companies in the future. Value-added solutions might be the code word for patient-centric sales but the key to unlocking it is still patients.
Katrina Megget is a freelance journalist specialising in the pharmaceutical industry
