Are You Sponge Bathing Regularly?

Is pharma's money really where its mouth is when it comes patient support?



It's amazing how much we hear about patient centricity.  Everyone is patient-centric these days - companies that don't have their patient support/patient centricity/patient focus functions are being left behind, clamoring to put something together - as well they should.  Clearly, pharma is making a major shift toward patients. For all the welcome changes in policies and organizations, there is still the question of just how much real effort is going into these initiatives and just how seriously these internal patient groups are being taken.

There are those who point out, quietly, that for all the talk about patients, budgets for patient support programs are the first to go when things get tight, as they inevitably do at one point or another, and that budgets are inevitably much greater for "revenue generation" activities such as marketing, sales, and market access.  In other words, is pharma's money really where its mouth is?

Sponge bathing means talking a lot about patient centricity while in reality doing only the bare minimum.  It means cleaning up your image with a smile and a washcloth while refusing to open minds and wallets to substantial patient support.

There are parallels in other domains. For example, many companies, inside and outside of pharma, talk up a good story when it comes to ecology and sustainable development, but they don't really do much besides putting sorted garbage cans in their offices.  This is universally known as "greenwashing".  Likewise, whenever a scandal of some sort breaks out and the muckrakers are placated with conciliatory verbiage, we speak of "whitewashing".  Recently, a new term has even arisen for those who pretend to give substantial proportions of revenue to causes such as breast cancer when the reality is less altruistic: this is known as "pinkwashing".

So, we have greenwashing, whitewashing and pinkwashing, all denoting a lack of sincerity behind apparently noble intentions.  What then should we call insincere patient centricity?  I propose "sponge bathing".

Sponge bathing means talking a lot about patient centricity while in reality doing only the bare minimum.  It means cleaning up your image with a smile and a washcloth while refusing to open minds and wallets to substantial patient support.  Typically, sponge bathing is driven by an inherent, pervasive, and utterly incorrect belief that supporting patients is a pure cost and that revenue generation comes from other sources, primarily focused on increasing prescriber market share.

Since chronic patients generally take only about 50% of the drugs they are prescribed, it is blindingly obvious that increasing adherence through patient support will have a direct positive impact on financial results.

This is wrong.  It's incorrect, it's a fallacy, it's not true.

Since chronic patients generally take only about 50% of the drugs they are prescribed, it is blindingly obvious that increasing adherence through patient support will have a direct positive impact on financial results.  Why, then, do many pharma boards seem to think the contrary?  Part of this conviction comes from the pervasive tendency to deny outright the fact that supporting patients helps revenues.  In many pharma companies you can't even suggest that, you can't put it on an internal presentation.  This is crazy and disingenuous.  In reality, it's far easier to measure the positive impact of a good patient support program than it is to measure the impact of your promotional efforts.  However, those instances in which pharma do these measurements are few and far between, buried in ad hoc, expensive consulting missions.  Imagine if that were the only way you measured your market share.

The truth is that pharma execs are terrified of public opinion, both the opinions of patients and of payers, and they think that if they admit the obvious they will be chastised for it.  They tremble at the thought that their activities toward patients could be construed as attempts to increase corporate profits.  This leads to the absurd and rather pitiful spectacle of corporate executives trying to pretend that their fortune 500 company operates like an NGO when it comes to patients despite the fact that increasing adherence is in the best interest of the patients, the payers, the healthcare community and investors

In reality, this is excellent news - the interests of everyone are aligned: patients need support to follow their treatment properly and pharma has the money as well as a direct financial incentive to provide that support.  Yes, there are restrictions to what can be done, but that's not an excuse to feign ignorance... or even worse, to actively foster it internally.

And yet, that is what most pharma companies do.  They pretend there is no link.  Unfortunately, they do this so very well that they end up convincing themselves.  By refusing to open their eyes even a smidgen, they do not systematically measure the financial impact of non-adherence.  In the last column, I talked about the importance of regularly measuring MPR, of making it a centerpiece of corporate strategy, a KPI right up there on the balanced scorecard with market share.  This can not happen, though, if pharma continues to pretend that there is no link between adherence and results.

It is much easier to offer patients a sponge bath instead of real care, but if you think this is helping patients you're wrong, and if you think that by refusing to measure the impact of non-adherence you are somehow being more ethical... well, you're not even being patient-centric.  If you want your own people to take patient centricity seriously you have to change your KPIs, measure adherence regularly, engage all stakeholders via this analysis (they are not stupid and will appreciate the lucidity of your reasoning), determine the ROI of your different initiatives and provide real support instead of sponge baths.


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