Blended: Pharma's New Multi-Stakeholder Model

Exploring the multi-stakeholder commercial model now and in the future



Physicians, patients, payers, providers, policy makers, partners, regulators, shareholders; the once slowing moving stream of pharma stakeholders has swollen into a roaring cataract in recent years.

The currents carrying pharma towards an ever-greater focus on patients, collaborations and technology are gaining power too, putting even more strain on existing assumptions and models.

However, among all the many stakeholders, the focus on the patient is paramount, says Bharat Tewarie, EVP and Chief Marketing Officer at UCB. “This means that we have to organize ourselves internally around the value that we create for our patients – helping them live the life they want. We need to bring the patients inside the value chain as early as soon as possible and we need to move away from validating solutions we developed for the patient to co-creating solutions with the patient, and maybe one day, as the patient.

To achieve this, horizontal collaboration and cross-functional working is essential, says Tewarie. “In the beginning, people think cross-functional collaboration means aligning everybody before you move but that is difficult and could slow things down. What you should ask is ‘How can I bring the right organizational strength at the right time?’.”

Co-creation with patients must be done from the beginning. “I don’t think we can assume we understand the needs and wants of the patient, or that we can think for them,” he says, suggesting that companies need a new set of rules around how to work with patients as well as systems, tools and processes to gain a 360-degree view of patients.

By definition, patient-centric working implies collaboration, says Pascale Witz, a member of the board of directors of Fresenius Medical Care and Savencia, and former member of the management board of GE Healthcare and Sanofi. “Collaboration will enable access to a lot more knowledge, competence and capability, and this I why it is so important,” she says. “You can never have all of the knowledge and all of the competence in-house. Most companies have already implemented this understanding at the research level, working with external partners, but we must take the same approach with other stakeholders, like payers, providers or technology companies.”

Collaboration is particularly important when it comes to technology, says Witz. “Technology has led the patient revolution; it started ten years ago when patients were coming to the doctor and saying, ‘Hey, I’ve read on the internet.’ Today we patients are empowered health consumers, while, at the same time, technology enables us to collect an enormous amount of data that, in turn, makes us understand the patient far better.”

She adds: “In a world moving towards evidence-based medicine, it is imperative that you find a way to ensure patients are really on board, since their engagement in managing their health can greatly improve outcomes. This can only happen if you work effectively with many different partners – including patients and payers. This is going to change the business model for the pharma industry.”

Innovation will come from the convergence of technology and science, adds Witz, but there are many challenges ahead. “This is really hard work; it doesn’t happen just by putting people together,” she says.

While an integrated multi-stakeholder approach is the way forward but it will take time, says Cord Friedrich Staehler, Global Head Medical Devices and Services at Merck and former Chief Technology Officer for Siemens AG Healthcare. “We are generating a new ecosystem, one more like the IT industry, and will be playing different roles in it. We have to understand each company’s role in this new ecosystem that is forming around serving patients. I don’t think it will only take 2-3 years, more like 5-10 years,” says Staehler.

He points to challenges such as the need for seamless interactions and the difficulty in monetizing activity within the new ecosystem, which will be markedly different from the current way companies receive payment for individual healthcare “building blocks”.

“We need to translate all of this into solutions, and a crucial part of that is to understand where we need to be and how to maneuver,” he says. “You need digital elements to understand that, to generate data and to create insights, then use the insights to navigate. This is happening at the speed of technology so we need to get ready, but I think most companies are preparing for it.”

Pharma’s FOMO may be well-founded, implies Witz. “It is very important that pharma companies not be disintermediated. You don’t want to leave the management of the patient to other companies or you’ll just be the provider of the drug and not a part the whole solution around it. This is where the mind-set of collaboration is critical because you need to think about solutions that are plug-and-play. You cannot have solutions that exclude anyone.”

The challenge is huge, says Staehler, but so is the potential pay-off. “It is technically doable to find a way to digitize the path of the patient, even to buy in services and goods, and get the funds for it, but it’s very complex, which is why it hasn’t happened yet. It will certainly be a very interesting business model, if we can get past the complexity.”

Pharma’s current advantage – that it understands the complexities of the healthcare ecosystem – is under threat, he adds. “This knowledge from an analogue world gets diluted if the entirety gets digitized. It’s just a question of time before your value disappears so you’d better make the next step in the new ecosystem.”

With so many possibilities and challenges swirling around in this space, what do the experts believe will actually happen in the near future? “What is needed is a common platform on which individual solutions will be built,” says Tewarie. “This would require a consensus of collaboration, a common perception within pharma that does not see the platform itself as a competitive advantage but the individualized solutions instead. A view of the ‘holistic patient’ will drive this; we have to figure out a business model to make this work.”

Witz adds: “We have to watch out because the industry tends to think that this is all so complicated that nobody else could work it out. But the technology guys are super smart.”


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