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Empowering the Patient
Pharma's changing relationship with its customers - eyeforpharma columnist Emma D'Arcy on patient expectations.
Would you like vine-ripened tomatoes or mini-bell peppers with that pasta? A recommended summer read your e-bookshop thinks you’ll enjoy? Big Data has made it possible for companies to know ever more about customers’ choices and habits.
Doctors and patients, like the rest of us, have come to expect the personal touch from service industries. From personalized bargains and recipe suggestions in our online grocery shop to tailored savings packages from our bank, we all recall great customer experiences.
On the flip side, we also, alas, tend to remember our worst experiences as consumers. According to Lee Resources, 91% of unhappy customers will not willingly do business with the same company again. And, according to McKinsey, 70% of buying experiences are based on how the customer feels they are being treated.
Whether it’s a face-to-face or digital encounter, creating a positive customer experience (CX) is therefore vital to revenue growth and long term success.
As our digital health gurus attest, Pharma is on the brink of a new relationship between the industry and the patient. In this new relationship, the emphasis needs to be focused on health rather than on disease, and show greater sensitivity to how people live their lives.
Making it happen can seem a Herculean challenge, thanks to two main factors: firstly, the highly regulated environment in which Pharma operates, and secondly, because the customer journey is very different than most other industries.
Patients are the end customers but all the professional decision-making intermediaries – prescribing physicians, payers and regulators – play a part. All these stakeholders influence the patient experience and affect decisions about whether and how to market individual Pharma products.
Empowered patients are driving change
For CX to move beyond merely delivering a message to customers, it needs to focus on how individual customers can personally benefit from what Pharma has to offer. We must stop talking about a homogenous group of “patients”, as Paul Tunnah, CEO of Pharmaphorummedia puts it, and start thinking of them as unique individual people instead. Tunnah believes a new kind of “empowered patient” is crucial to driving this new relationship between Pharma and customer. These individuals have a strong online presence thanks to their forums or blogs; they are often activists on behalf of loved ones or they may themselves be sufferers of a condition. Their hunger for information means that they are often not only abreast of the latest treatments and research but are in fact actively driving change.
To take just one example, retired aerospace engineer Andrea Borondy Kitts successfully changed insurance coverage for lung cancer screening in the USA through her powerful social media campaign. Borondy Kitts is what the industry is calling a Patient Opinion Leader (POL) and according to Emma D’Arcy, these POLs are going to become even more significant in the future. It remains to be seen to what extent Pharma will collaborate with these groups, and whether this is set to become an area for further regulation.
Pfizer’s Mike Bellis, head of CX Europe, says empowered customers are those whose local affiliates are fully accountable to them. He says Pfizer is developing what he calls “greater empathy with our customers to get a sense of what it feels like to be them.” To achieve this level of empathy, the company needs to know a great deal about its customers. This is where data analytics is essential, to track the patients at each stage of their journey, “to allow us to see how we are doing,” Bellis adds.
Empowered patients, as Emma D’Arcy points out, are fast becoming “expectant patients.” She urges executives not to lose sight of the fact that “patients don’t wish to perceive themselves as being ‘ill’. They want to be diagnosed, understand and adapt to their condition and get back to the business of living their lives.” Data analytics technology allows Pharma to track the patient journey, freeing up resources to work on the business of developing that all-important relationship of empathy with customers.
Emma D’Arcy is a Medical Biochemist and regular contributor to eyeforpharma, specializing in patient engagement, participatory medicine and socialized health.
Emma has an extensive network of relationships with patient groups, HCPs and has worked with KOLs in all therapeutic areas. She has received several awards for her leadership in Pharmaceutical medical communications and was shortlisted as a global influencer in the industry for her work on the socialization of health.
Patient collaboration - how do you define it?
The era of social health means that patients have changed the social contract they have with both their doctors and with healthcare providers. Add to that the influence of health commercialization, with trackers and platforms for health sharing created daily by corporations such as Microsoft, Google, Samsung etc; we are in a customer-centric world where patients expect to collaborate readily to find and resolve health challenges. Patients expect competitive collaboration between all healthcare organizations to ultimately expedite innovation and delivery of new solutions to health crises.
People used to be victims of ill health; now they are seeking victory over ill health. They expect more. They are no longer thrilled if a Pharma company has lines of communication open to them. They expect it. The whole concept of the empowered patient is dead. Long live the expectant patient!
Are patients fully aware of the strengths they have today?
Patients are influenced by, and influence others as consumers of healthcare. Accordingly, they are agile and adept in discerning between drugs and manufacturers and will readily compare, contrast and curate information about drug use, access to drugs and the manufacturers of drugs.
How will the collaboration between patients and Pharma reflect on internal departments?
People used to be victims of ill health; now they are seeking victory over ill health. They expect more. They are no longer thrilled if a Pharma company has lines of communication open to them. They expect it. The whole concept of the empowered patient is dead. Long live the expectant patient! Patient motivation is probably the best way of broadly categorizing patients. POLs sit at one end of the spectrum as people who want to talk to other experts and have high-level information needs.
There are also the so-called health hedonists who want answers quickly and efficiently, and those at the other end of the spectrum, the health deniers, who have difficulty accepting their condition and are by far the hardest for anyone to engage with.
Can Pharma digest the amount of information they will get from patients?
The most savvy Pharma companies accepted very quickly that they have to work with conversational, emotionally charged and often opinion-led people.
Increasingly, patients don’t wish to perceive themselves as being ‘ill’ they want to be diagnosed, understand and adapt to their condition and get back to the business of living their lives as unencumbered as possible by ill-health.
These companies also recognize that they have to be prepared to engage in proper dialogue and put in place the processes and procedures to allow their people to talk with patients. Some companies can do it; it’s not rocket science.
This can include providing them with tools to help them track their health, monitor their adherence to medication or, in any number of ways, enable them to adopt a more responsible and proactive approach to health. These are great projects because they work with the trends, which are to help people be victorious over their condition. Increasingly, patients don’t wish to perceive themselves as being ‘ill’ they want to be diagnosed, understand and adapt to their condition and get back to the business of living their lives as unencumbered as possible by ill-health.
That said, there is a rise in the ‘worried well’ – the ‘cyberchondriacs’ who are overwhelmed by social health sharing and the influence of non-medical experts who can elicit alarmist responses. Pharma can also play a role in helping KOLs to become socially savvy and help deliver trusted social-health content of medical caliber. Pharma will help patients if they catalyze an influx of clinical expertise into the social health and patient centric movement – to be in the center of the clean-up.
What is the role of big data in making the relationship between Pharma companies and patients smoother?
Patient centricity is best-served when Pharma employ POLs directly, open research grants to collaborate with all interested parties wholeheartedly and share fails and successes.
That includes candid debate and acceptance about the performance of drugs in the real world outside of the perfect patient population and sterility of the clinical trial.
Every AE from a product in the real world, for example, tells us something about the risk versus benefit of that drug. We need to amend our interpretation of real-world data and realize that signals from social sharing and real-world data provide invaluable insights and actually protect a product and a Pharma company’s reputation rather than threaten withdrawal or negativity, respectively.
Paul Tunnah is the CEO and Founder of Pharmaphorum media. He received an MA in Biochemistry and DPhil in Biological Sciences from Oxford University, UK. He has worked as a policy consultant to the British government and is a key industry advisor on social media communication.
You are a firm advocate for patient empowerment. You’ve been known to say the power of information is “quite literally, life-saving.” Can you explain?
The level of more direct engagement is increasing and there is enormous potential in gaining patient input into every aspect of developing and launching new medicines.
We tend to talk about ‘patients’ as being a homogenous group of people, which is not true, as they are all people and every person is different. It is probably fair to say that it is a minority of current patients who are well-informed as to how they can engage with, and impact, the way Pharma works. Equally, there is disparity among patients as to how much they want to engage in real collaboration with the industry and healthcare providers. Current collaboration between Pharma companies and patients is predominantly indirect, for example, through market research, advisory boards and clinical trial recruitment working through third-party organizations like market research companies and patient advocacy communities. However, the level of more direct engagement is increasing and there is enormous potential in gaining patient input into every aspect of developing and launching new medicines.
Open communication before, during and after any collaboration to keep everyone informed on objectives and progress against them is also very important.
What’s the secret to successful collaboration between patients and Pharma?
Transparency, transparency, transparency! Patients are generally well informed about the Pharma industry and understand its necessity to balance their needs with those of shareholders and investors, so, clarity on the benefits for each side in any engagement is critical.
As part of this, open communication before, during and after any collaboration to keep everyone informed on objectives and progress against them is also very important.
How will Pharma organizations and legislations change to adapt to new situations of patient collaboration?
The current regulatory environment limits direct patient engagement outside the US and New Zealand (where direct-to-consumer advertising is allowed), due to the fear of being seen to ‘promote’ products directly to patients. Greater regulatory clarity (from regulators and within Pharma) and case studies of how to engage without breaking the rules are therefore necessary to drive more collaboration and better explain the risks versus rewards of patient engagement.
What’s the next step in improving patient and Pharma collaboration?
There are three main challenges: regulations, communication and trust. The regulatory aspects have already been outlined, in terms of not breaching promotional compliance in patient engagement.
The second challenge – communication – relates to the different language that Pharma and patients often use. Industry-centric terms, such as, ‘adverse events’ and ‘product indication’, are often meaningless to patients, so, engaging in plain English is important.
The final challenge, relating to a lack of trust from some patients and the public towards Pharma, can only be addressed by actually doing more direct Pharma to patient collaboration, so will hopefully be overcome in time.
An exclusive interview with industry leaders, Paul Tunnah and Emma D'Arcy (reprinted with kind permission from Verix).
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