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Patient-centric programs and strategies can deliver improved market access, patient compliance and patient outcomes, according to a panel of industry experts assembled at a recent webinar, /Patient-centric Strategies for European Pharma/, organized by eyeforpharma in partnership with Innovex.

Patient-centric programs and strategies can deliver improved market access, patient compliance and patient outcomes, according to a panel of industry experts assembled at a recent webinar, Patient-centric Strategies for European Pharma, organized by eyeforpharma in partnership with Innovex. But the group stresses that truly successful programs require a long-term view towards delivering stakeholder value and improved healthcare outcomes.

Morna Butler, Director of Global Health Management at Innovex, says although pharma is getting closer to patients in its marketing strategies, improving patient adherence must be driven not simply by improving drug product revenues, but by a true and lasting commitment to improving the quality of care for patients. The benefits to pharma of developing patient-centric programs that support such improvement can be vast and significant, including better market access, improved loyalty and image with pharmas physician and patient customers and increased commitment to and endorsement of its products by payers, but require real-life patient outcomes and an ongoing demonstration of product value, Butler says.

Improving the patient experience
Truly successful patient-centric strategies focus more on the collaborative relationship between doctors and their patients (the process - concordance), than simply on patient behaviors (outcomes compliance and adherence), says Debbie Robson, program leader and research nurse in medication management at Kings College in London. I would argue that if we pay more attention to process and get that right, outcomes will take care of themselves, she says.

Despite powerful evidence of efficacy in clinical trials, Robson says, most pharmaceutical products suffer from less stellar evidence of actual effectiveness, or performance in real-life settings with patients once on the market. This efficacy/effectiveness gap results in a failure to translate the benefit of investment in new medicines into health gains for patients, she says.

This gap can be attributed to a combination of poor patient adherence and a lack of necessary knowledge and skills on the part of clinicians to work collaboratively with patients to improve adherence, Robson says. Although the stakes for patients, their caregivers, provider and payers are high, pharmas also suffer from the side effects of poor patient adherence in the form of lost revenue and false assumptions by physicians and patients that medicines are ineffective resulting in unnecessary switching of medicines, she says.

Because the factors influencing adherence are complex and interactive, no single assessment or intervention strategy can be successful across all disease areas or with all patients, Robson stresses. If the reasons for non-adherence are multi-factorial, then assessments and interventions need to mirror this, she says. From a healthcare perspective, improved adherence is pointless unless it leads to improved clinical outcomes.

Despite decades of research attempting to understand non-adherence and efforts to develop and evaluate interventions, Robson says we still need a better understanding of what patients think about medicines and what they expect from their treatments.

We must improve the patients experience of taking medications and the healthcare workforces knowledge and training, she says. We need to work across disease areas and professional boundaries to improve the patient experience.

In a qualitative concept mapping study of decision making conducted in four European countries, the UK, Germany, Italy and the Netherlands, Robson and her colleagues identified the leading factors that influence patients decisions about their medication, including:
Clinician characteristics
Medication side effects
Ability to self-manage side effects
Efficacy
Beliefs, insight and attitudes about medicines
Subjective experience of medications and illness

Robsons team discovered that although patients considered efficacy and knowing how to manage side effects are their top concerns, clinicians considered side effects and side effect management as the top factors influencing patients decisions about taking their medications. This clearly shows us that doctors dont really think like their patients, so its really important to go back to patients and gain an understanding of adherence from their point of view, she stresses.

Pharma can play an important role in bridging the efficacy/effectiveness gap to improve patient outcomes, Robson says, particularly when it comes to helping to train the healthcare workforce. Robert Van der Zwart, visiting assistant professor at Utrecht University and the director of business development at Quadia, agrees and says the goal of disease management programs is to provide the right therapies for the right patients, something pharma has a big stake and responsibility in.

Gaining share of heart
Healthcare in the 21st century, he says, has seen a rise in patient importance as a healthcare consumer, strong budget controls and payer influence, increasing competition among healthcare providers and more market-oriented healthcare institutions.

The goal of disease management programs, Van der Zwart says, is to shorten the process from early diagnosis to treatment, while increasing patient satisfaction and lowering the cost of healthcare. Disease management programs, he explains, can create loyalty, raise the barriers to exit (switching costs) and reduce overall costs through organization of the process.

Pharmas can create preferences for their therapies, Van der Zwart says, by considering care competencies, excelling in new drugs and therapies, communicating advantages, providing information and services (without strings) to the disease management programs of healthcare institutions, and positioning themselves as a partner to win share of heart at the institutional, prescriber and payer level.

The concept of creating share of heart, rather than share of voice or share of wallet to yield loyal prescribers and patients, Van der Zwart says, is critical for pharma to grasp and will improve both revenues and the industrys image. Disease management programs, he says, can be the silver bullet to improving healthcare quality and reducing costs.

Securing market access with brands that are more than simply products
Francisco Frattini, business development director at Roche Italia, agrees and says demonstrating the value of its brands via patient programs and advanced market access initiatives is critical to pharmas continued success.

But gaining market access is becoming increasingly complex, he says. With so many stakeholders and barriers, it is more and more important to focus on the value your brand brings, rather than cost, Frattini says. And with approvals and reimbursement often granted under conditions, we must not only create access, but maintain it. So we must continue to be able to prove value to our stakeholders as they use the drug once its on the market.

Brands are no long products alone, Frattini stresses. The battle for price, he says, requires new approaches and with stricter risk management controls, appropriate use assurances are key. Payers, he says, need evidence-based medicine with real-life outcomes and performance-based pricing.

There is an undeniable push toward pricing pills by the results, Frattini stresses.

The demands on pharma are broad. To gain market access, pharmas must communicate the value of their products, create clinical guidelines, support current prices, recognize the potential for negotiation and meet diverse payer needs, he says. In support of physicians, he says, pharmas should focus on best practice diagnostics and brand positioning and uptake, while recognizing that disease management initiatives that encourage adherence and appropriate use ensure safety and better healthcare outcomes.

Pharma must support patients by improving adherence through education, Frattini says, and ensuring that efficacy reflects R&D. These efforts, coupled with a focus on safety management, can improve patients perceptions of the industry, he says. And outcomes data can safeguard pricing by demonstrating real-life value, while supporting the needs of payers.

The long-term impacts and benefits of patient-centric programs for pharma, Butler says, include:

Patient identification (I want to find new patients for my brand)

Patient adherence (I want to support patients on my brand so they keep taking their medication)

Participation in healthcare (I want to show that my company supports patients on my brand)

Meeting payer requirements (I want to show the outcomes for patients on my brand are better than the competition and I want to prove to payers that my brand is worth endorsing )

The new imperative, Butler says, is long-term value creation. By looking closely at the different stakeholders needs, pharma can address a number of the challenges out there in the marketplace, she says.

To learn more, view the complete webinar .