From

ideals
to
execution
The Ashfield Patients & Pharma
Future Forum explores the reality
of patient-centricity in 2016 and
whats next for pharma

Patient-centricity issue

June 2016
Edition 1

Ashfield
Healthcare Communications

As a major provider of services to

the pharmaceutical industry, we
wanted to better understand the
needs of the industry in the patient
space, to evolve in partnership
with our clients and continue to
provide innovative solutions that
improve health outcomes.
Ashfield Healthcare Communications

Introduction
Since eyeforpharma, Barcelona 2015, we have heard industry,
vendors, specialists, advocacy groups and patients talking about
patient-centricity: what is it? What does it mean for the industry
and the wider healthcare environment? What does it mean for
patients? What will it look like in the future?
However, one question thats been
missing recently is Why does it
matter? The reason this question
is no longer prominent is that we
have moved past the phase where
we are looking for a rationale to

Estimated annual
pharmaceutical revenue
loss of $546bn due
to nonadherence

drive towards a more patient-centric

industry, and we are now actually
trying to shape, deliver and measure
it. However, for those still seeking
justification, the facts speak for
themselves:

Estimated cost of
nonadherence for EU
governments annually
is 125bn1

(Capgemini report, 2015)

1.
www.efpia.eu/topics/peoplehealth/patient-adherence

The top three areas

driving non-adherence
costs are:
High cholesterol

2.

High blood pressure

Heart disease2

Viewpoint: How Nonadherence

Is Killing Usand What Can
Be Done (Robert Nease,
Express Scripts)

Nonadherence
contributes to nearly
200,000 premature
deaths in Europe1

In Europe 50% of patients

dont take their medicine
as prescribed1

What we wanted to understand

was the reality of patientcentricity today, the truth behind
the buzzwords and challenges
in delivering this vision. Who
better to ask than industry
representatives?

Andrew Schorr,
Patient Power

We convened a panel of 12
representatives from pharmaceutical
companies, including large broad
portfolio companies as well as
smaller/mid-sized more specialist
providers, in a mix of patient-centred
roles from Chief Patient Officer
through to regional and functional
patient leads. We ran a 2-week
online expert panel earlier this year,

inviting our panel to discuss, as

openly as possible, their company
vision, the strategy and structure
that they were putting in place for
delivering the vision, and the key
challenges they had found in moving
towards patient-centricity. The panel
was moderated by Andrew Schorr of
Patient Power, along with Ashfield
Healthcare Communications.

We wanted to understand how the industry was

moving from vision to reality in patient-centricity.

How has the industrys

vision evolved, and where
does our panel align?
Before opening the discussion, we asked
participants to answer a series of questions
anonymously about their job and role.
Most had been in their patientcentred role less than 12 months,
and were unanimous in agreeing
that they were happy, excited and
even privileged to have this role,
but also very aware it presented a
huge challenge; the script (and
in many cases the job description)

hadnt been written yet. However,

they were confident they had the
right attributes to be able to deliver,
including experience across multiple
industry roles and functions, and
an understanding and empathy with
patients more than half have spent
time as a practising physician.

This is a new area and the rules

havent been written yet, which
means that we have to behave
responsibly and be able to explain
and defend our actions, but there
is no line to toe.
Forum panel member

Is there an optimal
approach?
It was clear from every participant on the panel
that the whole industry is embracing patientcentricity, however we can see that there is a wide
range of approaches with different drivers.
When asked about their vision, some panel members clearly had a patient
outcome focus, whereas others focused on how patient engagement would
help them to achieve commercial aims, and some focused on perception.

I am hoping it is a vision of a company where all

departments focus on doing whats right for the patient
and a universal belief that the business benefits in the
process; where the patient voice is sought after and
welcomed and where patients are not seen as statistics,
subjects or numbers on a spreadsheet.
Andrew Schorr,
Founder, Patient Power

To become the best

by winning for
patients worldwide
Global Head,
Patient Relations

The patient
community
persistently
perceives the
company as patientcentred, and that
our innovations
improve the life and
health of patients
Global Patient Affairs
Lead

To become the
patient-preferred
biopharma
company
Patient Value
Integration Lead

How are companies

approaching structural
organisation for
patient-centricity?
We saw a range of ways in which companies are
operationalising patient-centricity.
Half said their company had a person
in a high level Chief Patient Officer
role or similar, whereas half didnt
have one central lead but rather a
range of people across functions
with a patient-focused remit.

Do you have a Chief Patient

Officer or similar high-level
lead?

50%
No
Interestingly, these 50/50 splits
did not correlate with each other,
or with our split of larger broad
portfolio companies versus smaller
specialist ones, and crucially the
presence or absence of a

Half had already developed a

framework for their teams to use in
engaging with patients, and again,
half hadnt.

Do you have a patient

engagement framework in
place?

50%
Yes
figurehead Patient Officer, or
a patient engagement framework,
did not seem to give any indication
of how successful those companies
had been so far in delivering on
their strategy.

What we frequently saw was companies looking at how to

bring the patient into their current business model,
rather than building the model from the outset
with the patient at the centre.
We will see from the few brave frontrunners
whether this approach ultimately has a
greater long-term impact.

Adapting the current model

Or building a patient-centric one

Everyone internally plays a role in

that they have to ask the question
with everything they do, how
will this activity/solution/project
improve the lives of those living
with severe diseases?.
Patient Value Integration Lead

What does the internal

conversation feel like?
Are teams on board with the notion of a more
patient-centred pharma company?
What was encouraging to see
was that every respondent said
this is not a hard sell amongst
their colleagues. In fact, in many
organisations it is seen as a
positive factor in staff retention

and internal motivation. One

respondent mentioned an uplift
in job satisfaction scores when
internal messaging changed focus
from sales success to improving
healthcare and helping patients.

We have a strong focus on patientcentricity, and we believe that if we

focus on patients first, business will
follow eventually. So we do this by
our accountability to patients, not
to shareholders. I believe this is very
motivational for the whole organisation
and many employees express a strong
desire to help our patients.
Forum panel member

Its true that our industry contains a wide range of

people and skills, and we saw four key areas quoted as
the key drivers towards a patient-centric approach, each
resonating with different people in different ways.

To be drivers
of innovation

Its the right

thing to do

Better healthcare
for the 21st century

To understand
our customers

With the rising burden of chronic diseases and

scarce resources, new ways of partnering to
deliver healthcare need to be developed and
the starting point for this is that all stakeholders,
not only pharma, approach patients as equal
partners focused on their needs. This is to me
the most promising strategy for bringing all
the different stakeholders together to maximise
sustainable performance of healthcare systems.
 lobal Head of Patient Engagement and Insights for
G
Patient Access

But were
businesses!
How do we balance the need to make a profit,
to be answerable to shareholders and provide
a secure environment for future medicine
development with a patient-centric approach?
Our panel was clear about this key question. In essence, the two need to
go hand-in-hand, and transparency in the way companies are delivering
patient-centricity, and their reasons for doing so, are essential.
At eyeforpharma Barcelona 2016, the #trustpharma theme was
prominent and we continue to hear it from all parts of our industry.

Its not about balancing but rather careful consideration

of each. Its a matter of transparency that we are a
for-profit company with accountability to all of our
stakeholders including but not limited to patients.
Global Patient Affairs Lead

Understanding unmet patient needs and expectations are

crucial steps to success (not only in terms of reputation).
Patient-centricity across the biopharma industry provides
complex benefits for all stakeholders.
Global Patient Affairs Medical Lead

If we dont bring value

to patients then we also
dont meet commercial
goals.
International Medical Director
Patient & Nurse Relations

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Attending to unmet needs

and meeting patient
expectations is the
way to sustain business
in the long term.
Global Head of Patient
Relations

What are the key

challenges teams face?
There were four clear themes
that came through here:

Compliance and
the legal/regulatory
framework

Keeping the patient as the

consistent thread in companies
used to working in silos

Measurement and
defining success

Cultural change

Some of these challenges seem like

ones weve seen (and addressed)
before, for example legal/regulatory
rules of engagement, and cultural
change. Weve moved a long way
on compliance for example since
the end of the 90s, and
companies that embrace this
change successfully should find
that keeping the patient as the
continuous focus across functions
and drug life cycles will in fact cease
to be a challenge at all, if companies
genuinely evolve to be not just
patient-centric but patient centred.

Measurement and defining

success remain the big
unaddressed challenges. Individual
activities can often be measured, eg
patient input in clinical trial design
that impacts on speed of recruitment
to a study would be a clear and
measurable outcome, and improved
health outcomes for patients
participating in a patient support
programme would be another.
What is less tangible is the impact
of a companys overall approach to
patient-centricity.

How can companies check whether their approach is

working, how can they improve it, how can they tell if it
really makes a difference to patients?
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This is tough showing that you

made a better decision, or didnt
make a bad decision, by virtue of
listening to patients, is hard, and
for most of our decisions, it takes
years to work out if they were
right or wrong.
Executive Director, Patient Perspectives

What is clear is that there is no one-size-fits-all approach

to measuring the success of a patient-centric model. This is
very much a work in progress.

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Are there any

quick wins?
We asked if there were areas where companies could
make changes now that would have immediate impact,
and the response was essentially no, the focus is very
much on driving long-term sustainable change.
However, it is clear that there are
some quick wins that are achievable
in the short to medium term, the
example earlier of involving patients
in study design would seem to be
a clear opportunity. Additionally, if
pharma companies include upfront

in Requests for Proposals (RFPs)

an expectation of a vendor sharing
their values in this space, this would
help to change the way we all do
business, as we continue to look
both within and outside the industry
for innovation.

I am betting if patients are

included routinely in clinical
trial design that would lead
to quicker accrual.
Andrew Schorr, Patient Power

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So what does this really

mean for day-to-day delivery
of initiatives in our industry?
Surprisingly, this was the area where there were few surprises!
Companies are engaging with patients in a range of ways, from
expert panels to social media engagement, insights gathering
to patient consultants working internally with teams.
Companies are beginning to
understand how, when and where
to engage with the end users of
their products the patients.
As ever, the feeling was that it was
important to define the objectives
of engagement at the outset and
identify the best channel to reach
the most relevant patient group.
What we saw was that while teams
were comfortable with doing this in
the post-launch setting, and very
early on in the development journey,
there was some cautiousness
around how to do this during the later

stages of the pre-launch environment.

The old market research model
is now thought of as just one way
of asking patients to input, and
will need to sit amongst a much
broader view of patient needs
and experiences.
What didnt come through from our
panel was any indication of how
companies are looking to close the
loop on the way they interact with
HCPs and ways they are beginning to
interact with patients.

For patients to really benefit, the message communicated

and the engagement methods used need to be clear and
consistent.

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What can we collaborate on?

This was a tough question. Where should industry collaborate for
the benefit of patients? There was little consensus here, apart from
an openness to collaborate where it serves the industry as a whole.
We see initiatives from organisations like EUPATI, PFMD and IMI supporting
some of this, but it is clear that there is more that could be achieved here, for
example in defining the how and establishing cross-industry benchmarks.

Not everything is as important for one company as for another,

however collaboration and exchange with all stakeholders should
be the basis for important changes.
International Medical Director Patient & Nurse Relations

Identifying common areas where we all feel comfortable to enhance

collaboration. Define the framework to work together on improving
patient-centric initiatives and define a platform where this discussion
could happen.
Head of Global Patient Relations

We need to work together to ensure cross-industry standards

and benchmarks are developed to fuel healthy competition and
accountability to patient-centric performance. A driving force for
patient-centric innovation internally is for companies to compete on
delivering the most innovative value to patients.
Global Head of Patient Engagement and Insights for Patient Access

15

Measuring value for patients

An area yet to be defined is how to measure value from a patient
perspective and how to capture outcomes that are meaningful
to patients at an individual level, rather than defined by our
expectations of what a positive outcome looks like.
There is unlikely to be one solution,
rather a range of measures to
quantify value from a patient
perspective, with consideration
of their own goals. Its interesting
to see companies beginning to

move towards more patient-centric

KPIs and away from sales-based
incentives and towards metrics
designed around addressing an
unmet need.

Whats next?
Everyone is on the journey towards patient-centricity, but with a
range of different approaches time will tell what works best but
it is likely that different approaches for individual company and
patient needs is a good thing.
What is clear is that weve reached
the point where we can and should
stop asking why patients? and
why now? these were the
questions of 2015. For 2016 and
beyond, the challenge is making

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the vision a reality. We hope that

industry experts will keep talking
and consider collaborating in areas
where there will be benefits to our
businesses, to the healthcare sector,
and to patients themselves.

Ashfield Healthcare Communications would

like to thank the following companies for their
participation in our panel:
LEO Pharma, MSD, Novartis, Novo Nordisk,
Pfizer, Roche, UCB, ViiV Healthcare, and
Andrew Schorr from Patient Power.
Ashfield Healthcare Communications ran an
online collaboration and discussion powered by
Within3 in January 2016, the first of a series.
If your company would be interested in joining our
next online collaboration and discussion, please
contact Jo Fearnhead-Wymbs at:
Jo Fearnhead-Wymbs
Patient Engagement Director
Ashfield Healthcare Communications

j.fearnhead-wymbs@ashfieldhealthcare.com

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About Ashfield Healthcare

Communications
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Healthcare Communications

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Ashfield Healthcare
Communications,
part of UDG Healthcare plc
UDG Healthcare 2016

Ashfield
Healthcare Communications