Ashfield Patient Solutions had the opportunity to address an eyeforpharma audience recently about the subject of patient engagement and — more specifically — redefining connectivity and engagement to empower patients and care partners.
But before the presentation began, we asked the audience to describe patient engagement in one word, only; to give us the single word that best describes it for them. We hope you will agree that their answers were very telling:
We were glad to see that patient engagement was as meaningful and important to the audience as it is to Ashfield. If that meant we were preaching the choir, then we’ve never been so happy to do so.
Evolving beyond the old model
A new paradigm, by definition, must be understood in the context of what preceded it. In this case, the old model is, as everyone could probably guess, “Doctor knows best.” This is the familiar top-down flow of information where industry promotes products to doctors, who prescribe them to patients, who, in turn, are expected to “do as they’re told.”
While that still might describe some doctor-patient relationships, it’s pretty evident that simple model has evolved. Certainly, these days, it’s more accurate to say industry plays a critical role in supporting the dialogue between patients, their care partners and prescribers.
However, it’s during the last 10 years that we really saw huge changes in healthcare dynamics, largely driven by technology and industry trends. Patients had new access to information through the internet, mobile technology and patient groups. Technology advanced to provide electronic patient record systems, connected devices and wearables. At the same time, product innovation got harder due to crowded therapeutic areas and increased pressure to maximize the value of existing products. Meanwhile, health systems demanded more to address chronic diseases, aging populations, and the need to do more with less. Finally, the cost of nonadherence rose, with a direct cost up to $289 million annually and 50 percent of prescriptions taken incorrectly.
The new health ecosystem
In response to these events, pressures and needs, a new health ecosystem has emerged, one that looks very different. Simply put, the distinguishing feature of today’s ecosystem is that it’s patient-centric. The patient is the hub around which the activity of industry, HCPs, regulators, payers and care partners is organized. In particular, industry has an important role in this patient-focused model of healthcare, both with other stakeholders and directly with patients. Industry must now be in the business of developing both products and services to meet the needs of patients.
Patient support is one of the most important services the pharma industry is called on to provide. As such, it represents the biggest, direct opportunity for industry to make a difference. But patient support programs are too often designed and delivered based on a flawed perception: that patients are their condition, and that they form one homogenous group. To correct that, patient support programs must proceed from the fundamental realization that patients are people and that people are individuals with individual needs.
The unmet need of patient support
If we accept that patients are people, then we also have to acknowledge that people make mistakes. We have just seen that 50 percent of prescriptions are taken incorrectly, which falls under the category of nonadherence — the unmet need of patient support.
It would be hard to overstate the significance of nonadherence. For example, it contributes to nearly 200,000 premature deaths a year in the United States and costs the pharma industry an estimated $546 billion in lost annual revenue. Moreover, nonadherence results in a real-world perception of a lack of both efficacy and safety.
Despite this, evidence shows that on average, doctors spend only 49 seconds discussing all aspects of newly prescribed medications. In terms of helping patients avoid nonadherence, a critical window of opportunity exists between the point of prescribing and 3 to 6 months after patients start therapy. That’s where a properly designed and implemented patient support can make a difference. But what would that look like?
The new paradigm of engagement
Ideally, within a given therapeutic category and taking into account all relevant variables, each patient support program will be purpose-built to provide the best patient experience. So, while there is no off-the-shelf, one-size-fits-all design, patient support programs in the current technology-driven health ecosystem share certain characteristics.
First of all, they’re designed to leverage communication and healthcare delivery technologies the right way to make patients’ lives easier. They’re multichannel, yet organized to give the patient a sense of seamless, comprehensive support, rather than a disjointed experience.
They are forward-looking, making appropriate use of technologies now in widespread use, but also anticipating rapidly emerging applications such as remote monitoring and virtual care. Wearables, telemedicine, and artificial intelligence are all transformational high-value technologies that will come to define and augment patient care. New-paradigm patient support programs have to be responsive to those advancements.
Most of all, the new paradigm of engagement redefines connectivity to be, like the health ecosystem itself, patient-centric. It makes it possible to create personalized omni-channel care plans driven by patient preference — plans with the potential to create better-informed patients and care partners, to reduce nonadherence, and help patients stay actively involved in their health care.
It’s encouraging to realize that, in the new paradigm, enormously complex digital care and communication technologies let us provide patient support programs that accomplish the most human of goals: simply listening, caring, and helping.