Much has been written about the increasing influence of patients in the healthcare decision-making process, but this assertion
oversimplifies the changing dynamics of healthcare. Patients are not taking over the healthcare system, and this oversimplification could easily lead to poor marketing choices.
It is more accurate to say that the healthcare ecosystem is now comprised of multiple stakeholders with a far more complex
decision-making dynamic than existed just a few years ago. In addition, patients are not a single homogenous unit. Some may
have little or no impact on treatment decisions or healthcare choices while others may take an active individual role. But
the ones that we find really interesting are those taking on almost an 'activist' role, impacting not only their own healthcare,
but potentially many, many others as well. We call this last group the "pro-patient."
This is the pro-active patient. They are not just personally empowered and assertive, but broadcast their experiences, opinions, and objectives and therefore have a far wider sphere of influence.
We do, of course, know these people in the consumer world. There is the experience of Dave Carroll who, in July 2009, experienced
poor customer service from United Airlines after it damaged his guitar in transit. Not satisfied with the outcome, Carroll
posted his video "United Breaks Guitars" on YouTube and it became a sensation, garnering 5.5 million hits in the first year.
Such a widely broadcasted message made it impossible to ignore Carroll any longer. And more recently there was the online
outcry against Netflix. First the company mishandled a significant price increase (CEO Reed Hastings quickly apologized),
but then announced that it was going to split its offering into two separate services, the DVD mail-order service and the
online video streaming service. The blogosphere erupted and Netflix's stock lost $8 billion in value in a matter of weeks.
Patient Opinion Leaders
People like Carroll and the Netflix bloggers exist in the healthcare ecosystem too. If you search them out, you will find
this vocal minority active in online forums. The have become the de facto Patient Opinion Leaders (POL)—and just as every
pharma company has a KOL strategy, they now need a POL strategy too.
These people have always existed. What is different now is that Web 2.0 gives them a much broader audience. In the past their
sphere of influence was limited to family and friends, but now their audience can be measured in thousands or millions.
There are many services, such as Ipsos's buzz tracking, that identify and listen to the ongoing online exchange of information
and opinions related to healthcare conditions and medications. Work that our company recently completed in Europe sought to
profile these pro-patients and understand the potential implications for pharma.
We saw some examples of the negative passion of pro-patient activity, railing against the consequences of side effects of
medication, for example, but most of the pro-patients we spoke to had good intentions and saw themselves as providing a valuable
An example: Iris is past retirement age in the UK and balances running her own online cake business with authoring her own
online newsletter, website, and blog for Type 2 Diabetes. Iris's objectives are different from those of Dave Carroll. He wanted
to embarrass United Airlines by highlighting its poor customer service. Iris, on the other hand, wants to help people. She
spends a tremendous amount of time collecting new information about diabetes treatments from around the Web to provide a better,
more practical source of info than she felt existed for people like her. She believes that an educated diabetes patient will
only improve the physician/patient dialogue, and will ultimately lead to healthier patients.