A key driver in innovation is the explosion of health information and data—not only has the breadth and volume of information
increased, it is more accessible to outsiders. The challenge is making sense of this abundance and leveraging it to encourage
the uptake of the best new medicines. How is Pfizer responding?
KP: Information is the pillar that allows participants in the healthcare system to show how a given treatment improves outcomes.
So, building a coherent approach to managing the information flow is one of my most important priorities. Pfizer collects,
evaluates, and stores an enormous backlog of data about our products, but equally there is much more information now available
to our external stakeholders, including competitors, which can be used and interpreted in different ways. We have claims data
from insurers, scrip data from pharmacists, hospital admissions and discharge data, clinical trials data, and adverse event
reporting data—but none of this is really captured beyond the different silos they rest in. The challenge is establishing
"connectivity"—where information is aggregated and applied to target our development and marketing efforts, [and] delivering
more choice to the patient and informing actions throughout the healthcare system. Information alone is not sufficient to
provide the integrated solutions we need; it must be transformed into knowledge. Knowledge, in turn, creates the evidence
that is the basis for good decision-making. More important, the source of this information must come from a "real-world" rather
than hypothetical setting. It's not going to have any practical value to payers unless it is.
The regulatory community understands this and is insisting on a higher standard of disclosure from our industry, particularly
once a new medicine is on the market. But are we ready yet to engage? One of our priorities is that Pfizer has a seat at the
table when regulators pose fundamental questions about clinical benefit, access, and cost for a new drug. Getting to the right
answer requires the ability to amass a fully integrated data set, rather than bits and pieces. My fear is that no one is operating
with that full data set to really know what the right answer is. Practically, it means that insurers only know what the lowest
cost should be for reimbursing a new drug; there is no capacity to extend this to how much the healthcare system might save
by providing access.
Pfizer is taking an industry leadership role to increase the "connectivity" around information. My Executive Leadership Team
(ELT) colleague and Chief Medical Officer Freda Lewis-Hall sits on the board of the new Patient-Centered Outcomes Research
Institute (PCORI), which is a step in the right direction, for Pfizer and the industry. We are also working with Pfizer board
members like Dennis Ausiello of Harvard Medical School to explore ways to collaborate with hospitals and other outside players
in building that fuller data set. Finally, we are making the point to regulators of the need for flexibility in incorporating
real-world observational data in the decision-making process. At present, the industry is barred from promoting its products
on the basis of anything other than the standard randomized clinical trials we submit for registration. Insurance companies
and other payers are under no such limit, which is why we think it's important to get them to acknowledge that good information
must strike a balance between the cost of the drug itself against the total cost of the therapy in managing an episode of
What is the ultimate objective of the internal effort you are leading to integrate the information flow to deliver more value
to the customer? Will you seek to engage other companies around a shared platform? I am frequently told by insurers that they
desire cooperative efforts with multiple drug companies rather than just one.
KP: Pfizer believes this serious issue requires an equally serious commitment. The objective is to build more connectivity around
the separate streams of data that govern behavior of all parts of the healthcare system. That is why we are reaching out to
groups and constituencies—not just insurers, but the physicians and pharmacists who prescribe and dispense our products, or
the hospital chains that purchase drugs in bulk. We want data that is able to "speak" to a diverse group. This involves agreeing
on what kinds of data should be tracked and assessed and then building the technology applications to allow it to be shared.
We have a number of promising initiatives around this joint approach, with Keas and Quest Diagnostics, for example, to help
us relate more directly to the patient and his or her primary care physician, through new communication tools to help provide
for timely information about their condition.
Are there other examples of where Pfizer is working to accommodate new business models based on a health solutions approach?
KP: As I noted, the manner in which health services are delivered is changing; boundaries are falling fast due to the impact of
information technologies and an empowered customer base. To get ahead of these changes, Pfizer is exploring a direct-to-patient
marketing strategy that would allow us to provide medicines to patients who need them, with less reliance on the traditional
intermediaries. Innovations we are exploring to "operationalize" this goal include ATM-like drug dispensing machines; live,
interactive Web portals for targeted patients with chronic disease; and a virtual Internet pharmacy operation that allows
men with erectile dysfunction to obtain Viagra without visiting a pharmacy in person.
We are also looking carefully at how our marketing expertise in the over-the-counter (OTC) business we acquired from Wyeth
can be applied to soften the blow from loss of exclusivity. A prime example is seeking OTC or "behind-the-counter" status
for our cholesterol-lowering franchise. The idea is, a consumer can go to his pharmacist, get a quick check for blood lipids,
and then purchase one of our off-patent statins directly from the pharmacist—no doctor visit or prescription required. We
have a number of products where this basic strategy could work, saving healthcare systems a great deal of money. There are
real opportunities for this in emerging markets.