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Arun Thachi, Director, Head of IT Marketing and Sales, Boehringer Ingelheim, explains conversational AI and how it can be best-used in pharma to inform and engage. 

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In this interview, Arun Thachi, Director, Head of IT Marketing and Sales, Boehringer Ingelheim, discusses the AI journey in pharma. 


Pharma USA 2023: Conversational AI

At Pharma 2023 in Barcelona, Stefan Merlo, Vice President, Commercial Development at CSL Seqirus, discussed the global vaccine journey, the connected customer experience and the role of consumer and government education to improve public health. 

Stefan Merlo, Vice President, Commercial Development, CSL Seqirus discusses how COVID-19 has evolved the discussion of vaccines and the long-term concerns stemming from flu vaccine fatigue. 
 


Pharma 2023: Vaccines Journey to the Consumer

Rebecca Vermeulen, VP Global Patient Networks, Product Development Medical Affairs for Roche discusses how the role of patient advocacy groups to improve patient engagement, how Roche organizes their relationships and the key takeaways for industry professionals. 

Rebecca Vermeulen, VP Global Patient Networks, Product Development Medical Affairs for Roche discusses how they approach patient engagement. 

Pharma 2023: Working with Patient Advocacy Groups

Andrew Binns, head of digital and innovation, AstraZeneca, took the stage last week at Pharma 2023 in Barcelona, with Paul Tunnah, chief content officer and UK MD, Healthware Group, and founder, pharmaphorum, in a fireside chat that left no stone unturned for pharma marketers. Coming from the hospitality industry only five years ago, Binns quickly learned that there were many barriers in pharma marketing, and maybe, he mused, many of them self-imposed. “People need to be persuaded to believe in the product, and there is nothing wrong with that,” said Binns.

Binn takes issue that “we don’t acknowledge the amazing things we do in pharma.” Pharma marketing can tend to focus on the scientific side, but he believes industry needs more people awareness. And that means to take a content-first approach, not the science-first approach. He used this analogy: “Everyone liked 

 because it was a great show, not because it was on HBO Max.”

To Binns, omnichannel may be to blame and, at the same time, has become a meaningless word. “We became obsessed with what it looks like to be omnichannel,” he said. “It’s very arrogant of pharma to invest millions into a platform, expecting people to flock to it.” Binns believes that current practices are trying to start a conversation vs. engaging in a conversation. And in the pursuit of channel, he believes marketing has forgot about the stories.

“How do we keep the stories?” asked Binns. “You should have power over the content you produce”—and not be overly focused on the outcome or the behaviors of those receiving the content. In pharma, Binns urged the need to empathize, and create content that empathizes with the audience, “not churns out the [company] message.”

There are some mantras that are oft-repeated in pharma marketing, and again, as Binns said, these may be self-imposed. Take into consideration the following:

#1. “Doctors are too busy.” Binns response is that everyone is busy. “It’s that we aren’t giving them what they need. We can’t just throw crap content at them.”

#2. “Words matter in a regulated industry.” Binns agrees pharma is regulated, but so is the banking and legal industry. “As a marketer, it’s your job to put out material in engaging and compliant ways,” said Binns. “Compliance can still work. If you bring all your teams in right at the beginning—legal, content, medical, marketing, etc.—and bring their expertise that pharma pays good money for to talk through the issues. Then you aren’t doing [compliance] as a box-ticking exercise.”

#3. “Patients first.” Binns says, “Patients should be first because then it wouldn’t be about the departments.” Binn believes that the fragmentation within pharma is self-imposed. That commercial being split from medical and split from market access strategy, is not the solution to patients first. “That’s why all the departments need to work together,” Binns concluded.

: Pharma 2023, “Fireside Chat with Andrew Binns, Head of Digital and Innovation, AstraZeneca. April 20, 2023.

Digital and innovation leader takes issue with the current state of pharma marketing and suggests new approaches are needed.

Pharma 2023: Marketing to the Masses

In two Pharma 2023 sessions, “Digital Health: Does Pharma Know its Role Yet?” and “Power Patient-Reported Outcomes through Digital Health Tools,” the reasons cited for pharma being involved in digital health were threefold: engage patients for the long-term journey with their conditions; keep health systems and physicians connected to their patients; and find patients who need higher efficacy treatments at the right time.

In the second session, Johannes Munding, director, patient experience design and solutions, neuroscience, Novartis, noted of digital health solutions that it’s a good idea to understand how a patient is doing in real-time, in the real-world, and shift away from current irregular touchpoints in chronic care. “We can assume when a patient is declining by tracking health data," said Munding. "Then we can plug in different services or different support mechanisms, to give them care at the time it is needed and, therefore, providing a better care experience.” (See related 

Daniel Daugaard, CEO, Dawn Health, who joined Munding on the second session, said that it’s important to understand the benefits of digital health implementation for each stakeholder. For example, a digital health tool that would allow a neurologist, in the case of multiple sclerosis (MS), for instance, to focus care on high-risk patients. This could help translate time spent into more value. For payers, they would prefer addressing better ways to manage cases of disease progression, rather than paying for physicians' time on patients who have these factors controlled. And for patients: “Ideally, they would like to have a cure, but they would like to be in control of their healthcare, have more transparency, and feel more safe from a fear of relapse, especially in MS,” said Daugaard.

Getting to this point of bringing stakeholders closer to various digital health solutions is not easy for pharma. Daniel Anggono, global head, market access and pricing, digital healthcare, Sanofi, noted in the first session that his company is on a journey to align digital health as an enabler for the organization itself. “It’s possible, it just takes time,” he said.

BMS’s Spencer Jones, digital health lead, global drug development – oncology, says its process is to first do a deep dive into a problem and come up with a solution. “The answer becomes obvious to solve for the patient or healthcare system in that process,” said Jones. He added that it is very important not to define these exercises as pilots. “There is a lot of suppositions around that word. It’s really a fully functioning thing we are doing that we want to scale,” explained Jones. “It’s important for that first stage to have clear KPIs that are clearly understood by stakeholders, so we can explain what works based on this KPI or this metric.”

Anggono also pointed out that unlike in the pharma business, where the same active ingredient or product is available globally, digital health strategies require co-creation locally. “The product is there, but the care, patient, system is local," he noted. "It creates tension in large companies, so we need to demonstrate the concept is scalable while the product is not and will look different in every country—and that’s fine.”

Another takeaway from the sessions was the importance of partnering in the digital health space. For example, Rebecca Wray, senior director, digital health oncology R&D, AstraZeneca, shared, “Our differentiation is around the science and the disease, and digital health gives us a good opportunity to partner on the technology.”

Industry insights on how pharma is faring in tapping new innovations and approaches in digital health. 

Pharma 2023: Digital Health Key Takeaways

Moderator Catia Proenca, director in real-world solutions, Alira Health; Rolland Kacsoh, global product director, iron disorders and rare anemias, rare blood, early assets, Novo Nordisk; Omar Ali, visiting lecturer, value-based pricing and innovative contracting of new medicines, University of Portsmouth and former adviser for NICE adoption and impact program reference panel; and Gorana Capkun, global head, real-world evidence (RWE) analytics and enablement, Novartis, participated on the “Unleash RWE Benefits Along the Value Chain” panel at Pharma 2023 today in Barcelona.

Kacsoh noted that patient diaries could be used as RWE for quantifying a utility with the patient and the targets you will be targeting and doing your so-called payer research, already armed in advance of how much value you have with the patient and also the physician.

Ali shared that in his capacity with NICE, the health technology assessment (HTA) for using Botox for migraine, for example, showed that placebo saline offered the same efficacy data, specifically that the headache lasted one date. In examining patient diaries, the value story changed and the HTA dramatically altered their views. The diaries showed that while headache days were the same, the Botox treatment had significantly better duration time (not as long in the day) and the headache intensity was much lower. 

“This was the first time patient diaries and PROs (patient-reported outcomes) were used in that context,” said Ali. However, he did note that because of these results, payers wanted patients to keep diaries while on the therapy. Patient groups were not thrilled, so the actual deployment was fraught with additional issues, but it did outline the value story.

Similarly, Capkun pointed out that the gap from marketing authorization in some countries can be anywhere from four months to 81 months. “To wait four years to get reimbursement and a patient go without a treatment is [untenable]," she said. What would help drugs get released earlier for reimbursement is RWE. Capkun believes payers are more ready to hear the value story, and it’s become more important for all stakeholders in decision-making to change.

Additionally, Kacsoh noted that at Novo Nordisk, the company works to ensure PROs are successfully implemented, and in the rare disease space, it has a unique setup for very early commercial or early assets—in the preclinicial stage. The strategy focuses on the whole patient journey, including market research/RWE very early on to reach patients and ensure that in the clinical trial the outcomes included are ones that matter to payers, and that utility is based on actual patient symptoms and treatment-addressed needs.

Calling it the “ICER in reverse” (referring to the Institute for Clinical and Economic Review) in very early development using this PRO information, pharma can calculate the value story and target additional unmet needs and the value around those needs. “In what ways [the disease] affects the patients and not waiting until a Phase III study and running it by KOLs or patient advocacy outreach because, while it may make sense, it’s probably too late,” noted Kacsoh.

Panel discusses what real-world evidence—and related patient-reporting technology—need to achieve to better influence payer decision-making. 

Pharma 2023: Unleash RWE Benefits Along the Value Chain

Gizem Özbayraç, head of business, agility, digital, and customer excellence, Roche, presented on the topic: 

Roche Turkey has developed a digital platform for patients and healthcare professionals (HCPs) to manage the chronic disease journey remotely,” at Pharma 2023. True to the topic, Özbayraç’s first detailed the challenges in Turkey that spurred the development of this platform, initially in multiple sclerosis (MS).

These challenges included on the chronic patients’ side, where they often seek information from multiple online sources, but not all of them reliable. Other hurdles are not tracking symptoms over time; adverse effects or mismanaged disease progression; and problems with adherence to treatments. On the health system side, Özbayraç points to patient non-compliance or disconnect with the patient creating higher costs on the healthcare system.

For Roche, it saw these pain points, and decided to provide a disease management solution. The plan started with ecosystem discovery, then finding health tech startups to build the technology needed, which hadn't existed in Turkey or the surrounding countries. The company then tied in physicians, hospitals, and patient associations for a continuous feedback loop.

An example of this loop emerged when a physician noted that disease-progressing MS patients would not be able to use an AI-enabled chatbot because of their inability to type. The app, therefore, was replaced with a voice-enabled chatbot.

The platform features a mobile app for patients and for physicians, an app for access to the physician portal with a single database where the data is captured. Historically, many physicians in Turkey were using notebooks or WhatsApp as notetaking tools with patients. Hence, nothing was captured in an emergency medical record (EMR), which made patient management even more difficult.

For the patients, the app also featured one-click telemedicine appointments for supportive services. For example, dieticians or psychological support. Basically, Özbayraç noted that the platform is a real-world evidence (RWE) source that makes it more organized and doesn’t require the heavy lift that registries do.

Based on data that patients put in, physicians can get alerts. For example, with MS, disease progression can be determined by deteriorating walking times. If a physician wasn’t scheduled to see a patient for a few months, the alert would recommend the patient be asked to come in earlier.

The platform has been well-received, according to Özbayraç, and Roche is currently building its own clinical study to examine the significance of the outcomes with the app. Özbayraç shared that the app has provided 330 telemedicine appointments; 1,900 content reads; 340 symptom journals; and over 700 active users with a satisfaction of 97%. Roche is rolling the project out to other countries.

Tool highlights efforts to overcome the challenges of remote disease management in Turkey.

Pharma 2023: Roche Turkey’s Digital Platform for HCPs and Patients

Pharma 2023 featured Kishan Rees, senior director, CKD and digital global medical affairs, Bayer, and Steve Royle, founder, My Medical Affairs, in a fireside chat titled “Medical Affairs: The Sales Prevention Unit?” In an interactive format, Rees and Royle discussed the traditional role of medical affairs and its changes in the past 20 years. The exchange fostered audience questions submitted online, further inspiring discussion.

In response to one question, “How do you coach medical colleagues to elevate their business acumen and enterprise mindset?”, Rees stated, “Some of my greatest [medical science liaisons] came from commercial, who enjoyed the science but were not PhDs; but we need to leverage soft skills. We aren’t making the commercial more scientific, but rather medical affairs more conversational."

Royle remarked that such a statement could create heated debate. Even with medical affairs needing to offer insights to clinicians, it is still useful to have those soft and conversational skills to make the discussion more engaging.

Another observation that Rees shared from his experiences was that while the divisions and barriers that are set up internally in pharma between commercial, medical affairs, and R&D to external stakeholders, the pharma teams are “viewed the same.” Therefore, to Rees, it makes more sense to position the best people in the organization into the best roles—to present information to clinicians in the most impactful way.

“Generally, it comes down to the individual and the company. Diverse teams work the best. If you have different people, with different backgrounds, then you can choose the right people to bring into a meeting.” said Rees. “All in all, medical affairs, MSLs, and these activities provide value and should enable the field force.”

Experts explore MA's evolving role and skill set in engaging effectively with clinicians and other external stakeholders.

Pharma 2023: A More Collaborative Medical Affairs 

The early afternoon of the Market Access/RWE—Beyond Borders: Market Access Expanded track at Pharma 2023, being held in Barcelona April 16-18, was information-packed and offered a changing view of global market access on a number of fronts.

In the first session, Christoph Glaetzer, chief value & access officer, Johnson & Johnson, outlined the impact of the recently passed GKV Financial Stabilization Act in Germany. The primary goal of the law is to stabilize the finances of the statutory health insurance (SHI) policies and introduced significant changes to the legal framework governing the pricing and reimbursement of pharmaceuticals. However, as Glaetzer notes, these changes are not without unintended consequences, specifically to Germany’s reputation as an innovation leader.

Similar to the US, Glaetzer noted that there is a problem with the overall healthcare spend, and the portion of pharmaceutical spend has actually remained flat for the past 10 years. Meanwhile, the initiatives that have been enacted under the law, including a new 20% rebate for combination therapies, reduction of the threshold for orphan drug P&MA, and new pricing “guardrails” for price negotiation, including mandatory volume-based price model components, which were previously optional.

Glaetzer concluded that the short-sighted policy will lead to lower investments in Germany due to lack of incentive for innovation, which may not be felt until 10 years from now, when it will be too late to course correct. “Germany looks to lose its leading status for patient access to new treatments,” said Glaetzer.

While value-based contracts (VBC) have been enacted, a presentation from Omar Ali, visiting lecturer for the University of Portsmouth, former adviser for the NICE Adoption & Impact Program Reference Panel, and current head of payers for Verapro, a contract and VBC consultancy, offered his company’s own involvement with 742 such agreements. On average, Ali noted that there is an eight-fold underreporting of VBCs.

Walking the audience through a case study of Cimzia, a biologic for rheumatoid arthritis entering into a crowded field, Ali offered the steps and concerns from the payers. UCB Pharma was able to pivot and address the concerns, ultimately enabling a VBC that engaged both physicians, patients, and payers.

Ali outlined that the three factors impacting VBCs—geopolitical, affordability and uncertainty—all of which are in play in the current environment. For example, all countries are facing some sort of impact from innovation, gene therapies are testing the limits of country affordability, and uncertainty for the long-term effects for gene therapies, as well as chosen endpoints, are pushing VBCs to the fore of payer negotiations.

Anthony Nash, head of market access, global partner business for specialty pharma company CSL Vifor, took the stage to discuss the current access landscape of China, Brazil, and Saudi Arabia. Changes in China over the past 20 years, including faster regulatory review times; focus away from generics and onto innovative medicines by China-based pharma; and universal health coverage, with a quick formulary addition of eight to nine months, have given China the edge in global market access.

Brazil offers a case study in the split of public and private health coverage, which is leading the country to consider VBCs more often, and the involvement of health technology assessment (HTA) agencies.

Finally, Saudi Arabia has targeted healthcare as part of its Health Sector Transformation Program of the Kingdom’s Vision for 2030. As such, the investment in innovations is skyrocketing with hundreds of startups, and a focus on telehealth to enhance citizens access to better care.

Nash noted that each country’s needs from Europe are different. For example, China needs Europe to bring more global clinical development programs to the country. Brazil, to be considered for parallel launch with Europe, and Saudi Arabia, a part of health economics and outcomes research (HEOR) evidence generation. In the longer term, Nash noted that China is developing retail pharmacy chains and online drug selling. Brazil is looking forward to more alternative payment models and Saudi Arabia, the privatization of healthcare.

German laws, European VBCs, and trends in China, Brazil, and Saudi Arabia are changing the way global market access works.

Pharma 2023: Global Market Access is a Quickly Evolving Landscape

Tracey Dodenhoff, CEO of Medly Therapeutics, discusses her company's heart failure app and why pharma should consider prescription digital therapeutics among their offerings.

Using prescription digital therapeutics can lead to better outcomes for patients, making them a win-win for pharma and patients.

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