Creating Influence and Authority in Value-Based Healthcare

We may be only at the beginning of outcome-measured, value-based healthcare, but this is a chance for pharma organizations to show their mettle as roles are redefined and definitions of ‘value’ are agreed, says Gérard Klop of Vintura.

The major pharma companies have known for some time that the days of simply supplying pills are no more. Becoming more deeply embedded in the delivery and monitoring of patient outcomes offers pharma companies a new chance to reposition themselves as trusted healthcare partners who have a valid role to play in transforming healthcare, and build their reputation both individually and as an industry.

Today, while the vision and aspirations are there, there is much still to be aligned before new roles can be assumed and transformations can begin. There are organizational and cultural challenges, contractual considerations, and logistical, IT and data-based barriers to be overcome. And, although pharma would benefit from a seat at the table of related discussions, the industry must first demonstrate its commitment to strategic healthcare priorities such as patient-centred care.

Early innovation in action

In one of the most ambitious examples to date, in the Netherlands, a MedTech company was so intent on maximizing the impact of treatment for children with type 1 diabetes that it made the strategic decision to acquire an associated care provider network. This has allowed the company to influence and monitor the use of its product for the ultimate impact and benefit for patients, in parallel to (rather than getting in the way of) traditional healthcare. Diabeter is now one of the largest diabetes specialist centers in Europe, managing more than 3,000 patients, empowering them through self-care and a warm, non-clinical experience, with 24/7 expert support, and proactive measuring, tracking and analysis of patient outcomes.

Although at the more extreme end of the spectrum, this example demonstrates the scope not only for life sciences brands to become more engaged and invested in patient outcomes, but also to capture real-world information about the way patients behave, their adherence to their treatment regimes, and their overall wellbeing beyond their primary condition. As healthcare pivots towards more preventative interventions and more holistic assessments of treatment outcomes and what it means to be well, this kind of data (even anonymized and consolidated) will be invaluable right across the healthcare ecosystem.

Another pharma company has taken the initiative here by trying to understand more about patients’ priorities when at the end of life. Here, physicians have traditionally been guided largely by protocol in their decisions about how and when to continue to provide care. Seeing beyond immediate opportunities to continue selling products, the pharma company looked at how to extend the decision process to incorporate the patient perspective, developing a questionnaire based on patient preferences that clinician could use collaboratively. In other words, the company took the long-term view, thinking beyond product performance to its social/ethical responsibility to patients, building trust and brand equity.

Data is one of the biggest gaps in current plans to move to value-based healthcare, and it doesn’t help that healthcare systems are so complex and fragmented, often with poor visibility from one organization to the next. One doctor’s practice or hospital may log whether a patient smokes, as standard; another may not, for instance. Even if care providers are collecting the same data it may be in a different format, making it difficult to gauge wider trends.

When Novartis entered into an NHS-wide agreement in England last year, to enable broad and rapid access to first-in-class cholesterol-lowering medicine across the country, it was on the basis of the company’s ability to demonstrate clear trend information. It had identified tangible, demonstrable correlations between the impact and public benefit of treating adults with a history of certain cardiovascular events such as heart attack or stroke who record persistently high cholesterol (despite diet and treatment with maximally tolerated statins).

Aligning opportunities with strategic therapy areas

For any pharma organization to really assume a role as a trusted partner, it must first identify what it is bringing to the table, beyond mere access to products and therapies—and develop a business case around this.

For instance, pharma companies are typically ahead of the curve in their scientific knowledge and have deep research and valuable clinical development-based insights they can bring to bear, if framed in the right context. This in turn will be informed by their primary areas of therapeutic focus to which they have long-term commitments.

If and when accepted into more collaborative engagements and more direct involvement in the care pathway, pharma teams would have a chance to capture new insights into the impact of their therapies, enriching their own knowledge. That’s assuming they have appropriate people in place to fulfil this kind of role, along with fit-for-purpose data capture mechanisms—just two of the many important organizational considerations as part of pharma’s repositioning.

Preparing the ground

Undoubtedly pharma’s reinvention will be a gradual process and it is likely that companies will concentrate on forging new healthcare partnerships linked to their plans for advanced therapies.

We might see a ‘Traditional +’ model emerge first, for instance, which sees the company prepare market access then introduce the new therapy and its value story, later paving the way for associated care delivered in partnership with healthcare providers in innovative new ways. Beyond that point, companies might start to look at how they could help shape the healthcare system of the future—drawing on the particular knowledge and insights they have amassed.

The more that pharma becomes embedded in care pathways, meanwhile, the greater the scope to feed patient data and requests back to R&D—further boosting a therapy’s value and innovation over time and making treatments more sustainable.

None of this repositioning will happen overnight, and there are a lot of critical building blocks to assemble first, but setting the right intentions and knowing what to aim for is always a good place to start.

Gérard Klop is a partner at Vintura