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A patient-centric approach to drug development delivers the benefits that actually create value, writes Charlotte Vansgaard and Mikkel Brok-Kristensen.
Sarah has been living with her disease for thirteen years now. Her treatment plan involves regular visits to doctors as well as several different drugs. This month, like every other in the recent past, Sarah has held off on committing to events. Whether it is her granddaughter's recital or her husband's alumni lunch, Sarah responds to every invitation with the same answer: "We'll see."
"We'll see" is code for people like Sarah, patients trying to manage a life in the midst of chronic but erratic pain. It's ironic that Sarah's treatment plan excels at charting the long-term progression of her disease while giving her no way to chart its progress on a day-to-day basis. This leaves patients like Sarah feeling socially isolated with no way of predicting and preparing for daily activities. What if a pharmaceutical company were able to deliver the benefit of consistency to patients like Sarah?
A few pharma companies have started taking steps in the direction of "patient-centric" health care, and are using patient insights to guide early drug development and clinical trials.
What is the best way to benefit someone managing a life with Sarah's disease? How do people live and work with this disease? What are their daily concerns?
The point here is to understand the contextual needs of the patients. It is insight into human behavior, and that requires an anthropological approach: open-ended observations and nonlinear problem solving. Patient-centric health care focuses on a deep understanding of the everyday life and context of patients, prescribers, and payers. How are their perceptions, choices, and behaviors formed? It delves deeply into actual human behavior, often debunking industry norms, assumptions and expectations, to deliver one or two clarifying insights rather than a vast quantity of data points.
For example, in our work with a number of chronically ill people—administering their own medicines by taking a particular number of tablets, injecting a particular volume, or inhaling a particular number of times —we found that the majority of them had a negative association with taking the max dose. Even when a doctor directed them to use a dose level of 3 tablets, say, many of the patients would find some kind of compromise: I'll use a dosage of 2 because I don't actually "feel" like I'm at 3. This perceived danger of dosages at the "maximum" or "high" end of the spectrum has no correlation with actual medical science and yet it is an insight into human behavior that pharmaceutical companies might consider for innovation opportunities. In fact, the phenomenon exists in all the various disease cases we studied.
This kind of insight—patients tend to avoid the perceived risks of a maximum dosage by moving onto a new treatment—offers up unexpected innovation opportunities for drug development as well as for secondary services like education. In a marketplace growing ever more crowded, such patient-centric innovations provide genuine points of differentiation with competitors.
In our experience, the patient-centric approach can be used to:
» Design success parameters for a new drug in the earliest phases: beyond the core benefit, what other key benefits can the drug deliver on? How might this drug deliver on recognizable points of differentiation from competitor drugs?
» Guide clinical trial design: How can we structure trials to test the core benefit as well as key benefits that go beyond this core benefit (while still getting the end-points right)?
» Create a cohesive disease area strategy 'beyond the pill:' what key elements beyond the drug itself are needed to deliver the most value for patients and providers? How can a pharma company be a trusted partner in delivering on these secondary products, services or education?
When we refer to patient-centric health care, we are really talking about how to create genuine value for the customers we serve. We can never truly understand how to better design products, services and education until we understand how patients perceive the experience of living with their illness.
Charlotte Vansgaard is a Partner at ReD Associates. She can be reached at: firstname.lastname@example.org
Mikkel Brok-Kristensen is a Partner at ReD Associates. He can be reached at: email@example.com
Mads Holme is Senior Manager at ReD Associates. He can be reached at MH@redassociates.com