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Daniel Wetherill is a partner at Beghou Consulting. He has more than 20 years of experience in management consulting and helps biopharmaceutical companies improve their data and analytical capabilities, as well as their brand commercialization and portfolio optimization strategies. Contact him at firstname.lastname@example.org.
While patient support providers play an important role in keeping patients on therapy, biopharma companies have a great opportunity to push analytical sophistication beyond what many of these providers currently offer.
Getting patients to follow doctor’s orders is an age-old challenge in health care. According to the Annals of Internal Medicine,1 20%–30% of prescriptions are never filled. When it comes to a range of chronic diseases, up to 63% of patients don’t adhere to approved treatment regimens, according to a McKinsey study.2 And among those with rare diseases, specialty pharmacy Accredo found that more than 90% were late to refill at least once during an 18-month period.3
Patient compliance has become a more acute challenge during the coronavirus pandemic, when physicians are having fewer face-to-face interactions with patients. So, how can the health care industry encourage patients to start and stay on therapies? It should be as simple as explaining to patients the serious risks of noncompliance. But it’s usually not. After all, every patient brings a unique set of views and preferences – built off past experiences – to every medical encounter. The strategies physicians use to convince one patient to stay on therapy may not work for the next patient.
Patient compliance is a big, complex issue – and one worth addressing. After all, the stakes are sky-high. Poor compliance leads to poor patient outcomes and an increased burden on the entire health care system. Lack of compliance produces a lose-lose-lose. Patients struggle with poor health. Physicians lose patients. And biopharmaceutical companies lose customers and fail to prove the efficacy of their drugs. On the other hand, with improved compliance, patients get and stay on the critical treatments they need to be healthy. And biopharmaceutical companies get their life-changing drugs in the hands of more people who need them.
This opportunity is especially significant for orphan drug manufacturers. These manufacturers’ therapies treat a small number of patients, often with chronic conditions. Compliance is therefore an ongoing and important challenge for these companies. Improving compliance can translate into better patient outcomes as well as meaningful top-line growth and bottom-line profitability. Fortunately, biopharmaceutical companies can play a significant role in improving patient compliance by leveraging their advanced analytics capabilities and increasing collaboration with caregivers.
There are many factors that influence compliance. Some patients put off seeking preventative care or filling prescriptions because of financial limitations. Others defer treatment to avoid painful side effects. Others may balk at the proposed method of treatment delivery (Patients may shy away from self-administered injections, for example). But, the patient-physician relationship sits at the heart of the entire treatment journey and therefore plays an important role in determining whether a patient adheres to therapy. If a physician builds trust with patients, she will be able to more effectively encourage compliant behaviors. According to a study published in the Harvard Business Review,4 there is evidence that strong physician-patient relationships can contribute to improved clinical outcomes. Further, physicians and patients often have long-standing relationships. According to a study from Zocdoc,5 82% of Americans have ongoing relationships with their physicians. These patients see the same physician for an average of 9.4 years. Given the importance of these long-standing relationships in determining clinical outcomes, the industry needs to work hard to make them healthy relationships.
But while physicians are hyper-focused on patient care, they often lack the ability to preempt noncompliance. Without the analytics capabilities needed to create patient psychographic profiles or map out patient journeys, for example, they may struggle to identify the moments when patients are close to falling off therapy. Therefore, they’re often only able to act after the fact, which, for some conditions, could include a visit to the emergency room.
Biopharmaceutical companies are well-positioned to fill this void. With access to large amounts of patient-level data, as well as sophisticated data science techniques (such as machine learning and artificial intelligence), biopharma companies can chart out patient journeys with precision and gather insights that help providers more proactively address patient needs. While patient support providers can play an important role in keeping patients on therapy, biopharma companies have a great opportunity to push analytical sophistication beyond what many of these providers currently offer.
Biopharma companies must think more holistically and view caregivers as collaborators in the effort to improve the patient experience. To succeed here, companies should continue capturing new sources of data and integrating this data into their analytics platforms. This effort will help them gather the insights they need to develop the more collaborative relationships with caregivers that contribute to improved patient engagement and clinical outcomes.
Biopharma companies should work to arm caregivers with the information they need to more effectively treat patients and intervene before patients stop complying with therapies. In this way, biopharmaceutical companies can enhance patient care and support the industry-wide effort to boost compliance. Consider a few possibilities:
Find underlying causes of nonadherence. Biopharmaceutical companies have access to large amounts of unstructured data – from physicians’ notes contained in electronic health records to nurse educators’ conversations with patients. Using natural language processing tools, a company can turn this unstructured data into searchable information it can analyze to better understand the patient journey. Then, it can incorporate this information into its data analytics engine. In the end, this effort can help the company pinpoint the underlying causes of nonadherence and define effective actions to keep patients on therapy.
Create tailored approaches to treatment. While some patients respond to the cold hard facts about a diagnosis and treatment, others seek a softer, more emotionally attuned approach when a physician delivers medical news. Psychographics can provide sophisticated insights into a patient’s motivations and likelihood of compliance or noncompliance. Psychographic techniques can use answers to just a handful of questions to define personality types. Companies can collect answers to these questions as they onboard patients into assistance programs or when patients go through benefits verification. From there, biopharma companies can correlate personality types with compliance rates. These insights can help a company predict noncompliance. It can then equip physicians with these insights. Armed with this information, physicians can develop tailored communications and treatment strategies that account for different patients’ proclivities toward or against compliance.
Leverage technology and data science to prompt interventions. Taking a holistic view of all the data and information a biopharma company has can allow it to build an automated, machine learning-based recommendations engine to prompt next-best actions that drive patient compliance. For example, a company may be able to quantify (in terms of patient health and cost for the health care system) the impact of missing a single therapy within a cystic fibrosis treatment regimen. It may also be able to identify (using the NLP-based analysis detailed above) key points at which a patient is likely to fail to comply with therapy. The company can then create a recommendations engine with automated prompts tied to these tipping points so providers can prevent medical crises.
Utilize customer-centric channels to communicate with maximum impact. As biopharma companies and caregivers identify these tipping points, they must also determine the most effective communications channels. Using psychographic insights, longitudinal patient data, and analysis of communication channel activity, companies can aim to identify the most effective adherence communications channels for different patients (e.g., direct HCP-to-patient communications, traditional mailings, telephone calls, emails, text messages, etc.).
All these efforts lay the groundwork for more dynamic, predictive and coordinated care. To succeed, biopharma companies must begin viewing their relationships with physicians and their staffs as more than transactional ones. Instead, companies should work to develop more valuable and collaborative relationships with providers by filling in knowledge gaps and equipping providers with the tools and information they need to keep patients on life-saving therapies. Additionally, biopharma companies must proactively seek to supplement the work of patient support providers – and in some cases, take more of this patient support work in-house.
At the heart of this effort to improve patient compliance is the patient experience. If a patient feels understood and trusts her provider, she’s much more likely to comply with the provider’s instructions. Biopharmaceutical companies must recognize their integral role in equipping providers to better serve patients. With sophisticated tools and data science capabilities at their fingertips, companies can be a driving force in improving patient compliance and clinical outcomes.
Daniel Wetherill is a partner at Beghou Consulting.