So Much Depends on the Physician

TransCelerate BioPharma recently announced a grassroots One Person Closer (#OnePersonCloser) social media campaign to inspire more physicians to believe in clinical research and motivate them to have conversations about clinical trials with their patients. Joe Kim, senior advisor, clinical innovation at Eli Lilly,

Lisa Henderson

and campaign lead for TransCelerate’s Clinical Research Awareness initiative, mentioned that the top reasons physicians don’t refer patients to trials are lack of time, lack of financial incentive, lack of trust in the research enterprise, and lack of understanding on how to match patients to relevant trials.

After meeting photographer and co-founder of online patient community Smart Patients Gilles Frydman, Kim discovered that they shared a vision: telling the authentic stories of the real people involved in clinical trials-researchers, physicians, and patients-and conveying the essential role each person plays in the development of new medical treatments and breakthroughs. This vision is the inspiration behind the One Person Closer social media campaign, which can be found on Twitter, Facebook, and YouTube. 

As Dalvir Gill, CEO of TransCelerate, told me, “There are many things that are being done. But if we help one person get into a trial, and enough people try to do this, we can move the needle.”

Beyond the physician, the structure of healthcare and clinical trials in and of itself is a barrier to patient recruitment in these trials. Clinical trials are separated from healthcare because of regulatory and ethical requirements. And while physician investigators are, by definition, physicians, a physician in clinical practice is oriented toward providing patients with individualized care in their patients’ best interests. An investigator, on the other hand, makes no treatment decisions, but follows a protocol to further research. Though a patient-participant may benefit from research participation, that benefit or non-benefit is not the investigator’s concern.

On the commercial side of pharma, physicians have become an elusive, hard-to-reach stakeholder-a stakeholder that has the trust of his or her patients. The changing healthcare delivery system makes it challenging for pharma to find the prescribers and decision-makers at the larger integrated delivery networks (IDNs). According to an American Medical Association report from 2016 data, 38.7% of physicians in multi-specialty practice reported that their practice included 50 or more physicians, and physicians in multi-

specialty practice were also more likely to report hospital ownership, 43.6% compared to 22.8% for physicians in single specialty practice. 

Physicians and healthcare professionals (HCPs) have been increasingly burdened over the years with managed care, navigating their own billing issues with health plans, as well as helping patients navigate treatments and care; using electronic health record (EHR) systems; navigating the Affordable Care Act (ACA); and only having, on average, nine minutes to speak with patients in the exam room. Pharma wants to stay close to physicians and goes to great lengths to stay closer through targeted services that help them better inform and educate their patients about prescription costs, adherence, and access. 

On one hand, pharma has to be very careful about what it communicates to physicians and patients about prescribed treatments, as well as potential therapies in clinical trials. On the other hand, a well-intentioned and designed education and awareness campaign to physicians about clinical trials, in general, doesn’t seem a bad idea to me. Not promoting a specific trial, or even a specific therapeutic area, but maybe utilizing the same medical science liaisons (MSLs) or services that surround commercial physician engagement to reach out and educate them. In the end, until randomized clinical trials are not the standard for human drug trials, more patients having access to clinical trials is beneficial to everyone. 

I touch on this topic with our podcast editors in this podcast. 

Lisa Henderson is Editor-in-Chief of Pharm Exec. She can be reached at lisa.henderson@ubm.com. Follow Lisa on Twitter: @trialsonline