“Patient centricity” has been a popular concept in the healthcare industry for years, but due to changing dynamics, today the patient is truly becoming the center of care. According to a 2016 study, “consumers now directly control $330 billion annually in out-of-pocket healthcare expenses, and the choices they make have the potential to affect 61% of all healthcare spending.”  At the same time, there is growing recognition that when patients are active in managing their own care, outcomes improve and costs decrease.  These trends, coupled with dramatic changes in technology, reimbursement and culture, are leading the industry to rewrite the role of the patient—and to significantly expand its focus on patient engagement.
Three key trends affecting the role of the patient:
Greater focus on value and outcomes
The shift toward value-based reimbursement is driving greater focus on importance of patient outcomes. Physicians who participate in CMS quality payment programs like MIPS (Merit-based Incentive Payment System) will soon find that a portion of their payment will be based on the patient experience, which is leading to a more patient-centric approach to care.
For pharmaceutical manufacturers, there is increased pressure to demonstrate that new drugs can deliver meaningful outcomes. In some new contracts with payers, the cost of the drug will only be reimbursed if the patient responds positively to treatment and achieves defined clinical thresholds. As a result, providers and pharmaceutical companies are increasingly focused on ensuring that patients not only get access to therapy, but also take the right steps during the treatment journey to enable optimal outcomes.
The rise of consumerism in healthcare
Patients, increasingly engaged and informed, are playing a bigger role in making healthcare decisions and managing care than ever before. And because patients are also savvy consumers, they are seeking health solutions that are coordinated, convenient, customized, and accessible. Patients are using digital tools and technology to manage their well-being, and are starting to expect an “Amazon-like” customer experience when interacting with physicians, pharmacists and other healthcare service providers. According to industry research, 80% of internet users have researched health topics online and 32% post about the health experiences of family and friends on social media.  In this environment, healthcare stakeholders need to be prepared to engage patients using the digital tools patients prefer and deliver experiences that are on-par with leading consumer brands.
Digital medicine and greater availability of data
Apps, wearable medical devices, home monitoring devices and even traceable medicines are playing a growing role in how patients manage their health. In addition to making disease management easier, they can also provide meaningful insights into patient journey. This rapidly growing collection of Internet-connected devices has the potential to connect patients, physicians, pharmacists and other care providers in ways that would have once seemed impossible. To date, adoption of wearables and other monitoring technology has been highest among young, healthy patients who are focused on fitness. It is unclear whether those who are managing diseases or struggling with complex health issues will embrace it with the same enthusiasm. Persuading the right patients to use these tools is the key to making the data meaningful.
The movement toward patient centricity, fueled by value-based care, consumerism and digital medicine, is impacting every aspect of healthcare. Hospital systems, which are increasingly competing for patients in complex specialty areas like oncology and neurology, are investing in improving their patient experience in the hopes of becoming a treatment center of choice. Physicians are increasingly focused on collecting and analyzing patient data so they better understand the outcomes patients are experiencing and use those insights to improve their clinical decision making.
Drug developers also want to build deeper relationships with patients so they can facilitate easier access to their products, drive medication adherence, and help improve outcomes. And patients are looking for more support from drug companies. Research among patients shows that 76% expect pharma manufacturers to provide them with tools and support services  and physicians believe these programs can help improve outcomes.  However, despite the growing availability of patient data, pharma companies often lack access to the information they need to fully understand the patient journey and support patients along the way.
Pharma has historically had little direct interaction with patients, typically relying on information provided by other stakeholders, such as providers, pharmacists and payers. In a patient study, Deloitte found that only 19% of patients report being aware of the services provided to them by the manufacturer of their prescription medication.
“For a long time, we have talked about who ‘owns’ the patient, which is a very paternalistic way to view health care,” said Chris Zant, principal, Deloitte Consulting, LLP. “Instead, the pharmaceutical industry needs to talk about how we collaborate to support the patient, and new digital health platforms actually enable us for the first time to make that a reality.”
Patient services hubs
For pharmaceutical companies, the answer to two key questions “How do I better understand my patient’s journey?” and “How do engage my patient in a deeper relationship with my brand?” can often be found in their patient services hub. Because hubs interact with and gather data from patients, providers and payers all at the same time, they can be ideal sources of data—and some hubs are investing in tools to help their pharma partners harness this data. The challenge is aligning pharma’s needs with the right hub services, technology and team.
“Driving value for patients requires end-to-end visibility into the patient journey.” said Dave Rosner, principal, Deloitte Consulting, LLP. “This is particularly challenging for pharmaceutical companies in the specialty segment. Hub services companies are uniquely positioned to help specialty pharma bridge that gap and improve outcomes by using digital tools to facilitate interaction between the company and the patient.”
Below are a few recommendations for optimizing patient engagement using hub services:
When evaluating how to use hub data to deepen patient engagement, pharma companies should start with their objectives. Are they hoping to improve access to their product? Drive adherence? Do they plan to use patient data to enhance their reimbursement strategy? Support future regulatory filings? Refine commercialization efforts? Defining objectives will allow drug companies to determine what data they need and whether their hub has the systems in place to achieve the goals.
Identify gaps in the patient experience
Understanding the current gaps in the patient experience and how to fill them is another critical step. Are patients facing long delays in starting therapy because of a slow prior authorization process? Are patients falling off therapy at the same point in the treatment regimen—and if so, could more frequent touchpoints help improve adherence? Pharma companies should also look beyond clinical care when considering the patient experience. For example, could providing caregiver support programs or assistance with transportation help to improve the patient’s quality of life? Having visibility in the patient experience is critical to understanding how a pharma company can deepen engagement.
Understand the reimbursement landscape
A clear understanding of the reimbursement landscape can help to determine what type of support patients will need. Will most patients be on government or exchange-based systems, or private insurance? Will a prior authorization be required? Will the drug be a 3rd or 4th line therapy? Will a significant portion of patients be uninsured? Will co-payments be a barrier for patients? Payers are constantly evolving their approaches to specialty medicines, so being nimble when designing assistance programs for patients is advised.
The ability to harness meaningful data and insights through the hub will ultimately enable the pharmaceutical industry to deliver better patient programs, which will result in better patient outcomes. And while these patient-centric programs are particularly relevant for specialty drugs today, in the near future, manufacturers of nearly all prescription products will need to adopt an increasingly patient-oriented approach.
- Oncology Insights, June 2017, Cardinal Health Specialty Solutions.
- Deloitte research study, 2015-2017