Patient Centricity: Banishing Buzzwords

Whlie the pharma world has been talking about patient centricity for over a decade, a new book points out that executives and companies have only made piece-meal progress on this issue and have yet to deliver on their promise to hold the patients’ needs at the center of all decisions. Reinventing Patient Centricity, edited and co-written by Hensley Evans, leader of ZS’ patient and consumer health practice, and Sharon Suchotliff, who heads ZS’ patient centricity work, explores how pharma can move beyond just implementing what they call a “patient-centered corporate culture.” The editors and their contributors use real-world case studies, proprietary data from a range of studies, and insights from their own experience to offer tangible ways for pharma companies to make an impact on patient lives, from initial R&D stages, through to effective clinical trials and enhanced patient engagement during treatment.

Before joining ZS, Evans led consumer and patient marketing strategy at Saatchi & Saatchi Health and Wellness; she also spent eight years leading imc2’s health and wellness practice and four years as president of Harte-Hanks Direct and Interactive.

Prior to her role at ZS, Suchotliff led the engagement strategy practice at Saatchi & Saatchi Wellness, where she was responsible for developing and leading strategic marketing across the agency’s pharmaceutical, healthcare, and wellness clients.

As Reinventing Patient Centricity is set for release this month (April), Pharmaceutical Commerce sat down with Evans and Suchotliff to chart the book’s development and tap into their vision for a future where patient centricity is not just a buzzword or a hackneyed term but a tenet embedded at the heart of the industry.

Your book is called Reinventing Patient Centricity. “Reinventing” is quite a strong word, quite provocative. Does patient centricity need to be reinvented, and what would that reinvention actually mean?

Evans: The reason we use the word “reinvention” is that we did want to be a bit provocative. We’ve been talking about patient centricity in the industry for a really long time. I think it was 2010 when UCB put on the cover of their annual report that they were going to be the leader in patient-centric pharma. But our benchmarking studies of where pharma is in terms of implementing patient-centric initiatives has shown that no one is transformational. Companies are instead making very incremental changes, moving their business models toward one that’s more focused on delivering to patient needs and being patient-value oriented. So, we wanted to issue a bit of a challenge to the industry to take more meaningful steps to transform their organizations toward a patient-focused way of doing business.

Suchotliff: We looked at patient centricity, how companies are actualizing it, based on four dimensions (see chart on next page). We’ve benchmarked more than two dozen companies over the last few years. As Hensley says, no one is transformational. By and large, the industry is really foundational. We have seen changes over the last few years, but not enough. If we truly believe in patient centricity, we’ve got to change the way things are done. And we’re asking, “How might we do that? How do we walk away from the buzzwords? How do we make this meaningful and real?”

It does indeed feel like we’ve been talking about patient centricity for a long time. I’m surprised it’s only 10 or 12 years. So, we can ask, is that a long time, really? Haven’t we had to wait for technological advancements to really allow for patient centricity?

Suchotliff: I think technology has a lot to do with it. We now live in the “I want what I want when I want it” world. That’s been facilitated by personalization, and, of course, data and technology have helped to drive that. But there are other reasons. There’s the external environment, there are also business reasons, in terms of the decline in the return on investment of clinical development. And there is the fact that specialty and rare diseases, oncology, personalized medicine, gene therapy—all of these require a more focused and a better understanding of patients. We’re also seeing a shift in the regulatory environment. Both the European Medicines Agency (EMA) and FDA are asking for patient input. In the next couple of years, we can expect the regulators will want to see more of this input. And on the payer side, we’re at a place where payers are looking for value beyond clinical outcomes. Are patients better able to engage in their life? Do we see a reduction in overall healthcare costs? So, I think there’s a lot of different reasons that have led to this change.

Evans: Technology is a great enabler, so I was a little disappointed when we did the benchmarking last year to see that we hadn’t come further as a result of the incredible leap that we’ve made in terms of data and technology. And COVID pushed the pedal down further in terms of accelerating technology adoption. I don’t think that the lack of technology was what was holding pharma back. We talked to executives on our advisory board and they listed things like silos, concerns about regulatory issues, compliance. And yet I think the single-biggest reason is that pharma has been phenomenally profitable and successful for decades, if not more than a century, without having to make a radical change in this way. It’s kind of the “If it ain’t broke, don’t fix it” approach. There’s no burning platform to make companies adopt a radically different approach to their business. But a lot of the things that Sharon mentioned are driving senior executives to think, “Yeah, maybe I’d better start moving off this platform before it’s really on fire,” so I’m hopeful that we’ll see some more dramatic change.

We hope that by writing the book, we’re going to help push some of the folks who are behind the leaders to move more quickly. It’s doubtful that anyone who’s not already thinking about patient centricity would bother to pick up the book in the first place, but we are trying to preach beyond the choir, to reach a broader audience and move beyond the apple-pie notion that “Of course, patient centricity is a good thing.”

Suchotliff: You can have the best strategy, the best intentions, but without a focus on shifting the mindset, you’re dead in the water. I think a big cultural shift has to happen, and a lot of it has to be around what we believe and how we define value. Can we get to a place where value to the patient equals value to the company? I think that’s the biggest change, and it’s one that pharma’s coming around to very slowly.

Evans: A company can say, “I want to improve the experience that a patient has starting my therapy.” Primarily, that is a business objective—to get patients on a therapy faster. A delay of two to three months has a significant business impact. If a company delivers a much smoother and more pleasant experience to its patients, those delays and barriers can be eliminated; the patient appreciates it. It’s kind of a win-win. But if it’s only done for a business reason, then a company is only solving things in little silos, e.g., decreasing the patient burden in your clinical trials because, otherwise, patients are going to drop out or fail to enroll.

There has to be a cultural or mindset shift, or you are only ever going to get incremental change.

What did your collaborators bring to the book?

Evans: Everyone that we approached early on about collaborating on the book was hugely enthusiastic. One of the reasons we decided to write it in the first place was that we had so many different parts of the organization focusing on different aspects of patient centricity: the data and technology team; the digital connected health team; the rare-disease vertical focused on partnering with patient advocacy groups; the R&D excellence team looking at clinical development. ZS is a very entrepreneurial organization. We have lots of practices that are really able to innovate and independently develop solutions. We thought it would be a great way to bring together a group of people that are looking at different ways to help the pharma industry really evolve and change.

Suchotliff: One of the things that I really like about working at ZS is that on one hand, we have lots of innovation—big thinkers, folks who are really willing to challenge the status quo—and at the same time, there is this recognition that we’ve got to be a bit pragmatic. That was a big driver for us in terms of the book. In having conversations with many executives, sometimes the patient-centricity ambitions just seem unachievable, too lofty. We wanted to present the pragmatic ideas, the pragmatic solutions, so that folks can see they’re taking good steps. But we also invited a lot of external folks to contribute, so sometimes we heard things that were hard to hear, but that’s okay, right? I think it made our work better.

Evans: An early piece of feedback we got, actually from one of our patient advocates, was, “Do you guys have a group of patients that you work with consistently to get feedback on the work that you’re doing?” Of course, we advise our clients all the time to get patient input and take the patient perspective, but we kind of sheepishly said, “Um, no.” Well, now we do. The time it takes to publish a book gave us time to stand up a patient advisory panel. So, we learned a lot along the way; challenges from some of our collaborators caused us to do a little bit of rethinking.

Suchotliff: One interesting question we wrestled with, honestly, was around the use of the word “patient.” The industry, of course, has used this word consistently for a very long time. But most of the patient advocates we spoke to don’t like to refer to themselves as patients. They’re people; they’re more than someone who suffers from any particular condition or disease. We debated quite a bit about whether we should try to change the language that’s used around patient centricity.

But ultimately, we decided we’d reach a larger audience if we used the language that most people are kind of comfortable with or use now.

The book was being written as the COVID-19 pandemic was raging. What impact did that have on how the
book developed?

Suchotliff: It changed a lot. To some extent, it made it easier to collaborate because, all of a sudden, we’re working in this virtual world. Collaborating virtually became second nature. And of course, in terms of the information we were including in the book, COVID certainly changed things.

Evans: Yes, we had one conversation with an organization during COVID who put in place a mechanism to provide home care for patients because, of course, patients were unwilling to go to the physician’s office. And I said, “That’s great; it that a new insight that came up?” But they said, “Well, we always knew that patients didn’t want to have to go to the doctor’s office. It was always inconvenient for them. But they used to do it anyway.” So, it was only when patients insisted on not doing it that the company started accommodating them. Now, I don’t know that I want to call that patient-centric, right? It’s self-centered. The company only did it because it was hurting them financially, even though they knew that the patients would have preferred that all along. That was quite revealing.

How do you see the book being used? Will it become part of ZS’ package for clients or something independent
of the company?

Evans: In many ways, the book synthesizes a lot of thought leadership we had already been working on. Our company vision is “transforming global healthcare, driving toward a connected ecosystem, leveraging the power of data, science, and technology to make more intelligent healthcare decisions, and delivering innovative solutions to improve health outcomes for all.” The focus really is about patient outcomes and having an impact. At our partner meeting last August, which was exciting because it was the first time we’d come together in two years, our CEO held up the book during his keynote speech and said, “This really represents the thinking across the firm.” Everybody feels that the patient and patient outcomes are a critical orientation of our company as a whole.

But Reinventing Patient Centricity is also a book in its own right. And I hope it helps us to create some new conversations, particularly with more senior executives. One of the things we see is that there are some incredible evangelists for patient engagement and patient centricity at the senior director and VP level. But if a pharma company doesn’t have vocal SVP and c-suite leaders really pushing patient centricity, they’re only going to get so far.

We’d like to expand the scope of the conversations we’re having with the c-suite about patient centricity and how to make it a reality.