Astellas’ Dr Anthony Yanni on Creating a Strong Patient-Centricity Model in Pharma
Dr Anthony Yanni, SVP and Head of Patient Centricity at Astellas Pharma, discusses how to build and incentivize a patient-centricity model within an organization, for a greater patient focus in medicine development.
This Q&A editorial provides a summary of the podcast interview with Dr Yanni. To listen to the full conversation, click here.
What should a robust patient-centricity model within an organization look like?
Patient centricity should sit parallel to the existing work stream that is essential to developing a product patients can use. It requires engaging in research, discovery, in early development, late development, post-launch, etc, to help development teams understand the patient in the real-world setting.
Integrating patient centricity does not have to destroy the current work stream. Understanding behavior in the environments where the patients live, and creating an opportunity to take the patient information that we obtain and make actionable, allows teams to make better decisions that are more aligned with patient need and patient value.
What are some of the challenges within an organization that might inhibit the incorporation of patient data into decision-making?
I’ve encountered two challenges with regard to utilizing this information. The first is convincing people that it's important, essentially that you should have this information as part of the decision. Through example, we’ve shown that this patient information is critical to making important decisions.
The second piece is fear that this information could disrupt everything we’ve been working on, and my answer to that is, “Absolutely not.” No medicine is going to be effective if we don't have good science. Patient data is not going to disrupt good science.
It's going to be a piece of information that should be considered when we decide whether a medicine or a molecule should proceed toward regulatory approval, but it doesn’t necessarily mean that every piece of input from patient centricity is decisional. It’s just part of those decisions.
"We changed the idea of culture from being just the narrative to the action."
What’s your argument to incentivize medicine development leaders to make bigger changes, when it comes to incorporating patient centricity?
The most common thing I hear from people is, “Nobody’s listening to me and I can’t get the right audience. What I did was work the networks I had, built systems that could show the result of that patient input, and the impactful nature of what was built. That way, the very customers who asked for it, or who were willing to experience it, became the evangelists for it.
It’s a slow process but you can make a difference by simply delivering the patient voice in an integrated way. It doesn't have to be a big way, or global, or system-wide. But if you can show an example, you can build your network and build the business case for the patient centricity function.
How does a pharma company understand and assess what good looks like when it comes to real integration of patient-centricity?
There have to be two components: operational and cultural. Have you created teams to integrate the patient perspective into the decision making and do you have a culture that will sustain it?
We changed the idea of culture from being just the narrative to the action. We've created a bunch of cultural programs that are critically important to the sustainability of patient centricity: Patient Centricity University, curriculum-based learning modules; Patient Centricity Month, pharma video testimonials. It's through those activities that we get a fabric of team members. that are truly focused on the patient and believe in the work that we're doing every single day.
But the measure of success is whether we have the structure that can impact operational decision making and cultural evolution, without getting so caught up in quantitative metrics.
Can you expand on what you mean by not focusing so much on quantitative metrics?
Certainly we want to measure things that can be measured, but patient centricity is a piece of the decision tree when we're developing new medicines. Quantitative can become a point of paralysis because it's difficult to identify its components. But when we speak with researchers and ask them, “Have you made better decisions because we were providing you with our analysis?” The answer, universally, is “Yes.”
We asked the teams working with patients in the real world setting if the behavioral component we've provided have been helpful. 100 percent of the time, they said yes. Then, those internal customers start to tell their leaders, “We need this because it's helping us make better decisions.”
That leads to the quantitative “Here is the result of what happened. We've advanced more molecules because that are aligned with need and value,” or “We've gotten more product to the environments where the patient needs them.”
"You have to convince them that what you’re proposing will meaningfully improve their way of work, and they will get on board."
What’s the change management required?
In change management, 2.5% of the people you come across are completely opposed to any new idea, and 2.5% absolutely love change. But the 95% in the middle are just looking for ways to execute their work more effectively. You have to convince them that what you’re proposing will meaningfully improve their way of work, and they will get on board. We did that through example.
In the research space, we showed very early that bringing information from the exam room into the research labs, how the molecule would need to behave in the real world for it to be effective, helped researchers understand exactly how to deliver this molecule to patients.
What is the next opportunity for the patient centricity movement in today’s pharma economy?
Broad acceptance across organizations and saying, “This is the time to move forward because we have examples of why it works, and we have examples of failed attempts to develop medicines without patients.”
This is the time for us to not question whether or not patient centricity is necessary, but to ask how we can develop this process in our organizations to fully integrate it.
The challenge is how we convince other industry partners and organizations, in a pre-competitive space, to share how we are doing this, and then to bring it more fully into regulatory discussions. Regulatory is starting to look at this, but we have to link what we’re doing in patient centricity and drug development to the value we’re delivering to patients.
Do you have any other thoughts on how we can help the industry get to greater patient-centricity in medicine development faster?
The only way change occurs is by persistence in the face of resistance, is to say, “This is important enough.” This is not going to be a lightning bolt. It's going to be a stream eroding a rock, but every day we're going to make some progress. We’ve shown the value, so let’s move forward.
I believe the time is now. We're able to show results. We're able to share fully things that may work for folks in industry and in healthcare delivery.
