What do you see as the overwhelming challenge preventing greater patient centricity in pharma?
There is not a consistency of how and when we gather information from patients. There's not a consistency of how we utilize that information in decision-making. And from a regulatory perspective, there is the question of if and how they are planning on evaluating and weighing the insights we’ve integrated into our decision-making.
We're making progress, and we're at a point now where I believe patient centricity is going to be the biggest disruptor moving forward.
We need to work very hard together to share best practices. We need to work with our regulatory partners to understand how we can use this information not only internally, but through the regulatory process so that companies are recognized for making the effort to integrate the patient perspective in their solution development.
"We're making progress, and we're at a point now where I believe patient centricity is going to be the biggest disruptor moving forward."
How is patient engagement organized within Astellas?
One team specifically works in support of discovery, research and early projects. They provide a full analysis that includes the patient perspective. Another team, Patient Partnerships, is tasked with creating relationships with patient advocacy groups globally. These relationships hopefully will become bidirectionally beneficial and collaborative over a longer period of time.
A third team focuses on patients in the real-world setting, so as we get closer to delivering solutions, we can understand the patient, caregiver and physician in their respective environments. A fourth team focuses on fully understanding the behavioral drivers of care and the barriers patients face to good care, so that we can apply these learnings to how we can best deliver solutions to patients in their environment. The final team is focused purely on culture and integration through a systematic, project-driven approach so that every person in Astellas all over the world can participate actively in patient centricity functions.
What was the biggest surprise once you formalized patient centricity?
The biggest surprise was how quickly it took off once we were able to share an example, and how meaningful the teams felt the work was. Quickly, we became overwhelmed with requests. The biggest barrier initially was having that first research team say, “Fine, let's see what sort of analysis you're producing, and how we can use this information.” Once we did that, it took off very quickly. People saw the value and that it was supporting their work, not conflicting with their work.
"People saw the value and that it was supporting their work, not conflicting with their work."
How did your experience as a treating physician and hospital CMO impact your mindset when entering pharma?
When you’re in clinical practice, in the exam room or at the bedside, you quickly realize that healthcare is not cohorts or populations; it’s individuals. Individuals who are looking to you to help solve a very personal, significant problem. You also see the complexity of the healthcare environment that patients and caregivers deal with.
If you take those two things into the halls of pharma, and say, “Folks, this isn't about populations; this is about an individual waiting for a solution. Let's get to work.” We're doing something really big here. Let's not keep this in the abstract. Let's keep it in reality. And so I try to have our patient centricity teams, and the entire organization, realize that it doesn't matter what role you're in, you're contributing to this solution. So let's get to work for the people who are waiting.
What is your definition of patient centricity?
I have two definitions that are critical for me: cultural and operational. The first one, the cultural definition, is the conscious awareness of the patient, in every activity, every day, for all team members across the world. The second definition, the operational, is the consistent integration of patient insights into all decision-making.
How do those two definitions translate into your tangible work every day?
When we talk about the barriers in change management, it's first convincing people that the patient role is important in pharma. It’s a relatively low barrier, because I think most people realize this is important. But does an individual feel that importance every day when they come to work? Have we done a good job with the cultural piece so that when they come to work they feel the need? And the importance of that work?
The last piece is complicated: are we doing something with that information? Have we created processes and pathways to regularly and sustainably meet with patients, understand them and integrate that information into our decision-making? Those are the things that I think are critically important to anybody who's trying to build these processes.
How did you define the metrics for integrating patient insights into decision-making?
I look at this in two ways: qualitative and quantitative. In pharma, we are really focused on the quantitative. But most of us every day in our lives are making qualitative decisions, not quantitative. There are qualitative measures that are very important with patient centricity being integrated into pharma.
What questions are you asking to understand the qualitative impact of integrating patient insights?
Are the researchers feeling as though they have more robust information to make more meaningful decisions about their molecules? Have we utilized this information to better prioritize our early and late portfolio so that the science links more closely with patient need and value? Do we better understand the medical expectations of the physician, the caregiver and the patients in a particular disease state early enough to realize whether or not the science that we're promoting in our programs will actually have a chance of meeting those endpoints?
I think it's incredibly important if organizationally, people are saying, “We are making much better decisions because of this.”
How are you tackling the quantitative side of metrics?
The quantitative piece is more complicated, because even in its most mature form, patient centricity is only one of many decision factors that go into final decisions around molecule progression, clinical development programs, delivery in the real-world setting, etc.
There are ways over the longer period to reflect back on what the view of this particular program was of the patient centricity analysis. How did that align with what we’ve seen as programs progressed? There are ways to measure and we're working with other companies to try to figure this out.
What do you envision as the optimal version of patient centricity functioning within an organization?
It would be a patient centricity function that parallels the entire developmental continuum from discovery, through delivery, so that each of the steps – discovery, research, early development, late development, and then launch of a product – has a parallel step where the patient is being integrated. There's much more work to do, but I believe what we've designed here and established is exactly what I consider to be a form of mature patient centricity integration.
"For too long, patient centricity as a function has struggled to exist in many instances. Now it’s less about existing and more about perseverance; about creating a sustainable, impactful approach."
What is one thing about how patient engagement gets done in pharma that you’d like to see changed?
I'd like to see a programmatic approach in institutions. For too long, patient centricity as a function has struggled to exist in many instances. We have come a long way in the last 15 years and have had a positive impact. There’s certainly more to do but now it’s less about existing and more about perseverance; about creating a sustainable, impactful approach. An ad hoc approach will never take hold inside of an organization.
In my view, it has to be approached from a cultural perspective and an operational perspective. The cultural perspective is what keeps it sustainable. The operational perspective is what makes it impactful. And use examples to promote the work. And when we hit those change management hurdles, I just kept saying to the teams, “Keep executing. Share more examples.”
What do you find valuable about the Patients as Partners Conference?
Patients as Partners provides an opportunity for the sharing of ideas and best practices, to connect with others focused on this work, inside and outside of industry, and to foster future activities that bring this work closer to “business as usual” in the world of medicine and solution development.
For more information on Patients as Partners, visit patientsaspartnersconference.com.
