You often speak about universal design as a cornerstone of your approach to developing new therapies. What does universal design mean in the context of healthcare and drug delivery?
At its core, universal design is about creating products and systems that are usable by as many people as possible, regardless of age, ability or circumstance. In healthcare, that means thinking beyond the molecule itself and designing the entire therapy ecosystem, so it works for real patients in the real world. A simple example is font size. If we design labels with larger, clearer text so that older adults can read easily, every patient benefits. By intentionally designing for those with the greatest challenges, we improve the experience for everyone.
How do you take insights from specific patient populations and translate them into solutions that work broadly?
We need to build the right thing first and then we build the thing right. We start by co-creating with patients. We engage closely with targeted patient populations to understand what it’s actually like to live with their conditions and manage their therapies day to day. From a device perspective, this can involve formative and human factors studies. More broadly, we conduct ethnographic research where we observe patients and caregivers in their home environments.
We leverage a variety of methodologies to gather insights into what is the right thing. We do observational studies: for instance, photovoice, where patients take and rate photos of their environment so that we can understand what it means to be in a patient site. We also have pop-up labs where we may build a model kitchen and have people come in and go through their day, like stocking the kitchen, having conversations, etc. to observe what a day looks like in different settings and apply that to our thinking about at-home drug delivery. These methodologies give us context we’d never get from interviews alone. We also have formal and informal interviews with patients and do qualitative and quantitative market research to create a value proposition for the problem space.
By understanding these lived experiences, we can identify common challenges such as dexterity, cognition, memory or swallowing difficulties, and design solutions that address those issues across multiple disease areas. This approach not only improves patient outcomes but also helps patients feel more connected to their therapy. Importantly, it allows us to design products that can be used globally and comply with regulatory expectations across different regions.
From there, we move into “building the thing right” viz. ideation, prototyping, testing and iterating. We also have feedback sessions, human factor formative studies, usability studies with patients and external benchmarking – even looking at other industries facing similar problems – to look for and develop solutions with platform approaches. This lets us scale solutions faster and avoid rebuilding from scratch each time.
"Patients are much more than the disease state, so we are interested in what it means to be a patient with that disease. Medicine takes care of the disease, and it’s what we place on top of that medicine that makes it a viable market proposition."
You’ve mentioned that universal design also supports business and portfolio strategy. How do you balance patient needs with commercial considerations?
We’re very deliberate about that balance. Early in development, we focus entirely on defining the right problem. Framing the problem correctly is far more important than rushing to a solution. Solving the wrong problem, even beautifully, is not helpful.
Once we’ve deeply understood the patient, caregiver and clinical journeys, we define where we can make the most meaningful impact. We use tools like qualitative and quantitative market research, observational studies and Total Unduplicated Reach and Frequency (TURF) analysis to understand reach, frequency and tradeoffs. The goal is not to add features indiscriminately, but to select features that maximize accessibility while remaining practical and scalable.
We also look for platform approaches that allow a single design solution to be applied across multiple products. Designing one platform that works for five therapies is far more impactful than designing five isolated solutions. By putting the patient first, we have developed solutions that are commercially attractive too.
Patients are much more than the disease state, so we are interested in what it means to be a patient with that disease. Medicine takes care of the disease, and it’s what we place on top of that medicine that makes it a viable market proposition.
Can you share examples of where patient insights significantly changed development decisions?
One clear example is packaging. While we spend considerable effort ensuring stability and child resistance, we learned that many patients, say, with arthritis, neurodegenerative conditions or age-related dexterity loss struggled to open traditional packaging. That insight pushed us to redesign containers, so they are easier to open for patients but still meet child-resistance requirements. This small change can dramatically improve independence for patients with limited dexterity.
Another example involves swallowing difficulties. By replacing pills with powders that can be sprinkled into food, we addressed challenges faced by children, elderly patients and patients with neurological or psychiatric conditions at the same time helping them stay on treatment instead of skipping doses. Medication errors are another major concern. Simply using color coding is not sufficient, as not all patients can distinguish colors. Universal design pushes us to create layered solutions that don’t rely on a single sensory cue, but multiple layers of cue. This reduces the risk of medication errors for everyone.
How does patient input translate into a meaningful target product profile?
Developing the correct target product profile is one of the most challenging and most important steps. It requires bringing together three elements: clinical understanding of the disease, business considerations such as reimbursement and access and technical feasibility across delivery technologies.
We invest heavily to understand the person’s full life, not just their condition. Observational research helps us see where complexity, confusion or physical limitation exists. We then codify those insights into user requirements that shape dosing frequency, form factor, instructions for use and overall product presentation. This keeps the TPP grounded in real patient use, not assumptions.
"Universal design pushes us to create layered solutions that don’t rely on a single sensory cue, but multiple layers of cue. This reduces the risk of medication errors for everyone."
Patient advocacy organizations seem to play an important role in this process. How do you engage with them effectively?
We engage with advocacy organizations early and authentically. The goal is real patient input, not marketing validation. We often partner with multiple groups across regions to understand patient priorities, usability challenges, and design preferences.
These organizations provide invaluable feedback on what works, what doesn’t, and where patients struggle most. By applying those insights across our development portfolio, we avoid reinventing the wheel and can evolve our approach more efficiently for future therapies.
How do you design therapies that work across different cultures and regulatory environments?
We take a global view from the outset. Cultural norms, regulatory requirements and environmental expectations can vary significantly by region. For example, comfort with administering injections in public, or sustainability requirements around packaging can differ markedly across geographies. Even the foods patients mix their drugs into vary by region, which can affect the drug’s release profile. This helps us avoid regional issues that can delay or complicate global launch.
By understanding these nuances early and working closely with clinical, regulatory, CMC and regional teams, we can design platforms that meet the most stringent requirements and scale globally. If a solution works under the toughest regulatory or sustainability standards, it will typically work elsewhere as well.
"When teams truly understand the patient experience, design decisions change. People think differently, question assumptions and focus more sharply on independence, dignity and quality of life."
Anything else?
Empathy is essential. We work intentionally to help our teams understand what it feels like to be a patient or caregiver. That may involve hearing patient stories directly or experiencing simulations that replicate physical limitations associated with certain diseases. For instance, we had members of our team wear different glasses or gloves that stimulate pain like what patients with a certain severe neurological condition endure. These experiences make us think about design differently and ultimately enhance the patient’s experience and their health outcomes.
When teams truly understand the patient experience, design decisions change. People think differently, question assumptions and focus more sharply on independence, dignity and quality of life. At the end of the day, nothing is more fulfilling than seeing a therapy in the hands of patients, knowing it was designed with them not just for them.
Additionally, sustainability is becoming a more important piece for us. It impacts how we think about products from cradle to grave or even beyond grave. We think about all the various impacts that happen throughout the product development and life of the product and its disposal and try to figure out the best way for us to design it sustainably. We also ask our design and development partners how we can build in more sustainability to minimize waste and continue to provide therapy worldwide. This has also become an important aspect as more government payers and regulators are looking into how sustainability can be used as a differentiating factor between similar product types.
Lastly, we have embraced Artificial Intelligence (AI) throughout the development paradigm. For instance, we are creating virtual moderators to gather key patient insights to gather more meaningful insights, instead of asking patients to just take a survey. The result is much richer data that we use to develop our target product profiles.
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