For the past couple of years, patient centricity has been a major buzzword in pharma. One Big Pharma company, however, made a concentrated effort to ensure its new approach was more than just lip service. Last March, Sanofi hired Dr. Anne Beal, former Deputy Executive Director of the Patient Centered Outcomes Research Institute (PCORI), to the newly created role of Chief Patient Officer. Her new responsibilities included elevating the perspective of the patient within Sanofi and finding better ways to incorporate the unique priorities and needs of patients and caregivers.
Now a year later, PM360 spoke with Dr. Beal about how the position has evolved, what she has learned and how pharma companies can plan their efforts for 2020 and beyond, which she will discuss at eyeforpharma Barcelona 2015, happening March 24 to 26.
PM360: Sanofi was one of the first Big Pharma companies to hire a Chief Patient Officer. What did the job entail when you were first hired?
Dr. Anne Beal: One of the things that I wanted to do was take the time to think strategically about what this role would be, what type of value we would bring to patients and what type of value that we would also bring to the organization. I spent my first few months simply listening to my new colleagues, as well as patients. I’m glad that I did that—while thinking about our strategic framework.
What did you pick up from listening?
First I listened to our leaders who wanted talk about the ways they thought about patient centricity. I felt it was very important to ensure that we were not trying to drive patient centricity ourselves, but that it would become part of our culture and a part of how others were doing this work.
During initial interviews with our leaders we heard messages such as, “We want to ensure that we are soldiers for the patient’s will.” They also said they wanted to be sure that everything we do is focused on improving patient outcomes. They asked: How do we make sure that every employee understands what it means to be patient-centric?
It was very aspirational. The challenge is: How do you actually put that into action? We spent a lot of time thinking about it. The good thing I discovered: We were not starting with a blank slate. In fact, a lot of work was going on in patient centricity within the organization. We wanted to build on that already existing work—and think deeply about a framework for moving forward. That led us to develop the three-pillar framework.
The first pillar: Input and understanding. It’s about truly engaging patients in a meaningful way so that patients can inform the work we are doing within the organization. Many people also think about this in terms of market research—but this is about so much more. It’s about actively listening—not just around a product—but for what it is that patients need. It entails using social media; talking to individual patients; working with patient advocacy groups; and making sure that we gain patient input to understand their needs.
The second pillar: Outcomes and solutions—taking the insights we have gained and dragging them into our products, services and integrated solutions. This allows us to meet patients’ needs and be certain that our products fit into their lives. This is the most important part of a focus on patient centricity. It concerns what patients feel, our impact on their outcomes and, frankly, where the rubber hits the road—where we’re making a difference.
The last pillar: Culture and community—the focus on us as an organization. How do you ensure that everyone in the organization has a true understanding as to how their job impacts patients? What is it that they can do to improve patient outcomes? How can we work together in all parts of our organization to be much more patient-centered in everything we’re trying to accomplish?
For the first pillar, you discussed actually reaching out and talking with patients. Did you come across any surprises in what patients want from pharma?
I was surprised by how much patients want to partner with pharma. We recently acquired Genzyme, and the company had much experience of this. Focused on rare conditions, Genzyme allowed patients to drive some of the research agendas and the company focused on making certain that the products and cures in development were driven by patient interest. A lot of this is occurring in other spaces, such as the research being driven and the work going on with the Michael J. Fox Foundation.
Very recently, an announcement was made about the conversion of stem cells into beta cells for treatment of diabetes. That research was supported by JDRF, the Juvenile Diabetes Research Foundation, which is a patient organization. What struck me: Patients want to have an active seat at the table—and not just at the marketing end. They actually are interested in both scientific discovery and driving the research.
But what about the marketing end? Have you done any work with patients in that area?
Some teams have done that. One of the themes that started to emerge: Historically, much of the work has focused on, “Oh, the poor patient.” But patients say, “No, I have this condition—it’s not the poor patient. I want to be in control of my life and managing my condition.” That’s an example of what has come from the research that we’ve done regarding patient engagement and marketing.
You mentioned that as part of a patient-centric approach you want to be sure that every employee knows what patient centricity actually means. What are you doing to help employees to understand that?
No single magic bullet exists—but it involves three primary sets of activities. The first: Raise awareness about this way of thinking and the awareness of activities that are currently underway within the organization that are promising practices.
The second: Help people think through how they can take some of these principles and apply them into their own work. Whether we’re working on initiatives that we have driven or initiatives that others are interested in doing on their own, it is about giving people technical assistance or examples that helps them with their work.
The third: Communicate, communicate, communicate. Not just about work that’s being done but also about the impact, the outcomes and even the failures—to give people an awareness of how to do this better in their own areas.
Can you provide any examples of initiatives you are doing?
We engage patients in our research through patient advisory panels, which help us to think more about predictor measures and the outcomes that are important to patients. Another initiative involves working with online communities to better understand patients’ needs. We also use that as a way to test our ideas. If we’re not sure whether we should go left or right, we ask the patients. And we work with patients to develop better education programs or tools—and engage with them to understand how to better inform them about the use of a new product.
Pharma has a bit of a perception problem, at least in the U.S.—patients don’t always trust what pharma offers. As a pharma company, do you have any problems when dealing with patients?
You’re talking about a fundamental issue of trust, and frankly, trust is earned. Being clear about our core principles is one way we focus on patient centricity. We discuss the importance of transparency so that when we engage patients, we are clear about what we want to do. We also talk about commitment to partnership—not what we’re doing to or for patients, but how we can empower them and work in a partnership with them.
The third principle: Continuous learning and improvement. That’s a bit of a humble approach to recognize that some of this we know how to do and some of this we’re trying to figure out as we go along. So in order to ensure we are successful, we evaluate our knowledge as we move forward.
The last principal: A focus on outcomes and impact. We make this clear: We do not just engage patients so we can feel good about holding a good patient session. Instead, we engage them because we want to understand their needs in order to improve their outcomes.
Trust will be earned over time—when we show that we adhere to our principles and when we’re quite consistent about maintaining the focus on improving patient outcomes.
In terms of improving patient outcomes, part of that focus is creating value-added services for patients. What have you found in particular that patients want from pharma, such as apps or education programs?
One size does not fit all. Some patients like apps, some want to engage with a nurse, some want to use the Internet. Others want to use smartphones. We’re working to link patients to the best mechanisms for engaging them specifically and identifying what resonates best—and that changes for each patient. For instance, patient needs when first diagnosed are different from their needs 10 years later—and vary over time. We’re thinking about different ways to customize our approach and testing different models now.
What do you find are the best ways to get input from patients—talking with patient groups, engaging via social media, data mining on social media or more personal one-on-one interactions?
It’s all of these. Once you meet one new patient, you meet one new patient. It’s important to have the insight from individuals, it’s important to have the insights from patient advocacy groups, it’s important to have the insights from what I call the unaffiliated patients, the patients who are there in social media. It’s important to make use of your standard market research, which is a much larger dataset.
And to really have that kind of insight and understanding it takes time, it takes a lot of different inputs from different sources of patients. You also have to capture the different nuances between different patients in order to be able to customize. For instance, how you talk with a patient with type 1 diabetes versus type 2, a patient in North America versus someone in China, a patient who’s 40 years old versus 65 years old, will require a different approach.
The bottom line is to know that in order to customize patient services and solutions, deep insights must be developed. It is not just one survey, one session or one focus group. It’s an organizational commitment to gain patient insights over time and over a variety of different patient groups.
What has been the biggest challenge you’ve faced in this position so far?
One of the challenges we face is how do we know that this is making a difference? This is a new way of doing business, and if we just define this as a practice in increasing sales, then that’s a pretty myopic approach. So, how do we know we’re being successful? How do we know that we’re not? How do we improve our performance? And how do we communicate our success to people who might be skeptical or unsure that a real focus on patients is going to make a difference? We’re spending a lot of time thinking about that, and it’s going to have to be both a quantitative as well as a qualitative way of identifying successes in this space. We’re still in the very, very early stages of that, but this is one of our big challenges.
The keynote you will give at the upcoming Barcelona conference addresses how pharma can look to 2020 and beyond—and then how to plan that approach now. Can you tease a bit of what you plan to talk about. What should pharma companies be doing now to plan that far ahead?
It’s very simple. The patient is the future. So this becomes a question of: “How do we prepare ourselves for that future reality.”
Not only are patients now demanding more empowerment, but at the same time, the changing epidemiology of diseases and more conditions are requiring patients to self-manage. Thinking about it from the perspective of emerging markets, we see a rapid growth in the middle class, which means patients will now have access to these drugs. Unfortunately, they will also be diagnosed with non-communicable diseases that require significant patient self-management.
The focus in healthcare is no longer transactional. Historically, the U.S. was a fee-for-service environment. However, now we’re moving into a value-based environment in which it’s not just about how many visits or how many widgets or how many drugs, but more directly about the outcomes that are achieved. All of this is points toward a future in which the focus is truly on patient centricity, empowering patients and improving their outcomes.
