Today, any pharma marketing strategy has to take into account the perspective of multiple stakeholders, such as doctors, regulators, payers and the patient. Here, we speak with Dr Simone Seiter from IMS Health to hear how putting the patient journey at the centre is the key to providing the most accurate market research.
Market research has always played an important role in the ramp up to any new pharma product launch. Typically, secondary research is combined with both quantitative and qualitative physician interviews to identify the right positioning for the new brand and ensure appropriate capture of market share.
However, one voice is too often a minor component of this or even missing – the patient. pharmaphorum spoke with Dr Simone Seiter from IMS Health to understand more about a new analytical approach, labelled the ‘Patient Journey’, and how it is reshaping pharma strategy.
A new perspective centred on the patient
Patient research has, of course, been used in pharma research before now, but understanding the patient journey has never been the primary focus. Seiter believes it has been a critical omission, commenting that “it’s really important to understand how the patient actually travels through the system, meaning from the first incidence of symptoms down to the diagnosis of treatment, as well as compliance and adherence to treatment.”
"…one voice is too often a minor component of this or even missing – the patient."
The focus of the patient journey approach is to therefore put the patient at the centre of the analysis, to understand exactly what decisions they are directly faced with that can impact on treatment choice, even in pure prescription markets where the doctor has traditionally been regarded as the key commercial stakeholder. Overall, the aim is to provide a full 360 degree view of the decision making process based around six key objectives, and taking on board input from multiple stakeholders,. This concept is outlined in figure 1.
Figure 1: Analysis of the patient journey focusses on six key objectives
A well-constructed patient journey therefore provides a richer, deeper view of the market, covering areas such as “where the patient travels, which partners they engage with when considering symptoms, how they get diagnosed, whether they go to a specialist or GP and what the referral patterns are,” but with a key emphasis on the reasons behind all these aspects, elaborates Dr Seiter.
Looking at the problem from multiple angles
As with any robust analysis, the right interpretation comes from inputting the right information and the patient journey is no different. The type of longitudinal research that underpins it has been used for many years but with the combination of multiple rich data sources, it adopts an innovative approach.
As Dr Seiter explains, “we would advise a combination of quantitative data, like secondary data, as well as primary market research,” but she also stresses the importance of getting multiple perspectives on each decision, not least of which is the patient’s. Indeed, the reliance on purely physician research has, in some cases, been the failing of traditional market analyses, with Dr Seiter noting the “skewed approach towards their perception”, which is a recognised bias when asking doctors to qualify or quantify their patient flows.
After all, there is an old saying that there are three sides to every story – yours, mine and the truth. With the patient journey there are multiple sides to every story, with Dr Seiter summarising that useful inputs may come from “the physician, caregiver, other healthcare professionals such as social workers or nurses and, of course, the patient. The decisions on diagnosis and treatment are particularly important as well as the rationale behind them.”
"…the reliance on purely physician research has, in some cases, been the failing of traditional market analyses."
As we live in a connected world, digital channels also play a key role in developing the right market understanding, with social media providing essential inputs into the patient journey. As Seiter explains, “there are certain diseases where patients are very active and engaged in social media, trying to find out information, trying to comment or to get other patients to comment on treatment decisions or treatment suggestions.” Even without direct conversation with the patient, it seems a wealth of data is available online that could change the pharma perception of treatment approaches.
Driving the right strategic marketing decisions
It seems that adopting this more rigorous approach is already having a tangible impact on the way pharma positions its products, addressing the ‘why’ questions in much greater depth. In 2012, the patient has far greater impact on their treatment choice than we may like to think, especially when taking into account issues such as compliance and adherence. Pharma is waking up to this.
Some of the key questions that can be addressed with greater depth include:
• How is the treatment decision made?
• What are the treatment challenges?
• What are the manageable and unmanageable side effects?
• What underpins the decision to stay on the treatment, move to a different one or discontinue without GP approval?
To underpin this with a real example, Seiter outlines the case of a new anticoagulant agent entering a market dominated by the older drug warfarin. The pharma client had approached launch with the view that the heavy monitoring required for warfarin made it difficult and cumbersome for both patients and physicians. However, the patient journey analysis told a different story.
“It turned out that, for the patients in certain markets, coming in and meeting the doctor was almost like being part of a big family, because they would have appointments aligned with their friends and they would then go and have a coffee afterwards,” clarifies Seiter. This provided some new insight into why a supposedly inconvenient 40 year-old drug such as warfarin still enjoyed such success, with the client realising that their ‘easy switch’ was, in fact, quite a hard one.
This is just one example where the ‘unmet need’ turned out to have been unmet for a reason once the patient view was properly factored in. It is therefore no surprise to hear Seiter comment that a good understanding of the patient journey has the potential to identify new and more effective approaches at every stage of the pharma marketing strategy, as defined in figure 2.
Figure 2: How the patient journey lays a strong foundation for brand strategy
The focus has to be on what Seiter describes as ‘leverage points’, those defined decision points that have a major impact on the treatment pathway. Having a good grasp of these means that pharma companies can “leverage these decision points and either design services or information to support the referrals, make sure the way ahead is clear or provide additional information,” she explains.
"We would always recommend pharma companies really have a closer look at the patient journey right at the start."
So, it seems approaches such as the patient journey can have a significant impact on the way new treatments are adopted by regulators, physicians and payers, which means starting the analysis early. As Seiter succinctly concludes, “we would always recommend pharma companies to really have a closer look at the patient journey right at the start.” Here, ‘start’ means years before product launch, when decisions are being made about pivotal trial positioning and market access.
In conclusion, input from multiple stakeholders and information sources can be used to give the clearest view possible of the patient’s personal journey and the decisions they are faced with.
It feels like a pharma marketing approach designed for the 21st century age of listening.
About the author:
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Dr Simone Seiter is a Principal in the IMS Consulting Group and is also the leader of the Center of Excellence for Brand &, Commercial Strategy. She joined the company in July 2006 and comes with a deep healthcare and pharma knowledge combined with understanding of management and process consulting.
Prior to joining IMS Health, she worked as a Managing Consultant with Capgemini’s Life Sciences / Healthcare Sector for over 5 years focusing on patient management programs, market entry strategies and efficiency assessments, process redesign and strategies for hospitals.
Simone holds a MD PhD degree from the University of Heidelberg, Germany and is a board certified dermatologist with has broad clinical experience in dermato-oncology. She has served as a clinical investigator in multiple national and international clinical studies and is a member of different national/international clinical and research organizations. She also holds a degree in business administration (hospital management) and a MBA from the University of Applied Sciences Neu-Ulm, Germany.
Who determines treatment choice more – the doctor or the patient?