Tag Archives: Pharma

Physicians’ Increasing Digital Proficiency And Its Implication

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At a time, when an unexpected and unprecedented Covid-19 pandemic struck a catastrophic impact on human lives, livelihood, and the global economy the healthcare sector continued surging ahead. This is being fueled by exponential advances in medical science, and the pandemic-triggered explosion of digital technologies, data access, analytics – besides emergence of more informed and empowered consumers with new expectations and aspirations.

Echoing this, Deloitte’s paper - ‘2022 Global Health Care Outlook’ articulated: ‘The global health care sector continues to rise up to the new challenges presented by the ongoing pandemic, which continues to dominate health care systems’ attention and resources.’

No more than just a couple of years back, none could predict that a pandemic in these modern days, would have the power to initiate the unforeseen changes so quickly. This is especially applicable to – mostly tradition bound and slow to change – the pharmaceutical industry, even in India, which gets reflected in the growth of this sector. That too, amid sporadic disruptions in the operational areas of many companies.

As reported on December 29, 2021, Indian Pharma Industry registered a growth of 15% in 2021 led by growth of Covid-19 products, against a growth of 3% last year. The report emphasized that the challenges posed by the pandemic gave rise to new opportunities for the pharma sector to evolve quickly under changing circumstances.

Which is why, many players are being compelled to adapt newer digital processes and practices to survive and excel – while navigating through this uncharted frontier. These will call for growing investments for paving a high-tech digital pathway, primarily for an effective customer engagement, besides refinement of the product life cycle through digitization.

To give a sense of perspective on strategic implications of increasing digital proficiency of physicians, particularly in the context of an effective, patient-centric engagement by pharma companies, I shall focus on this development, in this article.

HCPs digital proficiency poses a fresh challenge – it’s real:

Increasing digital proficiency of HCPs during Covid-19 pandemic poses a fresh challenge to pharma marketers for several reasons. It’s so real, which will invite many fundamental strategic changes, as Covid-19 isn’t going anywhere, at least, anytime soon, contrary to what many people are expecting.

The emergence of Delta and Omicron like variants that infected a large number of fully vaccinated people, as well, is expected to continue. For example, as reported on January 27, 2022: ‘Just as the omicron surge starts to recede in parts of the U.S., scientists have their eye on another coronavirus variant spreading rapidly in parts of Asia and Europe.’

Increasing digital savviness of HCPs is now unstoppable. It is expected to keep rolling at faster a faster pace now than ever before. Endorsing this trend, an article published in the Pharmaceutical Executiveon January 20, 2022, made some interesting observations.

The author underscored that the trend of the digital shift of HCPs in their professional space, is an outcome of a catalytic effect of the pandemic. It poses a new challenge for the life sciences industry, requiring a complete revamp of the content strategy and customer engagement channels, for each specialty. It further said: ‘The wave of consumerism led by digital natives has impacted HCPs when it comes to engaging with content on various digital channels for personal consumption.’  

A recent research study vindicates the magnitude of the challenge:

A recently published Indegene study, revealed some thought-provoking areas in this space. The research surveyed 984 physicians from the United States, Europe, India, and China for this study. All participants have >10 years of experience and represent a broad spectrum of specialty areas. According to Indegene, the process of surveying HCPs had started since 2014, to identify how their digital habits manifest and how do they change. Some of the key findings of the study include:

  • More HCPs, in general, are increasingly adopting digital channels to consume content.
  • 77% of HCPs use digital channels primarily for personal learning and development.
  • 68% of HCPs prefer short webinars or webcasts over other virtual
    engagement channels, globally.
  • Only 47% of HCPs prefer receiving communication through the marketing e-mail channel, although, marketing emails are among the top 5 channels used by pharma companies to engage HCPs. 
  • 62% of HCPs are overwhelmed by product promotional content pushed by pharma companies on various digital channels.
  • 70% of HCPs said that pharma representatives do not understand their requirements completely. Further, 62% of HCPs said that the most significant area where pharma representatives can add value is, by understanding the needs of HCPs and sharing only relevant content with them to make the interactions more insightful. The one-size-fits-all approach will no longer work, and pharma companies will have to invest in greater personalization at scale and build better content development and operations capabilities.
  • Pharma to consider using digital channels to provide HCPs on demand access to reps and content.
  • Need to map and implement geographic variations in HCP preferences for content, channels, device, and time.

This evolving trend sends clear signals to pharma marketers that need for professional engagement with the HCPs has to be on their own terms in the new normal

‘Engaging HCPs on their own terms’ – the need of the new normal:

This emerging need also came out clearly in another recent Global Physician Specialty Survey by Medscape - with over 12,000 participants in key specialties across Europe, Latin America, Canada, Asia, and MENA.

It provided some actionable insights, highlighting online content consumption habits of HCPs across the globe, in the new normal. This study also found: ‘The pandemic has had an undeniable impact on the interactions between HCPs and the pharmaceutical industry, with the shift towards virtual engagement and online events likely to be long-lasting.’

Based on this finding, it flagged a critical issue. This is, while the consumption of online medical content is growing and traditional in-person meetings are still not completely back on the agenda, how can pharma players reimagine the way they reach their target audience? This is indeed a primary business requirement to maintain respective drug company’s share of voice and foster relationships with their key customers. The key takeaway from this study includes the following:

  • Being incredibly time poor even now, HCPs mostly prefer to engage with the pharma companies on their own terms.
  • Compared to traditional in-person interactions, most HCPs feel, digital engagement channels offer them greater flexibility that they desire.
  • Over half of the survey respondents rated their online consumption of digital content higher, or much higher now than before the pandemic.

Conclusion:

On the positive side, during a short span of the last couple of years, Covid-19 pandemic has also triggered unprecedented advances in various critical areas of medical science and related areas. These include, remote healthcare services, digital technologies, ease of access to required data by all, the application of sophisticated analytics and above all emergence of an increasing number of digitally empowered customers. Consequently, aided by greater disease awareness and the need for prevention, the ‘self-care’ space also witnessed exponential advances.

Besides, the pandemic has also offered a fresh opportunity to the pharma and biotech sectors – to leverage the break in the cloud for accelerating all-round innovation – charting new frontiers of the modern digital world to remodel their business models for a faster growth in a new paradigm. Although, pharma customers have remained mostly unchanged, their expectations, behavior, practices, and preferences have undergone a metamorphosis. Some of these changes may be stark, and more may be a bit nuanced. Marketers, need to map all the changes, which are specific to their organizations, to excel in the new paradigm.

That said and, as pointed out above, results of expert surveys and syndicated studies in this area, send a clear signal about the pandemic-triggered – increasing digital proficiency of HCPs, even in India. This trend needs to be leveraged for a thorough overhaul of pharma’s customer engagement models. This is a new ball game of the new normal – having a huge impact on the business performance of drug companies.

By: Tapan J. Ray  

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

Leverage Increased Focus On ‘Self-Care’ For Better Patient Outcomes

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‘People have been practicing self-care for thousands of years. Now an increase in self-care interventions is shifting the way health care is perceived, understood, and accessed, and adding to the many medicines, diagnostics, and technologies available for people to use by themselves.’ This was articulated in an article titled, ‘Self-care during the COVID-19’, published by the World Health Organization (W.H.O) on June 12, 2020.

That COVID-19 prompts increased focus on self-care was also vindicated by several research studies, including some conducted by global pharma majors, such as GSK, Johnson & Johnson, Sanofi as you will find below. In this article I shall, therefore, deliberate whether an increasing focus on ‘self-care’, as a critical service to patients can fetch better disease treatment outcomes with respective pharma brands in the new normal. Moving in that direction, let us first be on the same page about the definition of ‘self-care’.

‘Self-care’ and its key benefits?

The W.H.O defined self-care as: ‘Your ability to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a healthcare provider is known as self-care.’ Regular practice of self-care offers a holistic interlinked benefits to its practitioners, which many people have started experiencing during the COVID-19 pandemic.

As observed by BMI Healthcare, some of these benefits include:

  • Improving your physical health: By committing to looking after your body and becoming more attuned to its needs.
  • Reducing stress and anxiety: By making time for relaxing activities.
  • Boosting self-esteem: By helping to calm your nerves, taking time to relax and look after yourself can have a positive impact on the way you see yourself. Treating yourself with kindness can also make you look upon yourself kindlier. Studies have found that people with higher self-esteem find it easier to deal with setbacks and are more likely to achieve goals of self-improvement.
  • Protecting mental health: By making changes to prioritize self-care can help to manage mental health issues and might even prevent them from getting worse.
  • Fostering better relationships: Happier and healthier you are, the more you can give to a relationship. This is especially important if you are a parent or career. It can be so easy to put someone else’s needs first, but you must look after your own health too.

Pharma companies also echoed that COVID-19 has boosted self-care:

As I wrote above, besides W.H.O, several global pharma majors have also recently conducted their own research studies this area, for several reasons. One such research, shared by GSK Consumer Healthcare and IPSOS on 20 July 2020, reiterated that ‘the COVID-19 pandemic has had a significant impact on people’s behavior and attitudes to self-care.’ The study also endorsed, the pandemic has impacted attitudes towards personal wellbeing and self-care. This gets reflected on the increased importance that many people are now placing on looking after their own and others’ health.

Another article, published in the  Johnson & Johnson website on September 16, 2021, emphasized the same point. The Company reiterated, self-care – a holistic and preventive way to look after one’s health and wellness – is more than a passing trend. It’s a lifestyle shift that’s here to stay – one that has only been accelerated by the COVID-19 pandemic. The paper highlighted, ‘According to one recent national survey, 80% of adults said they intend to be more mindful about practicing self-care regularly after the pandemic. And global research conducted this year found that consumers’ prioritization of wellness has jumped as much as 65% in the past two to three years.’

Recently, even Sanofi in its website acknowledged, ‘COVID-19 highlights Value of self-care as a first line of defense.’ The article added, although, ‘there has been a global trend towards wellness for some time now, but the onset of the COVID-19 pandemic has accelerated it.  It also endorsed that defensive wellness is growing exponentially with people trying to protect their own health alongside their families. So, there has been a shift in attitudes in how people are practicing self-care, especially, as face-to-face consultations with doctors are now more difficult.

Why ‘self-care’ concept got a boost during COVID-19 pandemic?

There are several reasons behind such unprecedented boost in practicing self-care within the global population. The key ones include intense and continuous public messaging by various governments in response to the COVID-19 pandemic, has emphasized the importance of self-care by manifold. Some of these self-caring activities, such as, social distancing, wearing face masks and other preventative hygiene measures, which have been pivotal in the disease control process.

The national campaigns to tackle the virus with various social measures deployed by citizens, in tandem with traditional public health interventions, like testing and contact tracing, have been widely supported by NGOs, media and key influencers in many sectors. The core message has been, staying home or working from home, and observing government guidelines is – ‘doing your bit’ for others, as well as yourself. The same was also well-articulated in a paper – ‘Self-care and health: by all, for all. Learning from COVID-19’, published by the Mitchell Institute, Victoria University, in July 2020.

 ‘Self-care’ messaging in the old and new normal – the key difference: 

Several pharma companies have tried to understand what factors prompted to accelerate the ‘self-care’ process during the pandemic, as compared to the old normal. And what is the key difference in the core messaging content. For example, Sanofi construed that the self-care messages in pre-pandemic period were generally ‘positive’ ones, such as benefits of practicing yoga and other changes in the general lifestyle activities. Whereas, during the pandemic, the message has been very different. It generally revolved round the ‘fear of the unknown’ that can jeopardize lives and livelihoods.

This factor emerged as a powerful motivator in accelerating a shift to life-saving preventative wellness – not just for self, but also for others. An overwhelming sense of uncertainty put a different perspective altogether to ‘self-care’, especially, for people with co-morbidities or pre-existing health conditions, being more vulnerable to die from COVID-19 infection.

Can pharma leverage the win-win opportunity?

A global study by  McKinsey & Company in this area, published on April 08, 2021, vindicated the increasing trend of self-care among global population. Elaborating the point, it said: ‘These days, consumers view wellness through a much broader and more sophisticated lens, encompassing not just fitness and nutrition but also overall physical and mental health and appearance.’ The Company estimated ‘the global wellness market at more than $1.5 trillion, with annual growth of 5 to 10 percent.’ If pharma marketers can leverage this win-win opportunity creatively, brand related self-care measures would also come under this market.

Leveraging increased focus on patients’ self-care:

The fact that an opportunity exists for pharma players to leverage a new opportunity in the ‘self-care’ space, creating win-win treatment outcomes for all, isn’t a new concept. Over a decade, this is being deliberated in the healthcare space. This is evident from an interesting article titled, ‘Helping patients help themselves’, published in the ‘Modern Healthcare’ on June 21, 2010. Acknowledging that “Self-management is critical,” it wrote: “The patient spends one-tenth of 1% of their time in the doctor’s office and the rest of the time on their own. Coming up with good ways to engage them and encourage them to take control and make changes is very important.”

Interestingly, another article carrying exactly the same title – ‘Helping patients help themselves’ – penned by another author, was published after more than a decade – in the ‘Reuters Event’, on November 19, 2021. This author also emphasized: ‘Self-care offers a new way for health care companies to serve patients better, globally and industry collaboration will drive faster progress.’ It reiterated: ‘There’s an opportunity here for healthcare companies to put patients even more at the center of care and to help them achieve better outcomes.’ Pharma marketers, wearing their best creative hats, will find several novel strategic ways to reap a rich harvest from this opportunity. I shall, therefore, won’t step into that area in this article.   

Conclusion:

Ongoing awareness campaigns, encouraging people to take primary ownership of their own health to prevent any serious medical interventions – both for infectious and non-infectious ailments, can be a force multiplier to protect a nation’s health.

Several ‘self-care’ practices during the pandemic like, wearing face masks, maintaining social distancing, hand washing and self-isolation to contain spread of infection, continues. In tandem, as many experts reported, more people are now using digital tools, wearables, symptom trackers – for self-care. Alongside, virtual medical consultation, home care and telehealth services, purchasing medical products and diagnostic services from e-pharmacies, digital health solutions and the likes are also increasing significantly, for the same reason.

Collectively, self-care initiatives have paid rich dividend – in varying degree, almost in every country, notwithstanding some catastrophic onslaught of the virus in many nations, including India. Otherwise, the numbers could have been worse, as many experts project. That said, as the McKinsey & Companysaid: ‘If the pandemic has taught us one thing, it’s that physical and mental health will remain a priority for millions of people across the globe for a long time to come.’ Being in the thick of this process, the drug industry, by and large, has also realized that ‘self-care’ is crucial to ensure better treatment outcomes. This, I reckon, opens a new vista of opportunity for pharma to leverage, with increased focus on most of these ‘self-care’ practices – for business excellence.

By: Tapan J. Ray

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

Create Novel Marketing Pathways As Covid Mutants Keep Emerging

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The World’s battle against wave after wave unsettling onslaught of Coronavirus on human lives and livelihood continues, since December 2019. The first wave was triggered by the novel Covid-19 from Wuhan in China, the second by its deadly – Delta variant, and now – the third by Omicron. In India, first case of Covid-19 was reported on January 31, 2020.

Initially, global experts contemplated vaccines to prevent and contain Covid-19 and were the best hope for ending the pandemic. However, the effectiveness of existing Covid vaccines apparently declines against its subsequent mutants. This is evident even in India when the next variant Omicron commenced its onslaught.

The good news is, AstraZeneca has now claimed, a third booster shot of its Covid-19 vaccine willsignificantly boost antibody levels against the Omicron variant. However, Omicron may not be the last Covid-19 variant, as it appears today.

As the world grapples with the highly mutated Omicron, scientists have identified another new strain of the COVID-19 causing virus – in Southern France – known as ‘IHU’. This B.1.640.2 variant was reported by researchers at institute IHU Mediterranee Infection in at least 12 cases. However, it is too early to speculate on how this variant behaves as far as infection and protection from vaccines is concerned. This process is likely to take, at least, some more time.

Thus, in the current situation, when increasing numbers of even fully vaccinated individuals are getting re-infected caused by emerging mutants of Covid-19, and some more than once, the focus expanded towards more effective disease treatment. Some countries, such as the US, have decided for the 3rd booster shot of Covid-19 vaccine. Israel has even gone for the 4th booster shot of Covid vaccine. Be that as it may, in this fast-evolving scenario, even bright pharma marketers have been experiencing new strategic challenges, as we move on. Against the above backdrop, this article will delve into that space, focusing on some of the new trends of the new normal.

Pharma’s focus expands towards more effective Covid specific treatment:

Visualizing the way Covid-19 pandemic could possibly pan out in the foreseeable future, several global pharma and biotech companies have started focusing on specific treatment for this virus, ensuring speedy patient recovery.

For example, on November 21, 2020, the U.S. FDA issued an emergency use authorization (EUA) for a cocktail therapy of casirivimab and imdevimab for the treatment of mild to moderate COVID-19 in adults and pediatric patients.

Just a month later, on December 22, 2021, the U.S. FDA issued another emergency use authorization (EUA) for Pfizer’s (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use). This was also for the treatment of mild-to-moderate coronavirus disease (COVID-19) in adults and pediatric patients.

A day after Pfizer’s the first oral COVID-19 treatment, approval, on December 23, 2022, the U.S. FDA issued one more emergency use authorization (EUA) for Merck’s molnupiravir. This is the second antiviral pill authorized in the U.S, for the treatment of mild-to-moderate coronavirus disease (COVID-19) in adults. Nearer home, the Drug Controller General of India (DCGI) has also given EUA to Molnupiravir for the treatment of adult patients.

Interestingly, French regulators rejected Merck’s molnupiravir pill for low efficacy. They found other therapies were much more effective than this molecule. Even in India on January 06, 2022, the Indian Council of Medical Research (ICMR) also expressed safety concerns on Molnupiravir. Thus, it has not been included in the national list of Covid treatments in India. That said, such brilliant initiatives by several pharma companies in the battle for saving lives and livelihoods against Covid-19 pandemic, made those companies household names like never before.

Covid made several pharma companies household names, but not brands:

This point was restated in a recent article, published in the Fierce Pharma on December 22, 2021. It emphasized, Covid-19 ‘has brought the words of the pharma industry into people’s lives like never before: Moderna, Pfizer, BioNTech, AstraZeneca and Merck have become household names.’ One may not remember the names of their Covid products, but will mostly know the company.

Many people have now started referring to Covid vaccines and drugs in generic names. As from the very beginning we started hearing people saying, like – I got ‘AstraZeneca Vaccines’, ‘Remdesivir’, or ‘Covid Cocktail therapy’. Company names usually followed the generic names in most cases. Although, ‘that’s been good for pharma’s reputation, but has left marketers in a bind about branding, commented the above article.

Most Covid-19 drugs and vaccine brands are on ‘emergency use approval’

In the Covid dominated year of 2021, drug and biotech companies managed to get USFDA approval for 55 new drugs. However, many of those drugs and vaccines got only Emergency Use Approval (EUA) and only under emergency use basis. This basically means, under EUA these companies did not get full marketing approval and were handicapped to go whole hog with the usual new brand marketing campaigns.  This critical issue is expected to remain even in 2022.

In a situation, such as this, when the full scale branding initiatives can’t be undertaken, intenseCorporate Branding Campaigns, I reckon, would pay a rich dividend. This process will be quite different from creative new brand marketing in the old normal. Some global innovator companies are using even the mass media to promote their respective vaccines, albeit differently.

Such promotions include, Open Letter from the Company CEO, creative use of TV shows, messages of the head honchos through twitter or word of mouth campaigns – creating a snowballing effect. Alongside, healthcare marketing professionals are also intensifying their Covid-vaccine ad campaigns, sans brand names, to increase awareness and persuade more people to get vaccinated, soon.

To move in this direction, at least, during EUA period for Covid drugs and vaccines, hybridization of pharma marketing will be necessary in many cases, which won’t be an easy task for all, though.

Hybridization of pharma marketing – necessary – but not an easy task:

Based on experience of almost the last two years, many drug companies have realized that virtual-only customer engagement models have some serious shortcomings to fetch desired outcomes. This issue was studied and well-articulated in an article, published in the Reuters Events on November 30, 2021.

It found: “Virtual-only engagement can make it harder to create a real connection.” Further, as the paper articulated: “Even if HCPs share their video, we are losing the third dimension, hence losing out on parts of that personal component.’ Besides, although, online meetings are flexible regarding timing, if a doctor doesn’t dial-in, there is only a small chance the meeting will happen later that day, unlike waiting in a clinic for the interview to take place.

To address this issue, pharma players are now in various stages of creation and adoption of their respective hybrid marketing models. However, the process offers its own challenges. Working out customer-specific hybrid engagement models are a different ball game altogether- requiring very different skill sets, continuous training and above all a very different mindset.

Conclusion:

As reported on January 06, 2022, rapidly spreading Omicron variant of the novel Coronavirus threatens to rewrite the business recovery timelines, even in India. Even recently, many CEOs and top executives have opined, businesses would have to live with Covid-19 uncertainty. The article further added: ‘Many companies have suspended their return-to-work plans and are reassessing business continuity measures as a third wave of the pandemic starts to surge.’ Most CEOs also expressed one of their top priorities was to ensure Covid-19 protocols were being followed and all employees were safe.

Similar situation arises for all Covid drugs approved under the EUA by the Drug Controller general of India, and are being marketed by Indian companies against non-exclusive voluntary licensing agreements with the innovators. Thus, an analogous marketing issue exists surrounding all such EUAs, as the company concerned can’t undertake a full brand marketing campaign. This constraint is likely to pose a major marketing challenge for several potential Covid blockbuster drugs in India, at least in 2022, which marketers need to overcome, creatively.

From the above perspective of Covid-19 drugs and vaccines, companies would need to create novel and effective strategic pathways for performance excellence. At least, as long as Covid-19 mutants will continue to emerge, causing operational disruptions in the pharma business.

By: Tapan J. Ray

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

 

Enhance Customer Experience By Enhancing Employee Experience

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Pharma is slowly but surely realizing that enhancing their customer experience can help reap a rich harvest by maximizing the business Return on Investments (ROI), significantly. However, the key architects behind creating a roadmap for the same are employees of the organization, at various levels of the hierarchy. They ferret out the cutting-edge and data-based inputs. This may, therefore, prompt a very pertinent question for many – what could then be the key drivers for enhancing the customer experience?

A Gartner research paper on ‘customer experience’ found, two-thirds of the drivers for customer satisfaction are related to “feel factors,” or how customers feel during and about their experience. It suggested that ‘leaders should take a similar approach to employee experience, focusing on influencing and improving employees’ feelings about their overall experience through the use of psychological, motivational and social principles. Improving the way the experience feels, can lead to a boost in employee engagement and support a positive company culture.’

Consequently, better the employee experience with the organization, more productive is expected to be the customer experience with the Company’s brands and services.

Against the above backdrop for the pharma industry, this article, besides exploring further developments in this area on a contemporary critical need of today’s pharma leaders. This, I reckon, is - focus on enhancing the employee experience for enhancing the customer experience.

Enhancing employee experience - more important in the new normal:

A recent McKinsey & Company article on employee experience, published on September 30, 2021 – nearly two years after the workplace upheaval by the Covid-19ew pandemic, echoed the same. It reiterated: ‘In an era of workplace upheaval, companies that create tailored, authentic experiences strengthen employee purpose, ignite energy, and elevate organization-wide performance.’

McKinsey research also found, while most people have felt supported by their organizations throughout the Covid-19 pandemic, many have struggled. This continues to linger as some companies are exploring hybrid working models, while many are expecting a full return to the office. Consequently, a gap is getting created between employees’ new concerns and employers’ expectations from them. Some of the major concerns and related expectations of many employees in the new normal, need to be addressed, expeditiously.

Some major ‘employee expectations’:

The McKinsey survey to assess employee views on work and how it has changed, commenced since the Covid-19 disrupted the world, included almost 1,000 individuals. The experience of most respondents was personal in nature and specific to an individual. However, there were several common threads, which include employees’:

  • Desire clear responsibilities and opportunities to learn and grow
  • Expect their personal sense of purpose to align with that of their organization.
  • Want an appropriate physical and digital environment that gives them the flexibility to achieve that elusive work–life balance.

The challenge, therefore, is how do leaders create a win-win situation between an employee’s new expectations and the business interest of the organization while creating a new pathway for business excellence? The researchers opined, this process would provide the leaders a unique opportunity to listen to employees on an ongoing basis and engage them on what matters most for organizational excellence—both near and long term.

Employee experience to occupy the center stage as the pandemic fades:

Based on emerging data, many experts now believe – continuously enhancing the employee experience is a prerequisite to continuously enhancing customer experience, for any sustainable business excellence in the new normal. Thus, organizational focus on the quality of employee experience is expected to occupy the center stage as the pandemic fades.

Several research findings have even gone a step forward. For instance, the Harvard Business Reviewarticle, published on January 14, 2021, on – trends that will shape the work in the new normal, pointed to an interesting area. It said: ‘Employers will shift from managing the employee experience to managing the life experience of their employees.’

Elaborating this point the author reiterated, the Covid-19 pandemic has given the business leaders significantly more visibility in the personal lives of their employees. Particularly in the last two years, as they navigate through unprecedented personal and professional challenges. The study also emphasized: ‘It’s become clear that supporting employees in their personal lives more effectively enables employees to not only have better lives, but also to perform at a higher level.’

Obviously, the question that will follow: Is there any tangible evidence to establish that enhancing the employee experience will improve organizational performance?

Focus on enhancing employee experience improves business performance:

Among studies in this area. I shall quote here a study that was conducted amid the Covid-19 pandemic. This one is Gartner’s 2020 ReimagineHR Employee Survey, which found, among others:

  • When employers develop deeper relationships with their employees there is a 23% increase in the number of employees reporting better mental health and a 17% increase in the number of employees reporting better physical health.
  • Employers who support their employees more holistically realize a 21% increase in high performers.
  • At typical organizations where employees work a standard 40 hours per week in the office, only 36% of employees were high performers. When organizations shift from this environment to one of radical flexibility where employees have a choice over where, when, and how much they work, 55% of employees were high performers.
  • The researchers concluded: “Offering employees more choices, over when, where and how many hours they work, is not only better for employees, but also better for employers who end up with more high-performing employees as a result.”  

Positive employee experience creates 16 times more engagement level:

Another McKinsey survey noted, enhancing employee experience would basically entail what they value in the life stages they are. Different propositions may attract different people. Thus, an organization needs to ascertain by talking to them on an ongoing basis, how they view their employee journeys, for delivering well-tailored interventions to maximize satisfaction, performance, and productivity. It’s worth noting that some employees now may be happier feeling a powerful sense of being able to influence outcomes that matter to them—allied with a strong sense of identity and belonging.

It also found, people with a positive employee experience have 16 times the engagement level of employees with a negative experience, and that they are eight times more likely to want to stay at a company.

Conclusion:

Another article - ‘The future of work after COVID-19’, published by the same Company, on February 18, 2021, reported something that’s worth pondering. It said, ‘that jobs in work arenas with higher levels of physical proximity are likely to see greater transformation after the pandemic, triggering knock-on effects in other work arenas as business models shift in response.’ Many pharma marketing related activities will fall in this category.

Hence, the bottom-line is, enhancing the customer experience by enhancing employee experience, will be imperative for business excellence in the new normal. However, successful accomplishment of this task on the ground by pharma leadership may not be a piece of cake. They need to walk the talk, jettisoning the traditional top-down model in most organizations of the industry.

By: Tapan J. Ray        

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

 

Deliver The Best Patient Outcomes With Right High-Tech-High-Touch Combo

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Healthcare is regarded as an industry where high-quality technology and high-quality human touch can’t possibly be separated from each other, ever. Since long, this is considered essential in delivering better treatment outcomes – the core value most patients desire, and buy – directly or indirectly.

Why high-quality technology helps make treatment of various diseases increasingly more effective, is no-brainer. However, amid high decibel ‘digital’ buzz during Covid-19 pandemic, some may also wonder how does ‘high-touch’ help improve treatment outcomes? Against this new backdrop, I shall explore in today’s article: why high-touch is so important for most patients alongside high-tech, and the critical need of striking a right balance between high-tech and high-touch in most areas of healthcare delivery. Let me start with a brief recap of the same in the pharma industry perspective. 

Balancing high-tech and high-touch in pharma – a brief recap:

In a similar context – against the  contemporary market dynamics, I discussed about Pharma’s new and still evolving pathway for digital and F2F customer engagement on February 15, 2021. This is primarily because, today’s patient-centric marketing model has to be on Omnichannel platforms to deliver patient-expected value, effectively – and more.

In this mix, F2F customer engagement process is just one among several channels – but a critical brand demand generation tool, though – giving a feel of ‘high-touch’ – in-person interactions to many key customers. Many studies show, alongside acceptance of ‘high-tech’ digital channels, customer expectations for ‘high-touch’, by and large, continue to exist, even today. Thus, one of the key responsibilities of pharma marketers is to arrive at the optimal combination of in-person F2F engagement channel, and high-tech digital channels for remote engagement.

However, this isn’t the unique need of the new normal. On April 29, 2019, I wrote about the evolving new pathway is a hybrid business model. It is customer-centric and helps create a right blend of high-tech and high-touch approaches. Striking an optimal balance between the two is critical to successful business outcomes. This brings me to the point of the relevance of ‘high-touch’ in healthcare.

The relevance of ‘high touch’ in healthcare:

Since time immemorial, a strong bond of trust-based doctor-patient relationship has remained pivotal in the disease treatment process, across the world. This still exists regardless of the socio-economic status, and degree of patient literacy, including digital – particularly for moderate to severe ailments.

A recent article – ‘High-Touch Telemedicine’, published by CFHA on June 04, 2020, also highlighted, “Touch has been central to the physician-patient relationship for as long as there have been physicians. Patients allow their doctors to touch them in places and in ways that they would allow to no one else.  The gentleness and the carefulness that doctors are trained to use on this touch is a bonding experience that supports healing.  If this trust is violated, if a doctor is unduly forceful or disrespectful, this can be a cause for grievance and even litigation.”

The scientific pertinence of physicians’ high touch for patients:

This point was lucidly elaborated in the above paper. It said, the doctor’s comforting physical touch, and interactional touch, have impacts on the Neuroendocrinology of the patients involved. Thus, physicians’ high touch when used in a benevolent conversation, releases the neuropeptide oxytocin in the brains of both participants. This, among others, helps to improve recognition of emotions, increase mutual trust, so compliments and the recognition of a person’s efforts and successes.

Covid-19 propelled ‘high tech’ in healthcare to a new high sans ‘high touch’:

The Covid-19 pandemic, undoubtedly, propelled healthcare into a virtual world. It triggered the development of a plethora of ‘high tech’ innovations to deliver prompt healthcare to patients suffering from various ailments, even from remote locations. One such example is telehealth. Many healthcare providers, including the Government of India realized that leveraging the potential of ‘Telemedicine’ can effectively address the healthcare needs of a large population, across the world.

That said, I reckon, although, healthcare can’t survive without high tech. But, a high-tech-healthcare, like telemedicine, can’t totally replace high touch, at least, in the treatment process of several moderate to severe ailments.

The Best and the worst-case scenario for only high-tech healthcare:

As studies indicate, only high-technology based healthcare sans high-touch, in the best case scenario, would facilitate affordable access to treatment for more patients, bringing down administrative time and cost, in tandem. Which is why, when Covid-19 pandemic posed unique challenges to providing health care, India’s health policy makers revised the nation’s Telemedicine Practice Guidelines on March 25, 2020. They acknowledged in the manual, high-tech Telemedicine ‘increases timely accessto appropriate interventions, including faster access and access to services that may not otherwise be available’.

Whereas, in a worst-case scenario, only digital access to healthcare may create some barrier to direct physical examination of the patient by the doctor, and their interaction. This may impact patient emotion – so important in the disease treatment process. Thus, although high-tech is essential for the advancement of healthcare, but can’t totally replace a patient’s need for high touch care.

High tech is essential, but can’t replace high touch-based trust:

Several recent papers deliberated this point with umpteen evidences. One such paper was published in the Harvard Business Review on October 30, 2019. The article is titled, ‘AI Can Outperform Doctors. So Why Don’t Patients Trust It?

The research points out, ‘patients are reluctant to use health care provided by medical artificial intelligence, even when it outperforms human doctors. This is because, patients believe that their medical needs are unique and cannot be adequately addressed by algorithms. To realize the many advantages and cost savings that medical AI promises, care providers must find ways to overcome these misgivings.’

The study also found that when health care was provided by AI rather than by a human care provider, patients were less likely to utilize the service and wanted to pay less for it. They also preferred having a human provider perform the service even if that meant there would be a greater risk of an inaccurate diagnosis or a surgical complication.

Given a choice – ‘patients will always highly value and seek out human touch’:

This point was also deliberated in another study, published in the MedCity News on January 14, 2021. Acknowledging: ‘Effective, modern medicine cannot survive without technology,’ it brought to the fore an important finding: ‘Regardless of how intuitive the software – or how advanced the technology – patients will always highly value and seek out human touch’ because of several reasons. Some of which are as follows:

  • Patients believe that their medical needs are unique and cannot be adequately addressed by algorithms. Patient experiences aren’t meant to be 100% digital. And despite the accuracy of computers, humans prefer to seek care from other human beings.
  • Different patients have different emotional needs. Life-altering diagnoses and unforeseen outcomes are best delivered by a living, breathing, feeling individual who can fully understand and address these needs.
  • Physical examinations by a doctor are more reassuring and restorative for patients.

The author concluded, high tech is absolutely necessary for the progress of health care, in general. However, in the foreseeable future, high touch would remain an instrumental part of patients’ healthcare experience.

I believe, one can even experience it as the Covid-19 safety restrictions will start easing, or even now – to some extent. Therefore, ‘healthcare professionals must find a way to blend the sophistication of technology with the power of touch in order to continue improving patient experiences, care, and outcomes’, the paper underscores.

Conclusion:

Just as in the pharma business, a right-mix of high-tech and high-touch is also necessary in overall healthcare space, to deliver the best health outcomes to patients. After initial disruptions, a similar trend is emerging even in the new normal. No doubt, usage of high-tech digital platforms is here to stay, and further improve in the years ahead. But, digitalization alone in the healthcare space, should not be construed as something that can make high-touch totally irrelevant or redundant in a patient’s journey for disease treatment.

The mindset of mutual exclusiveness of high-tech and high-touch, if any, either during patient-treatment or in the customer engagement process needs a revisit. As it appears, it is neither desirable in customer engagement, nor in patient treatment processes – akin to one approach suits all. This is because, healthcare is very personal to patients – more than most other areas. A lot of individual feelings and emotions are involved in patients’ end-to-end journey for treatment, where only high tech-based solutions may not meet all patient expectations – sans high-touch of physicians, as I deliberated above.

Thus, effective integration of high-tech-healthcare with high-touch of physicians, nurses, and some technicians, is evolving as the right way to deliver patient expected values, for better health outcomes. From this perspective, alongside most other stakeholders, astute marketers are realizing that high-tech digitalization isn’t a panacea for effective pharma marketing. Delivering the best patient outcomes with the right high-tech-high-touch combo, is the name of the game.

By: Tapan J. Ray       

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

 

Expand Market Share Unleashing Digital Health Potential For All

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“Advancement in digital health is currently restricted mainly to economically and socially privileged populations. Those having access, resources and basic digital skills, are reaping disproportionate benefits from the technology and other associated infrastructure available for this purpose. Unfortunately, underserved population, mostly in rural hinterland and in some urban areas, still do not have much access to this technical advancement in the healthcare space. Ensuring affordable access to “Digital Health” in digital India, would help augment quality healthcare support with equity, to all in the country.” I wrote the above in my article on digital health, published in this blog, way back on March 09, 2015.

About two years down the line from that date, the IQVIA report – ‘The Growing Value of Digital Health’, published on November 07, 2017, also reported: ‘The impact of Digital Health on patient care is accelerating with the increasing adoption of mobile health apps and wearable sensors.’ It highlighted, among others, the following important points:

  • Health-related mobile applications available to consumers nearly doubled from the number available just two years ago, with increasing clinical evidence on app efficacy – supported by 571 published studies in 2017.
  • The use of Digital Health apps with proven reductions in acute care utilization include, diabetes prevention, diabetes management, asthma, cardiac rehabilitation, and pulmonary rehabilitation.
  • ‘Digital health’ signals a high potential in reducing overall health care cost for both patients and the providers – reducing huge burden on the health system, significantly.
  • Efforts by patient care organizations to fit ‘’Digital Health tools into clinical practice have progressed with 540 current clinical trials in the U.S. incorporating these tools, and an estimated 20% of large health systems shifting from pilot ‘Digital Health’ programs to more full-scale rollouts.
  • However, despite progress to date, several barriers still exist to widespread adoption by patient care institutions, and only an intermediate level of adoption has yet occurred.

In this article, I shall explore – how pharma marketers can expand their respective brand market share by unleashing the full potential of digital health, for all, and equitably, while formulating their marketing strategies of the new normal.

Digital health accelerated effective response to COVID-19 challenges:

Never has extensive operational overhaul been more urgent in health care than in the current climate of the COVID-19 pandemic – emphasized the article on ‘Digital health during COVID-19’, published in the February 2021 online issue of The Lancet (Digital Health). The paper underlined – the urgency of the pandemic prompted new models of patient treatment, providing medical professionals tools to respond effectively to the unprecedented crisis, with the advances in digital health.

However, the authors cautioned, ‘to ensure sustained adoption, it is necessary to not assume that digital solutions will naturally assimilate into clinical practice, and instead adopt participatory approaches that regularly involve stakeholders.’ Meanwhile, a confused signal is causing delay in the speedy adoption of digital health.

Is a confused signal delaying speedy adoption of digital health?

As Covid vaccination process gaining steam, the pandemic, apparently, is coming under control in many places of the world, just as it is in India. Alongside, several optimistic health care facilitators, providers and even regulators are probably awaiting the old normal to return – especially, F2F customer services.

Whereas, the above The Lancet (Digital Health) study finds – the clinical demand for digital services are gradually picking up – mostly because of the sudden surge in patient demand during the pandemic. Intriguingly, amid this situation, weak governance of digital technologies and platforms, is increasing health inequities and compromising human rights, which I wrote in my article on digital health, published in this blog, on March 09, 2015.

Weak governance of digital health results, increasing health inequities:

That weak governance of digital technologies and platforms, is increasing health inequities, was reiterated by yet another contemporary article titled – ‘Digital technologies: a new determinant of health,’ published in the November 2021 issue of The Lancet (Digital Health).

The article revealed, ‘The Lancet’ and ‘Financial Times’ Commission on governing health futures 2030’ has made important recommendations for successful integration of digital technologies in health. The bottom line of which is, weak governance of digital technologies is causing health inequities and compromising human rights. The study also emphasized, the future governance of digital technologies in health care ‘must be driven by the public purpose, not private profit’.  

Points to ponder for pharma marketers:

As iterated in the article of the November 2021 issue of The Lancet (Digital Health), the following facts needs to be considered by all, especially I reckon, by astute pharma marketers:

  • The COVID-19 pandemic has caused massive disruptions within health care, both directly as a result of the infectious disease outbreak, and indirectly because of prompt public health measures to mitigate against transmission.
  • This unprecedented disruption has caused rapid dynamic fluctuations in demand, capacity, and even contextual aspects of health care.
  • Therefore, the traditional face-to-face patient–physician care model has had to be re-examined in many countries, including India.
  • To rapidly tide over the crisis, and thereafter to avoid similar possible situations in the future, digital technology and new models of care are being rapidly deployed to meet the challenges of change, triggered by the pandemic.
  • The new models include remote digital health solutions such as telehealth, artificial intelligence – decision support for triaging and clinical care, and home monitoring of several ailments.
  • Operationalizing these new models will be based on the choice of technology support, clinical need, demand from patients, and manpower availability – ranging from pre-hospital to out-of-hospital models, including the hub-and-spoke model.

Conclusion:

It is widely believed today, the pan-industry shift toward digital health of different types is here to stay, in varying degree, though, and accelerate further for several strategic reasons. These include, adding more flexibility in attaining greater efficiency and effectiveness for customer engagement, and patient-perceived brand value delivery to them.

That said, as I wrote before, customer engagement may call for a hybrid business model of virtual and in-person F2F engagements. However, going back to the old normal of in-person F2F engagements for all doctors could probably be a far cry. Similarly, the initial success of e-customer engagement is unlikely to replace in-person and in-clinic F2F engagements of sales reps completely.

From the above perspective, I reckon, pharma marketers may now wish to expand their brand market share, significantly, by unleashing the full potential of digital health for all, and equitably, particularly, in the new normal.

However, in that process, they need to be vigilant for not deviating from the key purpose of digital health for the end users. This must reach across all socioeconomic strata, regardless of patient demographics or their geographical locations. It’s, no doubt, easier said than done, but has to happen – for the sake of health-equity - augmenting healthcare for all in India.

By: Tapan J. Ray      

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

What Have And Haven’t Changed In Pharma’s New Normal?

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While navigating through the challenge of disruptive changes, several pharma marketers are now focusing more on creating, connecting, and leveraging all market and customer related data, across the organization. Astute ones are using state-of-the-art tools, platforms, and techniques to gain actionable insights on new demands of pharma markets. I wrote about it in my article - ‘Data: the new ‘Magic Wand’ For Pharma Business Excellence,’ published in this blog on October 01, 2018.

This process is helping them to fathom what areas the pandemic has changed and what it hasn’t. Their aim is to draw cutting-edge strategies accordingly for market effectiveness – outperforming competition. This article will explore that space with contemporary examples. Let me start with a few illustrations of some hits and misses for the treatment of Covid – as the world started learning to live with this menacing virus. This was enviable, as the requisite scientific date wasn’t readily available at that moment of truth. But the time has changed now.

Some hits and misses:

As the pandemic overwhelmed the world, and no well-documented treatment for infection caused by the brand new virus – Covid-19 was available, many drug players were given quick emergency approval by country regulators for some repurposed drugs. But most of those weren’t found effective as fresh clinical data started pouring in. For example, the World Health Organization (WHO), have, reportedly, indicated that remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon regimens appeared to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients.

More recently, Gilead Sciences Veklury – a failed Ebola drug, repurposed for hospitalized Covid-19 patients, suddenly became a blockbuster drug, according to a September 17, 2021 report. However, in less than a year, alongside more research data - a study from Europe, published in The Lancet Infectious Diseases, showed that Veklury has no real benefit. The report also highlights: ‘Aided by a ringing endorsement from then-president Donald Trump, Veklury rang up sales of $2.8 billion in 2020, including $1.9 billion in the final quarter. But those sales slid this year to $1.5 billion in the first quarter followed by $829 million in the second quarter.’

Similarly, there are several areas that are seemingly getting transformed, triggered by the pandemic and the time for resorting to a hit or miss approach, is now virtually over. From pharma marketers’ point of interest, it will now be at one’s own peril for not challenging the pre-Covid business traditions, rules, and well-tried strategies on customer relationships and brand building models. This brings us to the question on what specifically have changed in the new normal as the pharma industry navigates thorough the Covid pandemic – for close to two years now.  

Pandemic-triggered changes in the pharma marketing area:

Changes are many and are being studied across the world. One such recent analysis, articulating how the pandemic triggered changes have redefined marketing, was published by the Harvard Business Review (HBR), on March 10, 2021. This paper came more than a year after the pandemic overwhelmed the world. This article listed some interesting macro-level changes, including the following:

  • Old normal: You are competing with your competitors.
  • New normal: You are competing with the last best experience your customer had.
  • Old normal: Customers hope you have what they want.
  • New normall: Customers expect you to have exactly what they want.
  • Old normal: Courting customers is just like dating.
  • New normal: Courting customers is just like online dating.
  • Old normal: Customers must sit at the heart of your marketing strategy.
  • New normal: Customers must sit at the heart of your customer journey.
  • Old normal: Agility is a technology process.
  • New normal: Agility is a modern marketing approach.
  • Old normal: Your brand should stand behind great products.
  • New normal: Your brand should stand behind great values.

To illustrate the point, let me now give a few examples of some micro-level changes in the same space.

Some transformation trends:

I am citing a few examples related to pharma’s traditional sales and marketing models. One such area is, quite a few companies are adopting connected data based and analytics-supported Omnichannel approach for customer engagement. The key objective is to deliver coherent and high-quality customer experience.

The need for new commercial models for the changing life sciences market, was also highlighted in an interesting article, published in the Pharmaceutical Executive on September 16, 2021. The authors identified six health care macro trends, demonstrating the value of transforming care delivery and shifting market behavior that prompt to reframe customer value propositions.

Taking a cue from this paper, I am listing below some of the current trends – as I see these and wrote before in this blog. Each one of these calls for well-connected data with analytics support:

  • Fostering a new genre of ‘customer-brand relationship’ to drive more targeted go‑to‑market strategies, enhanced agility/mobility of resources and highly personalized customer interactions.
  • Meeting the growing demand for value‑based care with novel risk‑adjusted and outcome‑based Price-Value-Models, supported by ongoing innovation in this area and sophisticated approach to value, affordability and outcomes.

Interestingly, despite Herculean constraints, many pharma players continued creating and delivering value, as the customers were expecting with changing situations.  

Drug-price sensitivity is increasing:

In the new normal, drug price sensitivity of customers is increasing manifold, for various reasons. A June 18, 2020 study, flags: ‘Nine in 10 Concerned About Rising Drug Costs Due to COVID-19.’ Although, this particular study (Gallup Poll) was conducted in the United States, general public apprehension is no different in other parts of the world, including India.

In my article of September 14, 2020, I also wrote that the concept of ‘fair pricing a drug’ is being deliberated by many experts around the world, since quite some time, till today. But it continues. Most recently, as reported on September 22, 2021, for different reasons related to its new Alzheimer’s drug - Aduhelm, including its hefty price tag of $56,000 annually per patient, ‘Biogen reps banned from D.C.-area neurology clinics.’

Regardless of such customer reactions, the pharma industry, as reported on September 17, 2021, continues to advocate – drug pricing pressure will stifle innovation, blocking patient access to needed medicines and dry up investment in important R&D on new therapies. Curiously, the Pharmaceutical Research and Manufacturers of America (PhRMA), is spending more than $1 million on TV ads as part of a massive lobbying and communications campaign emphasizing the potential harm to patients seeking cures for deadly diseases, as the report highlights.

Innovation – remained mostly unhindered from old to new normal:

Customers’ expectations can’t be ignored indefinitely. Interestingly, the world has also witnessed it with Covid drug and vaccine innovation continuing even during the most trying times during the pandemic, even in India. It is, therefore, quite understandable why unfettered access to drug innovation is considered an oxymoron, by many.

The good news is, despite shrill voices over pricing measures, the quest for adding meaningful value to the healthcare space continues unhindered. As reported on September 19, 2021, both Pfizer and Merck are advancing oral antiviral candidates targeting Covid-19 into late-stage testing. Thus, I reckon, regardless of jarring noise from pharma lobbyists, drug innovation, willy-nilly, has to satisfy the diverse demand of health care customers.

Innovation needs to satisfy demands of diverse healthcare customers:

That, increasingly, drug innovations will need to be based on their ability to satisfy the demands of life sciences companies’ diverse customer-perceived value-based, was also echoed by the Pharmaceutical Executive article of September 16, 2021.

While doing so, companies will need to structure innovation in terms of health outcomes, affordability, and personalization, as the paper emphasized. It further added, ‘broader definition of innovation means products are no longer the central driver of value.’ Instead, innovation will be powered by an increasingly diverse stream of data that resides outside the confines of the traditional health ecosystem.

Covid pandemic accelerated the transition of this process of innovation, drawing its new focus on providing a seamless and holistic customer experience in the disease treatment process – supported by advanced analytics and this deeper understanding of customer segments.

Conclusion:

Many pharma marketers have possibly undertaken a sophisticated and credible market scanning exercise in the new normal, to assess by themselves what have or haven’t changed in their customer preferences and market dynamics. If not, I would encourage them to initiate it, at least, now.

Equally noteworthy, as the above HBR article wrote, in the post pandemic period: ‘Beyond geography, marketing messages need to be personally relevant, aligned to an individual’s situation and values, as opposed to demographics, such as age and gender.’

The objective is to create a personal connection between the customer and the brand promotional content, aiming to influence the prescribing and purchasing behavior, based on their psychographic to attitudinal characteristics. This process would require creating and screening lots of customized data, supported by sophisticated analytics.

From the above perspective, I reckon, deep insight on what have or haven’t changed in the healthcare environment alongside its customers, would be of fundamental importance for pharma marketers, in the new normal.

By: Tapan J. Ray  

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

Unfettered ‘Access To Drug Innovation’ – An Oxymoron?

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The mass paranoia, as it were, over Covid pandemic has now started fading with drug regulators’ ‘emergency approval’ of several Covid -19 vaccines, and its free of cost access to all, generally in most countries. As the endgame of the pandemic, supposedly, depends on the speed of Covid-19 vaccination, the drug industry’s public reputation in the interim period, driven by its rapid response to the crisis, got an unsurprising boost (62%). This was captured by the Harris Poll, released on March 15, 2021.

Interestingly, soon after the high of 62% approval rating, the decline began. It came down to 60% in May and then 56% in June 2021—and now down three more percentage points, according to the Harris Polls that followed. No wonder, why the FiercePharma article of August 24, 2021, carried a caption: ’Pharma’s reputation drops again. Could it foreshadow a return to the bottom?’

Further, in the new normal, especially when customer expectations and requirements from drug companies have significantly changed, MNC Pharma industry still appears to be in the old normal mode in this space. It still, reportedly, ‘believes that the need for innovation must be balanced with the necessity for more accessible medicines, within a robust IP and regulatory environment,’ in India.

The hidden purpose of the same could possibly be, as several industry watchers believe – availing benefits of greater access to one kind innovation, making access to other kind of innovation more difficult. Consequently, two critical points are reemerging, even in the new normal, as follows:

  • Aren’t Indian IP and regulatory ecosystems still conducive enough for MNC pharma players’ access to drug innovation?
  • In the name of greater access to pharma product innovation, are they creating barriers to pharma process innovation, delaying market access to complex generics and Biosimilar drugs – besides systematically eroding consumer confidence on such products?

In this article, under the above backdrop, I shall try to explore why the epithet – ‘access to drug innovation’ is considered an oxymoron – with contemporary examples from around the word, including India.

Aren’t Indian IP and regulatory ecosystems conducive to drug innovation? 

This allegation doesn’t seem to hold much water, as several successful local initiatives in Covid-19 vaccine development will confirm the same. Besides, already marketed Covaxin, developed by Bharat Biotech in collaboration with the Indian Council of Medical Research (ICMR) and Zydus Cadila’s ZyCov-D, there are several others waiting in the wings. These include domestic drug makers like, Hyderabad based Biological-E, Bengaluru-based medical pharma startup’s – Mynvax, and Pune-based Gennova Biopharmaceutical’s m-RNA vaccine candidates. However, only critical difference is – Indian made Covid vaccines are more affordable and accessible to patients, as against those manufactured by MNCs, such as, Pfizer, Moderna and J&J.

If we look back to the old normal, one will also find similar instances of new drug discovery in India, which deliberated in my article of September 02, 2013. Let me give just a couple of examples below:

  • Ranbaxy developed and launched its first homegrown ‘New Drug’ for malaria - Synriam, on April 25, 2012
  • Zydus Cadila announced in June 2013 that the company is ready for launch in India its first New Chemical Entity (NCE) for the treatment of diabetic dyslipidemia –Lipaglyn.

Hence, meager wherewithal for R&D notwithstanding, as compared to the MNCs, Indian pharma players don’t seem to find the country’s IP and regulatory ecosystems not conducive to innovation of affordable new drugs with wider patient access.

Off-patent drugs also involve another type of major innovation:

Discovering an NCE is, unquestionably, a product of drug innovation. Similarly, developing a new – cost-effective, non-infringing manufacturing process to market off-patent drugs, like biosimilars, also involve another type of major innovation. Intriguingly, when the MNC pharma industry talks about ‘access to innovation’, the latter type of innovation isn’t publicly acknowledged and included in their drug innovation spectrum. This practice, reportedly, remains unchanged in their advocacy campaign, even in the new normal.

However, the fact is, the manufacturers of off-patent drugs, such as biosimilars, also need to follow a major innovative process, for which they require access to innovation. This was also captured in an editorial of the newsletter – Biosimilar Development. The deliberation addressed the question - Do biosimilars fit into the innovation paradigm? The editor began by articulating – hardly anyone publicly argues that the development of new manufacturing process of Biosimilar drugs is not an innovation. The industry can’t call them as a copy of an existing innovation, either.

This is also vindicated in the Amgen paper, published on February 11, 2018. It acknowledges, “Unlike small molecule generic drugs, biosimilars are not identical to the reference biologic or to other approved biosimilars of the same reference biologic, because they are developed using different cell lines and undergo different manufacturing and purification processes.” Moreover, biosimilars also carry a different International Nonproprietary Name (INN), because of their molecular differences from the reference drug. This has been specified in the nonproprietary naming Guidance document of the US-FDA of January 2017.

From this perspective, the next question that logically follows: Is process innovation as important as product innovation?

Is process innovation as critical a capability as product innovation?

This question was unambiguously answered by a pharma industry-centric Harvard Business Review(HBR) article – ‘The New Logic of High-Tech R&D’, published in its September–October 1995, issue. The paper emphasized, for the commercial success of a product ‘manufacturing-process innovation is becoming an increasingly critical capability for product innovation.’

When to meet patient-needs ‘access to innovation’ an oxymoron: 

‘Access to innovation’ is an interesting epithet that is often used by many drug companies for meeting unmet needs of patients. However, the same is also often used to create barriers to meeting unmet needs of more patients with cheaper biologic drugs, like Biosimilars, immediately after their basic patent expiry. This is mostly practiced by creating a patent thicket. Hence, drug companies’ advocacy for greater access to innovation is an oxymoron to many.

The same was echoed in another article – ‘How originator companies delay generic medicines,’ published by GaBI. It wrote, such practices delay generic entry and lead to healthcare systems and consumers paying more than they would otherwise have done for medicines. These include the following:

  • Strategic patenting
  • Patent litigation
  • Patent settlements
  • Interventions before national regulatory authorities
  • Lifecycle strategies for follow-on products.

A very recent piece on the subject, published by Fierce Pharma on August 31, 2021, vindicates that the patent life extension through the patent thicket is happening on the ground – denying patients access to cheaper equivalent, especially of off-patent biologic drugs within a reasonable time period. It highlighted:

  • The exclusivity of AbbVie’s Humira, which hit the market in 2002 and generated nearly $20 billion in sales last year was extended by 130 patents.
  • The same company has applied for 165 patents for its another blockbuster Imbruvica. Launched in 2013, Imbruvica has already generated sales of $5.3 billion for AbbVie.

No wonder, why in February 2021, during a Senate Finance Committee hearing, Sen. John Cornyn blasted the company saying:

“I support drug companies recovering a profit based on their research and development of innovative drugs,” Cornyn said. “But at some point, that patent has to end, that the exclusivity has to end, to be able to get it at a much cheaper cost.”

More reports are also available on attempts to erode consumer confidence in Biosimilar drugs, as compared to the originals.

Work for innovation sans eroding consumer confidence in Biosimilars: 

Making affordable new drugs and vaccines available to patients with ‘access to innovation’, deserves inspiration from all concerned. Curiously, even in the new normal, some big companies continue trying to erode consumer confidence in off-patent drugs, especially Biosimilars and complex generics.

For example, an article on Biosimilars moving to the center stage, published in the Pharmaceutical Executive on August 12, 2021, quoted an interesting development in this space. The article highlighted that US legislators are now ‘eyeing measures to deter innovator promotional messages that disparage follow-on competitors.’ This initiative was spurred by US-FDA criticism of an Amgen promotional communication for undermining consumer confidence in Biosimilars to its Neulasta (pegfilgrastim) injection.

On July 14, 2021, US-FDA’s Office of Prescription Drug Promotion (OPDP) sent a letter to Amgen carrying a caption ‘FDA notifies Amgen of misbranding of its biological product, Neulasta, due to false or  misleading promotional communication about its product’s benefit.

The letter, as reported in the above article, criticized the company for making a false claim of greater adverse events with the injection system used by Biosimilars compared to the Amgen product. OPDP advised Amgen and other firms to “carefully evaluate the information presented in promotional materials for reference products, or Biosimilar products” to ensure correct product identification and avoid consumer confusion.

Conclusion:

When the point is, creating a conducive ecosystem to promote access to innovation, it should be patient-centric – always, and, more so in the new normal, considering changing needs and expectations of health care customers.

The innovation of usually pricey new molecular entities, no doubt, meets unmet needs of those who can afford these. Whereas, manufacturing process innovation expands access to the same molecule, particularly when they go off-patent, by making them affordable to a vast majority of the population.

But powerful industry lobby groups continue pressing harder for unfettered ‘access to innovation’ with greater relaxation of the IP and regulatory framework of countries, like India. The situation prompts striking a right balance between encouraging more profit by helping to extend patent exclusivity and encouraging greater access to off-patent cheaper Biosimilars as soon as the basic patent expires.

The bottom-line is, both need to be actively encouraged, even if it requires new laws to discourage practices like, creating patent thickets or undermining the use of generics or Biosimilars, and the likes. The good news is lawmakers have started deliberating on this issue – along with increasing public awareness, which gets reflected in the pharma industry’s current reputation ratings.

Left unresolved soon, such piggyback ride on ‘access to drug innovation’ bandwagon to serve self-serving interests, would continue denying speedy entry of cheaper Biosimilars. From this perspective, it isn’t difficult to fathom, why unfettered access to drug innovation is considered an oxymoron, by many.

By: Tapan J. Ray  

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.