The UK market access landscape is constantly evolving with environmental developments, pricing and reimbursement challenges, regulatory changes, customer financial pressures, and innovations through new technology. However at the heart of the pharmaceutical industry remains the need to develop and communicate a medicine’s value proposition to all relevant stakeholders from macro to micro level in order to ensure that our true customer, the patient, receives the greatest benefit.
The last few years have seen a genuine move toward patient centricity as the industry has realised the benefit of the informed, educated and motivated patient.
However is there still more that can be done to understand the pharma/life sciences industries-patient dialogue and its role in market access, becoming truly patient centric?
A PM Society patient engagement survey1 in October 2017 found that 100% of the respondents felt that there was more that pharma could be doing to engage with patients, whilst 89% believed a patient-centric approach was extremely important. As a follow up, a recent PM Society report2 highlighted that there is also a real need to engage patients not only in commercial and patient support programmes, but also in research and development, clinical trial design and market access communications.
Patient centricity refers to the process of developing improved healthcare outcomes through direct engagement with patients – in the UK within the frameworks set out by the ABPI/PMCPA3 and MHRA4. Patient centricity should be focused on:
- understanding the patient’s experience of their condition
- the treatment journey that the patient has to take
- their pathway of touchpoints with healthcare providers and healthcare professionals along the way
- most importantly, what the individual patient’s values and needs are.
Historically the product-based pharmaceutical culture has not necessarily been aligned with the more agile and responsive patient centric culture. However, patient centricity has moved from a buzzword to a concept embedded in many organisations, resulting in them engaging differently with patient and carer groups and representatives. There are numerous ways the pharma/life sciences industries can hold dialogue with patient and carer groups and patients for mutual benefit.
From an access perspective, patients are now more involved than ever, with patient groups and patient responses involved in UK health technology assessments, in particular in the rare disease sphere, whilst payors are increasingly accepting evidence in the form of patient-reported outcomes and quality of life/carer burden measures.
There is increasing recognition from regulatory bodies that patient input is critical to informing clinical decision-making processes and the management and treatment of patients to help, while also aiding in the evaluation of novel medical interventions. With regard to health technology assessment and patient centricity in Scotland, the Scottish Medicines Consortium has the Patient and Clinician Engagement5 (PACE) process for either end of life treatment or very rare conditions.
The main part of PACE is a meeting which brings together patient representatives with healthcare professional experts which allows a discussion on the benefits of a medicine, including how it can impact the quality of a patient’s life – potentially capturing feedback and information which may not always be fully captured within the conventional assessment process.
For the rest of the UK, patient carer organisations can register with NICE as consultees for technology appraisals or an independent motivated patient can feedback on appraisals via the NICE website during public consultations6. Decisions regarding treatment reimbursement are becoming increasingly dependent on the demonstrated value of medicines not just to healthcare providers but also to patients.
Obviously when patient engagement is considered it is vital to ensure compliance frameworks are adhered to. This includes ensuring that campaigns include a clear declaration of sponsorship, that sponsorship of patient organisations is listed on the pharmaceutical company website, and all third parties are informed of their compliance responsibilities. To overcome historic misconceptions around patient group engagement by the pharmaceutical industry, any related activities must have clear rules for engagement and mechanisms in place to ensure transparency. When executed well and with the intention of improving outcomes and value for patients, working in partnership with patients and patient organisations can ensure a positive result for all involved.
Join the conversation
At the PM Society, the Patient Engagement Interest Group is focussed solely on the pharma/life sciences industries-patient dialogue and seeks to explore and support initiatives to improve the way in which we involve patients in the decisions, strategies and policies that shape their healthcare. With patient centricity being a major focus for the industry this group is invaluable for anyone wishing to be involved in sharing best practice initiatives and success stories relating to patient engagement. Check out the PM Society website to get involved and join the conversation!
1. PM Society. 2017. PM Society Patient Engagement Interest Group. [ONLINE]
Available at: https://pmsociety.org.uk/article/patient-engagement-survey-results. [Accessed 8 June 2018].
2. PM Society. 2018. PM Society Patient Engagement Interest Group. [ONLINE]
Available at: https://pmsociety.org.uk/uploads/files/Empowered%20patients%20improve%20outcomes%20March%202018.pdf. [Accessed 8 June 2018].
3. The Prescription Medicines Code of Practice Authority (PMCPA). 2016. Welcome to the Interactive ABPI Code of Practice for the Pharmaceutical Industry 2016. [ONLINE] Available at: http://www.pmcpa.org.uk/thecode/InteractiveCode2016/Pages/default.aspx. [Accessed 8 June 2018].
4. Medicines and Healthcare products Regulatory Agency (MHRA). 2014. The Blue Guide advertising and promotion of medicines in the UK. [ONLINE] Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/376398/Blue_Guide.pdf. [Accessed 8 June 2018].
5. Scottish Medicines Consortium (SMC). 2017. PACE – Patient and Clinician Engagement. [ONLINE] Available at: https://www.scottishmedicines.org.uk/files/PACE/PACE_factsheet_0417.pdf. [Accessed 8 June 2018].
6. National Institute for Health and Care Excellence (NICE). 2018. Patient and public involvement policy. [ONLINE] Available at: https://www.nice.org.uk/about/nice-communities/public-involvement/patient-and-public-involvement-policy. [Accessed 8 June 2018].
7. PM Society. 2017. The PM Society Market Access Survey 2017 Results. [ONLINE] Available at: https://pmsociety.org.uk/article/the-pm-society-market-access-survey-2017-results. [Accessed 8 June 2018].