For Breakthrough Health Care Communication, Try a Visual

 For breakthrough communication, add a visual

How one picture turned the tide against obesity

For most people who read the New York Times article, “Americans are Finally Eating Less”, there was exciting news about the fight against obesity. But for alert pharmaceutical marketers, the article contained the key to changing patient behavior: an effective visual!

While study after study had described the magnitude of the obesity problem, it wasn’t until a researcher put up a set of bright blue maps did people begin to grasp the magnitude of the problem. These maps graphically depicted the dramatic rise in obesity rates in all 50 states from 1991 to 1998.

Power of visual

The article points to the blue map visual as sparking the turning point in the fight against obesity. In the article, Hank Cardello, senior fellow at the Hudson Institute, is quoted as saying “People became more aware of it in a very visual and impactful way… That created a lot of attention and concern.”

An underused tool in pharmaceutical communications

In Pharmaceutical marketing, each word directed at the patient is scrutinized endlessly. Visuals or videos are often an afterthought, if they exist at all. While Pharma has embraced the concept of health literacy, its execution has been incomplete, with a narrow focus on grade level.

But visuals are critical to driving health behavior change. For example, in one instance with a low-literacy population at particularly high risk for pneumococcal infection, the group that had viewed a simple visual communication aid was five times more likely to have received the pneumococcal vaccine than those who had not received the visual education tool.

Not just for low literacy populations

But it is not only the low literacy population that gets more out of visualization. Consider Cisco, a world leader in IT, which found that 96% of its customers watch videos for business.  So Cisco started creating videos, over 1,000 new videos a year.

And visualization doesn’t have to be expensive. According to Cisco’s Leslie Drate,“it doesn’t really matter how much we spend on producing the video. The results for what we spend $100,000 on could be similar to what we spend $1,000 on. It just has a lot to do with content and audience.”

                                 Picture Source: Movie CLIP

So to paraphrase the famous phrase from the movie The Graduate, I want to say one word to Pharma marketers responsible for changing patient behavior. Just one word, Visuals!

To meet patient’s need for speed, Pharma needs more lawyers

What kind of crazy talk is that? Everyone knows that it is the legal and regulatory teams and the whole review committee process that keeps Pharma moving at a lugubrious pace. Certainly that’s the biggest excuses I hear for why patient complaints languish in the blogosphere or why websites aren’t updated on a regular basis.

It can’t be the shear size of the pharma organization that slows decision-making. Larger companies have shown they can be nimble when it counts. Take Apple, the largest company in the US and how their rapid fire response to the Taylor Swift incident. It took Apple less than one day over a weekend to reverse a policy about paying royalties during the Apple music trial period. And Apple’s senior vice president of Internet Software and Services, Eddy Cue, communicated it simply with a tweet.

Moving faster requires real teamwork, the type of teamwork highlighted in Fortune magazine’s recent profiles of the small teams within big companies like Nike, Starbucks and J&J. And it is shared goals that fuel these integrated teams’ stellar performance.

In my opinion, Pharma’s sluggishness comes down to the antiquated brand team structure. Most teams are comprised of three marketing sub-teams (HCP/Patient/Payer) overseen by a legal/regulatory/medical review committee with an entirely different reporting structure. Operating in siloes, these different departments often have different, and often, conflicting goals. The legal and regulatory departments are charged with protecting the company and the brand marketers are charged with growing the business.

But what if the Pharma brand team was a fully integrated team—with marketing, legal and regulatory all aligned around improving patient outcomes?

More crazy talk! What if reviewing patient comments, whether online, over the phone and deciding how to respond, was a daily job shared by all? What if lawyers attended focus groups? How about the regulatory team member meeting with patients at an advocacy event? What if everyone was co-located? What if marketing/legal/regulatory acted as a unified SWAT team dedicated to listening, responding and creating new ways to improve patient health?

For the SWAT team concept to work legal and regulatory colleagues must function as full members of a brand team, not just as a panel of judges at weekly review committee meetings. That’s where the idea that Pharma needs more lawyers (and regulators) comes in to play. Moving faster means brand teams should include marketing, legal and regulatory expertise to make decisions on a daily, if not hourly basis.

With consumer expectations regarding company response time rising across all industries, speed needs to be the rule in Pharma rather than the exception. And contrary to expectations, moving faster requires ongoing, rather than foregoing legal and regulatory input. Simply put, Pharma needs more lawyers (and regulatory experts) to move at the speed of patients.

The #Powerof1Million changes everything

Last week, I got an email from 23andMe announcing that they had “genotyped more than one million people worldwide,” and that I was number 85,552. Big news for a company that has weathered a lot of ups and downs, particularly in November 2013 when the FDA demanded that they stop providing health information.

As number 85,552, I had signed up prior to the health information shut down, so I was privy to my health information. Luckily, as it turns out, my health information didn’t contain any earth shattering news. My ancestry results however were a big surprise.

Even with my unexpected genealogy results, my 23andMe results didn’t have a big impact on me personally. However, professionally, as a health care communicator, I believe that the fact one million consumers are willing to be genotyped is a big deal.

As their press release states, “Today, 23andMe has the world’s largest database of re-contactable individuals who have consented to participate in [genetic] research.” Talk about empowered consumers.

And 23andMe is just one of the many emerging services and products aimed at putting more health information into the hands of consumers. Consider the Scanadu Scout, a device that sends blood pressure, heart rate, temperature, and blood oxygen levels to a consumer’s iPhone.

I believe that the colossal amount of health information now available to consumers ups the ante for health care communicators in three ways:

The ability to explain complex health information in simple ways is even more critical than ever before. Having a commitment to health literacy built into a company’s DNA will be the cost of doing business in our data rich world.

Factoring in the consumer’s emotional increases in importance. Understanding the impact health information can have on a person’s emotional state can be the difference between effectively communicating and sending a consumer into a downward spiral of fear and confusion.

Helping consumers turn knowledge into action is vital. Providing concrete next steps to help consumers act upon what they have learned turns reams of data into potentially lifesaving information.

As health care communicators, our ability to help consumers process the avalanche of health care information coming their way can make a real difference in people’s lives. For a robust understanding of what is coming down the pike, read Eric Topol’s latest book, “The Patient Will See You Now.” The book is a veritable canon on the trends in personalized medicine. As 23andMe’s #Powerof1Million announcement makes clear, the future is closer than we think.

Overcoming the DTC Fear Factor

FDA gets on the “Less is More” bandwagon

The “Less is More” approach is gaining traction in health care. Fear is what often causes people to gird themselves with potentially unnecessary health care interventions: fear of getting it wrong, of missing out, of being criticized, of dying. Atul Gwande details the bravery required to challenge the medical status quo in his recent book Being Mortal. Gwande does a great job of debunking the myth of “more care is better care” when it comes to end of life treatment.

Now “Less is More” is being applied to health care communication. The FDA is overcoming the DTC Fear Factor and casting aside unnecessary risk information with the intent to drive superior patient comprehension. The FDA has issued draft guidelines that require less, not more, risk information in the Consumer Brief Summary portion of DTC print ads. PharmaGuy provides a comprehensive (and as always, entertaining) review of the proposed guidelines in his February Newsletter.

But the FDA is not using the editing pen wily-nilly. Knowledge born of research, is taking the edge off of their DTC Fear Factor. Upcoming research includes a study on the risk information presented in television ads. The objective is to see whether listing only the most actionable risks leads to better comprehension than the usual mind-numbing laundry list.

Certainly the FDA has reason to fear getting the level of risk information wrong. As Daniel Carpenter, a Harvard professor who studies the FDA posits in a Health Affairs article, the FDA is driven by it’s “desire to safeguard its reputation for protecting the public’s health.” The FDA’s “Less is More” approach certainly has its critics. Public Citizen criticized the FDA for its proposed August ’14 guidelines on how pharmaceutical companies should present risk information to physicians

This new “Less is More” approach to risk information demonstrates that the FDA is willing to undergo reputational risk to do the right thing for patients by presenting the information in a way patients can understand and act on. There is substantive evidence that links lack of patient understanding with negative health outcomes.”

So what is the likelihood of pharmaceutical review committees embracing the “Less is More” philosophy regarding risk information? Certainly the new review FDA guidelines will help, but as anybody who has sat through a review committee meeting can tell you, there is wide latitude in how FDA guidelines are interpreted. Many opt for the most conservative approach.

My guess is that review committees won’t get over their DTC Fear Factor anytime soon. There is just too much reputational risk. And it is hard to blame them. The media’s knee-jerk reaction is to attribute any misstep to a nefarious motive on the part of Pharma.

Overcoming the DTC Fear Factor will require Marketing Departments to do the hard work of proving that using fewer and simpler words to describe a product or disease state results in better comprehension. Just as the FDA Researchers helped their Reviewers get over the DTC Fear Factor with data, Pharma marketers will need data to bolster the courage of their Review Committees with solid research.

However, conducting research brings along its own “Fear Factor.” What if the language causes consumers to overestimate the efficacy or underplay the risks of the product? So why bother? In the past, trying to boost outcomes by improving communication comprehension was a “nice-to-have,” despite the compelling health literacy case.

But now, the Affordable Care Act makes reimbursement dependent on outcomes and patient experience. So ensuring patient comprehension is critical to the financial viability of Pharma’s direct customers: physicians, hospital systems and health plans. So follow the dollar. Customers care, so pharma marketers should care too.

Complexity is easy in Pharma communication, just go to the label. Eliminating the DTC Fear Factor in Pharma will take hard work. However, in health care, the “Less is More” train has left the station. Time to put fear aside, join the FDA and jump on the “Less is More” bandwagon.

Purple Cow or Bull in a China Shop?

How to make change stick

A colleague once generously called me a Purple Cow.

I say “generously” because he used the phrase as Seth Godin did, to mean someone/something intrinsically different. As a Pharma marketer, I constantly pushed for new marketing approaches. However, much of the time I tried to drive change, I probably behaved more like a bull in a china shop than a remarkable purple cow.

In fact, the Pfizer Health Literacy principles were launched internally two times because I had not fully involved my marketing colleagues the first time. After the initial launch, less than 25% of the patient literature coming out of my own department adhered to the principles. When even the people you directly supervise refer to a pamphlet written according to health literacy principles as using “dog food language” you know you haven’t done a good job socializing the concept.

As the founding partner of extrovertic, a health care consulting firm focused on delivering innovative marketing solutions, I continue to seek out new marketing approaches. However, I now appreciate the importance of involving others and managing the change process. So extrovertic has enlisted the help of a former colleague of mine, Susan Domotor, an expert in change management, to help extrovertic clients to successfully implement the change they seek to build their businesses.

According to Susan, studies show that business initiatives rolled out with less than adequate focus on the employee aspects of the change have about a 30 – 40% success rate” (Blanchard, IBM). As I found out in rolling out the Health Literacy Principles, this translates into significant amounts of wasted time and money.

Here are Susan’s top three recommendations for getting your colleagues to embrace the change you seek:

1. Create a strong business case – A business case helps people understand the importance of the change, conveys a sense of urgency for what you are trying to achieve, and generates a sense of ownership for a successful transition. A strong business case answers three questions: Why is the change necessary? What is the change? How will we achieve the change?

2. Ensure that Leadership is visibly engaged and is driving the change – Visible leadership support is critical for success and it cannot be delegated because employees will only commit to efforts that are driven by their leaders.

3. Develop a focused Communication Plan – An effective communication plan is critical to influencing employee behavior. The plan must create understanding for the initiative; provide employees opportunities to question, digest, and internalize the change; and as the initiative progresses, celebrate successes, share best practices, and capitalize on opportunities to highlight the performance and behavior that are valued in the new way of doing business. It is important to build the communication plan before kicking off your initiative. You can modify it along the way.

Change is being continually foisted on the pharmaceutical industry. Chances are that no matter what your job function, it now involves change. Whether it is to instill a new patient-centric mindset into your organization or to get your colleagues to embrace multichannel marketing for physician outreach.

Lucky for me (and patients struggling to understand health care information), my colleagues gave me a second chance. After the re-launch, over 95% of the patient pieces produced met the Pfizer Health Literacy Guidelines. But with a strong change management plan, you don’t have to count on being lucky, just being prepared.

Tom Brady and Atul Gawande: Designing a Different End Game

Tom Brady and Atul Gawande, two Bostonians with wildly divergent careers, both take the same approach to designing a different end game; they flout the conventional wisdom to achieve their objectives. For marketers wanting to change the trajectory of their brand, company, industry or career, these two prominent Bostonians show the power of doing things differently.

Tom Brady, the New England Patriots quarterback, has always been vocal about wanting a different end game, one that would keep him playing high-level football in his 40’s. So according to a recent New York Times Magazine article, Tom defies conventional training practices designed at building strength in favor of those that create more pliable muscles. He credits his unique training practice with sparing him from career ending injuries, ultimately enabling him to win 4 Super Bowls (so far).

Atul Gawande, Boston surgeon and best selling author, challenges the more medicine is better medicine dogma that runs deep in our American cultural veins. Gawande addresses the literal “end game” in his best-selling book Being Mortal, to propose a radical new approach on appropriate care in our last years. Rather than doing everything possible to ensure maximum patient safety and longevity, Gawande contends that instead, a doctor’s role is to ensure that people leave this earth in a way that respects their values and priorities.

To do this, physicians and family members need to understand what constitutes quality of life from the patient’s point of view. In one example, Gawande tells of a daughter’s surprise at her father’s definition of quality of life as “being able to eat chocolate ice cream and watch football.” Her father had been a professor emeritus so she assumed he would not have wanted to live unless it was as a fully functioning intellectual. It was this knowledge that helped her make an entirely different choice for her father when faced with a life and death decision by her father’s surgeons.

I wasn’t so lucky with my father. The idea that more medicine, more effort, is not always appropriate was a totally foreign concept to me for most of his illness (and most of my life). So the poor guy cycled in and out of the hospital to rehab a number of times, getting weaker with every visit. By the time a palliative nurse friend of mine, helped me to see the light, it was too late. Having made the decision to bring him home after our post-dinner talk, I received a call the next morning that he had died in the Rehab institution.

While I can take comfort that my father seemed to enjoy all the attention he received at the Rehab facility, I often wonder if he would preferred a different ending. With my 88-year old mother, I have an opportunity not to make the same mistake.

The lessons of Gawande’s Being Mortal and Tom Brady’s historic Super Bowl victory transcend their individual career choices. Their work is testament to the truth of Einstein’s definition of insanity–doing something over and over again and expecting a different result. These two different men offer the same valuable lesson about the need to challenge the status quo to achieve a different result.

In the pharmaceutical industry where my company, extrovertic, does most of its work, there is a lot of organizational dogma about how to drive sales. It includes “HCPs write prescriptions, not patients,” or the time honored “the sales representative call is the best way to reach physicians.”

I know a lot of talented and progressive marketers who are confronting these doctrines on a daily basis. It’s hard work to be the one constantly going against the grain. But the experiences of Tom Brady and Atul Gawande are proof that a successful end game is worth the fight.

Three Prescriptions for Patient Centricity

Patient Focused. Patient Centric. Patient First. There are lots of buzzwords companies use to describe their aspirations for a renewed focus on patients. But as my 8th grade Latin teacher once told me,

“The road to hell is paved with good intentions.”

Whatever phrase your company uses, here are three prescriptions on how to “walk the talk” of patient centricity in 2015 (and avoid a dance with the devil)

1. Fully infuse the voice of the patient into drug development. Historically, patient marketers are among the last to join pre-commercial or even launch teams. To be more patient focused, teams need to be staffed with patient experts early in the game.

And once in the game, patient marketers should make development of customer service and adherence programs the first order of business. As payers and patients have to increasingly make cost/quality trade-offs, it is critical that marketers can prove that their patient services actually make a difference in adherence rates, patient experience and clinical outcomes.

In fact, patient services already a factor into 3rd party purchase decisions. For example, according to a Duke physician I heard speak at a conference, Eliquis, a medication in the very crowded stroke prevention category, was chosen over competitors because the brand had the strongest co-pay assistance program.

Or just listen. Patients in clinical trials are already shaping opinions of the drug through their online conversations. An extrovertic social media analysis found an average of 30,000 patient conversations taking a place every month by patients involved a clinical trial.

2. Partner with providers and payers to meaningfully improve the patient experience at the point of care. HCPs, Integrated Delivery Systems and Payers are going to be judged on outcomes and patient experience. Pharmaceutical companies have the know-how and resources to help their customers meet the triple aim of improving patient experience, lowering costs and driving better outcomes. Take a look at all the governmental metrics requirements and pick a few to partner on.

It will also be important to have an expansive definition of point-of-care, both in terms of place where care happens and the people who provide the care. Care is now being highly distributed, it’s happening at home, at the retail pharmacy, at work, at Costco and at urgent care centers. And with the looming primary care physician shortage, care will be increasingly be delivered by nurses, physician assistants and even lay health workers.

And let’s not forget the increasing role patients are playing in their own health with the explosion of wearable technology and the whole quantified-self movement. The point of care is now everywhere and the smart pharmaceutical marketers will be conducting pilots to figure out how they can add to the patient experience.

3. Adopt a cross-channel patient experience framework to conduct marketing activities. A good patient experience is one that is consistent throughout every interaction, whether it be through a website, a phone call or in person meeting. Many of these touchpoints are managed by different functions in a pharmaceutical company, yet to the consumer it all comes from the same company. So the company has got to start acting like one company.

And this one organization needs to be reoriented towards driving patient satisfaction rather than driving sales. Driving satisfaction doesn’t mean revenue generation takes a back seat. There is a whole body of literature that proves that higher customer satisfaction scores result in higher sales and profits, in industry after industry.

But first the voice of the patient needs to be heard. This will require an integrated system of collecting patient feedback in a way it can be acted upon. For example, how well is the medical information call center doing in meeting patient needs? I would guess most marketers don’t know.

So take these 3 Rx’s and make 2015 the year that pharma companies turn patient centric talk into action. (And to my eighth grade latin teacher, Mr. Riggs, I really did “disce diligentius.”)

The Orphan Impact: Small drugs drive big changes

Seems everybody’s talking orphan drugs these days. No wonder, according to EvaluatePharma’s 2013 Orphan Drug Report, orphan drugs are estimated to reach 15.9% of total worldwide prescription sales by 2018. But the orphan drug impact goes beyond sales numbers. I believe that the patient centricity blossoming in the rare disease divisions will eventually spill over into the primary care divisions of pharmaceutical companies.

With the big blockbuster primary care drugs, development success lay primarily with company research departments. The halls of Pharma echo with stories of researcher heroics—how the lone scientist kept a molecule from hitting the drug dustbin only to become the next blockbuster.

But in orphan drugs, the heroes are as likely to be individual patient family members as researchers. In some cases the drug literally starts with patient families. Thanks to advances in digital technology and social media, orphan drug patient families play a major role in every aspect of bringing a drug to market, going far beyond traditional advocacy roles. Now individuals are able to leap tall barriers with a click of a mouse to accomplish superhero feats formerly reserved for massive organizations like the NIH and pharmaceutical companies.

Consider the role of patients, families and organizations in:

Disease discovery: Matt Might, a father whose son had a disease entirely unknown to science, leapt over barriers of scientific self-interest to find other patients and give his son’s illness a name.

A well-known blogger in his field, Matt’s post about his quest helped identify patients like his son across the globe. In the New Yorker article, which describes Matt’s disease naming odyssey, a Duke geneticist, who worked with Matt, sums up the new patient paradigm with this quote:

“It’s kind of a shift in the scientific world that we have to recognize—that, in this day of social media, dedicated, educated, and well-informed families have the ability to make a huge impact…Gone are the days when we could just say, ‘We’re a cloistered community of researchers, and we alone know how to do this.’ ”

Research direction: John Crowley funded individual scientists to fill the treatment void when he learned his daughter had Pompe disease. Ultimately John ended up partnering with one scientist to form a company that eventually was folded into Genzyme. And while his story is certainly one of the most dramatic (to the point of being the subject of a major motion picture starring Harrison Ford), John’s ability to drive the course of scientific discovery is becoming more commonplace in the rare disease space.

Product approval parameters: In June 2014, the Parent Project Muscular Dystrophy (PPMD) patient group, submitted the first ever-patient advocacy-initiated draft guidance for a rare disease to the FDA for Duchenne muscular dystrophy. Patients, through organizations like the PPMD, are now directly driving how Pharma should be conducting their research.
Because of the outsized role patients and their families play in bringing a drug to market, building strong patient relationships is a key marketing investment for orphan drug marketers. For example, Biogen Idec, deployed over 15 community managers to support people with living with hemophilia even before they had an approved product.
There are already signs of an “orphan drug spillover effect” on primary care marketing. Consider Sanofi’s community manager position in their Diabetes franchise. Or more recently, that Sanofi appointed a Chief Patient Officer. And this I believe, is just the start of the orphan drug effect.

Soon the patient centric tactics of Rare Disease marketers will be highlighted in “marketing excellence” meetings all over Pharma. Then questions will come during marketing plan presentations about “why can’t primary care teams start building patient relationships like their rare disease counter parts?” And before you know it, the small seeds of patient centricity will finally blossom throughout Pharma.

Patient Shopping in Our Lifetime?

This was the one of the final questions asked at a recent Elsevier conference where I was a speaker. The panel charged with answering this question was largely pessimistic. Panelists felt that the byzantine system of setting prices for both medical procedures and pharmaceuticals made it unlikely that consumers would ever get the cost data required for effective shopping behavior. They couldn’t imagine that anyone in the industry would step up to the challenge of making prices more transparent.

There is certainly reason for their negative outlook. For example, a recent study by Verilogue and Duke Medical Center found that when oncologists discussed  breast cancer treatment options with patients, costs were only discussed in 20% of the cases. If patients can’t get information on the costs and outcomes of various medical and drug treatments, then they can’t make the appropriate trade-offs.

In my opinion, the Elsevier panel was right and wrong.

Right because strides towards increased pricing transparency won’t come from within the industry. But wrong because change will be instigated from outside the industry—by government, non-profit organizations and entrepreneurs unencumbered by the war wounds of fighting vested health care interests.

Here are a couple of examples that provide me with hope:

  • On the non-profit side, there is the Minnesota Community Measure Up coalition. They created the Minnesota D5 program, which provides effectiveness scores for treating diabetes by individual clinics/HCP offices.
  • Newer health care services like Counsyl, a genetic testing company, have actually built cost transparency into their business model. Counsyl has developed a proprietary tool that allows patients to calculate their exact costs once their particular insurance policy is factored in before they sign up for the service.
  • Iodine, a newcomer in the cost and rating business for drugs, has developed a very easy interface to help consumers start evaluating the cost/quality trade-offs for different medications.

Information will drive true shopper behavior.  Contrary to popular belief, patients can make educated choices. Patients don’t reflexively opt for latest and the greatest medical solution. As reported in the New York Times, a recent study in the Annals of Surgery, found that parents actually made the cost effective choice regarding appendectomies for their children.

When parents were told that both conventional and laparoscopic surgery yielded the same results, but that conventional surgery was far less expensive, two-thirds of parents chose the less expensive conventional surgery. 31% said that the information they received was the primary driver in their decision and 90% liked having a choice.

Pharma companies are going to have to learn how to market to health care shoppers rather than patients. This means that not only will pharmaceutical companies have to include cost in their outcomes studies with payers, they will also have to convince health care shoppers that their drugs represent a good value for the money.

And much like restaurants and hotels, Pharma companies will have to regularly monitor the various patient quality and cost rating systems to make sure their medications are fairly portrayed. A bad rating will have a direct impact on revenues, as consumers fail to start or stop using a medication, based on a rating they saw.

Pharma companies will need to include these products ratings from patient sites in their analyses of sales results. I predict that these analyses will show a direct correlation between consumer ratings and revenue. And when that happens, it will be the dawn of the era of the true health care shopper!

Follow the Money to Patient Engagement

4 Reasons why Pharma will finally become patient-centric

Pharma Financial Stars Lie with Patient-Centricity

Pharmaceutical marketers have been talking about Empowered Patients ever since I joined Pfizer Pharmaceuticals in the mid-90’s as one of their first consumer marketing hires. But despite all the talk, most pharmaceutical companies are nowhere near being patient-focused.

Pharma marketers know things are changing but are holding onto the HCP-focused status quo for as long as possible. In fact, I was recently asked by a Pharma Exec charged with driving patient engagement, “When do we really have to get serious about patients?” They felt that their primary customer was still the physician.

But ever the optimist, I believe that the next 2-5 years will represent a seismic shift in pharmaceutical marketing. Away from a singular focus on the physician towards a more patient-centric way of being. And that’s because patient-centricity is increasingly critical to a pharmaceutical company’s growth and financial health. As Watergate’s Deep Throat said, “Follow the Money.”

To my mind, there are four market trends that are helping to realign Pharma’s financial stars towards patient-centricity:

1. The Dawn of Health Care Shoppers-Historically, consumers exhibited very little true shopping behavior, even as they became increasingly responsible for their health care costs. This lack of true shopping behavior was largely because consumers had little visibility into costs and quality data and therefore couldn’t make the necessary trade-offs.

But that is changing.

Health care reform, combined with private sector efforts, are increasing transparency around both costs and quality, allowing consumers to start making trade-offs with their health care expenditures, including medications. Patients will move from merely asking a physician for a particular drug they saw advertised on television to making a highly considered decision to pay for drug A or drug B.

With this true decision-making, patients will be able to move markets. As this market moving ability starts to show up in pharma company regression analyses, Pharma companies will be stumbling over each other to be the most patient-centric.

2. The shifting economics of their customers-HCPs, Hospitals and Integrated Delivery Systems won’t be rewarded on the quantity of services they deliver anymore, but rather on the quality of those services and the patient experience. The smart pharmaceutical companies are going to look for ways to help their customers deliver better patient outcomes and experiences. And that is going to require additional investment to prove their patient interventions actually deliver.

3. The exploding orphan drug opportunity-Specialty and orphan drugs now represent the path to financial growth for many Pharma companies. And along with the orphan drug opportunity comes the empowered patient. These patients play a significant role in which drugs get into clinical trials, get approved by the FDA and reimbursed by insurers. If a company is in the Orphan Drug space, then by default they have to be patient centric. I predict that this “patient centricity” will eventually work its way into larger, primary care marketing practices.

4. Patient Reported Outcomes (PROs) in clinical trials will increasingly become commercial differentiators-In many categories, pharmaceutical researchers have already captured patient-reported outcomes, particularly on quality of life. However, these metrics have had little true commercial value since the FDA has been leery of approving claims based on patient reported outcomes. I believe that the FDA’s new focus on patient centricity, as witnessed by their “Patient Focused Drug Development” initiative may signal a growing acceptance of PRO claims. And as PROs become more important to the commercial success of a medication, so will the patients.

It is this alignment of Pharma’s financial stars around patient-centricity, that makes me believe that pharmaceutical companies will finally begin to truly embrace the empowered patient. Just follow the money. It never lies.