April 6, 2010
Peter Mansell investigates how pharma companies can use Web-based media to improve adherence and become part of the treatment decision-making process.
The shift in emphasis—from compliance to adherence to concordance—in strategies to ensure that medicines are used appropriately and effectively reflects a broader agenda of patient empowerment and shared or negotiated decision-making between patients and healthcare professionals (HCPs).
In one sense, this is a pragmatic response to an era of rapid technological change and global information traffic in which, increasingly, patients are finding out for themselves what may be wrong with them and the best options for dealing with it.
This can have the undesirable effect of putting HCPs on the defensive or undermining their experience and authority. At best, though, it allows for mutually beneficial dialogue in which the HCP can better tailor treatment to the patient’s personal wishes, characteristics and awareness of their condition. And patients are more likely to invest seriously in a treatment program that has been mutually agreed.
Health information on the Internet
One obvious driver in the concordance relationship is the plethora of health information now available on the Internet. This again is something that can work either to the advantage or disadvantage of both healthcare professionals and the pharmaceutical companies for which HCPs are a gateway (or barrier) to market access.
Unvalidated, anecdotal or just plain hostile information, distributed freely on the Internet, can leave HCPs and pharmaceutical marketers with a lot of awkward questions to answer.
Equally, though, properly credited information from company websites or reliable objective sources can serve as a useful complement to the standard tools of concordance, such as patient information leaflets and advice from HCPs. This is all the more the case as marketers find their access to healthcare professionals increasingly limited, and patient demand whittles down consultation times.
At the same time, the emergence of personalized medicine and more complex therapy regimens is raising the stakes for concordance. Letting patients actively seek out, and absorb in their own time, the necessary guidance through Web-based media makes them feel in control of the process and – arguably – more likely to stick with it. The doctor or pharmacist is always there for extra support, reassurance or clarification.
The value of accredited Web resources
A recent study by Manhattan Research suggests that doctors in Western Europe see real value in referring patients to accredited Web resources. Among the 1,125 practising physicians interviewed online in Germany, Spain, France, Italy and the UK for the Taking the Pulse Europe v9.0 study, around three quarters wanted sales representatives to let them know about their company’s patient education websites, so that the doctors could in turn recommend these to patients.
“Sales reps are a great way to get the word out about these digital resources to key physician targets and, on top of that, the physicians actually want this information,” comments Joe Farris, president of Manhattan Research.
“With almost half of online European physicians recommending health websites to their patients, this is an opportunity for pharma companies to become part of the treatment decision-making process.”
As Manhattan Research notes in a white paper on Navigating the European eHealth Landscape, the doctor remains “the ultimate voice in the physician-patient relationship” but online health content is “helping the traditional one-way lecture evolve into an educated conversation.”
From a marketing viewpoint, it adds, brands “can become part of the treatment discussion if they make disease education tools and resources readily available to the patients and physicians seeking them.”
The evolving digital landscape is providing new channels for that “educated conversation” between doctors and patients. “Physicians now whip out smartphones at the point of care to reference drug information and patients use online resources for education and support at multiple points along the disease management continuum,” the white paper observes.
In its annual global pharmaceutical report, Progressions, Pharma 3.0, Ernst & Young notes that trends such as health reform, information technology, comparative effectiveness assessments and growing consumer power are prompting pharmaceutical companies to broaden their focus from producing new medicines to delivering “healthy outcomes.”
This wider perspective will require creative partnerships and business model innovation, Ernst & Young says. But as patients play an increasingly active role in managing their own healthcare with the help of personal health records, smart phone applications and other new technologies, pharmaceutical companies “remain largely on the sidelines of this revolution, hampered by a regulatory framework governing patient interactions that has been slow to evolve,” it warns.
A new patient-HCP dynamic
Managed carefully, patient education websites should be one way for companies to tap into the new patient-HCP dynamic without crossing any regulatory boundaries. However, companies also need to keep a sharp eye on other information channels.
As Manhattan Research point outs, doctors “also have a multitude of other online patient education resources to recommend, so pharma companies should gain an understanding of how their products are represented online beyond on their own properties, and wherever possible, ensure that product information is complete and accurate on third-party sites.”
At the same time, these companies need to ensure that websites are not standing in for valuable patient-HCP interactions. “It should be emphasized, though there is significant potential for digital tools and content to support disease management, effective adherence programs require significant involvement from all stakeholders,” the Manhattan Research analysts comment.
And at the moment, they add, consumers or patients mainly use the Internet to find health information, “with only a small share using digital tools for adherence purposes.”
Nonetheless, “consumers are becoming more immersed in digital media each year, so there’s potential to move towards a culture that uses the Internet as a health management tool,” the analysts observe. Getting there will “depend on how this opportunity is approached and committed to by manufacturers.”
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