The Next Phase of Pharmaceutical Value Propositions Needs to Include the Real Meaning of Synergy

Synergy Blog ImageExpress Scripts recently issued a report on drug spending that made some headlines in the business press.[1,2] This compelling report shows that, from the perspective of a pharmacy benefit manager (and its pharmacy claims database), evidence confirms the trends of increased drug spending, particularly in the subset of patients that consumes at least $100,000 worth of drugs annually:

• The population of patients that takes at least $100,000 worth of drugs has almost tripled from 2013 to 2014
• Compounded drugs were the 3rd highest driver of the trend, behind HCV antivirals and oncolytics
• 9 out of 10 patients with drug costs over $50,0000 used specialty medications
• Men and baby boomers (those aged 51-70) make up the majority of those with high drug costs
• Comorbidities and polypharmacy were prevalent among patients with high drug costs

Glenn Stettin, MD, the SVP of Clinical, Research, and New Solutions, outlines in this report implications and recommendations, most of which are feasible for a PBM to consider:

• Eliminate wasteful spending and improve medication adherence
• Manage specialty and traditional medications together
• Pioneer new approaches in cancer care that both offers patient access and sustains payer affordability

While these are important recommendations, there is an opportunity for pharmaceutical manufacturers to consider extending and enhancing the value propositions of their drugs, and it relates to the “comorbidities and polypharmacy” finding in this report, which is pretty remarkable. The report shows that:

• Among patients whose drug costs reached $100,000, more than one-third were treated for more than 10 conditions
• More than 60% were taking more than 10 medications
• One in four patients had prescriptions from at least 4 different prescribers
• More than half of patients with $100,000 in drug costs were prescribed medications by physicians from at least 4 difference specialty areas

Now, as we read daily in the business press, the drug industry is facing pushback about its pricing of newer agents (specifically HCV antivirals and oncolytics). This resistance from customers is normal, and has taken various forms of stricter precertifications and/or formulary requirements.[3] Recently, legal patent challenges have surfaced; in some countries, various advocates are asking that patents on drugs be voided, so that generic competitors can appear earlier.[4] Nonetheless, evolving industry forces, such as comparative effectiveness research, constrained health care budgets of some payers, and new competitors have started to create a new equilibrium between sellers and buyers, and these forces are helping to more quickly vet winners and losers. It is encouraging to see the manufacturers (particularly of HCV and cancer drugs) refine the value propositions of their drugs, which now include cures for some patients.[3]

But disease is multifactorial (and, as the ESI report shows, multiple diseases are, too), and treatments often need multiple approaches. Manufacturers may need to extend the current value proposition of “one drug that treats one disease at one time” and add it to the complicated heath care mix that includes other variables, for example:

• Combination therapies (with other drugs, including competitors and/or generics, and with other modalities such as devices, diet, surgery, etc.)
• Timing or sequence of treatments (ie, phase of the disease)
• All of the factors in “care coordination” (ie, different physicians, different specialties, different settings)

In other words, manufacturers need to demonstrate the synergy produced by their drugs. “Synergy” is often misused, but I like the Merriam-Webster definition of synergy as “a mutually advantageous conjunction or compatibility of distinct business participants or elements (as resources or efforts).”[5] Certainly some treatment guidelines, pathways, and medical policies attempt to address these multiple variables in health care. But manufacturers can bring their significant credibility in clinical research and patient experience to identify, define, and demonstrate the specific opportunities that optimize their drugs’ performance. They are best-suited to do so, and the customers are receptive to that type of message. (Note: as this heads to posting, 2 manufacturers are reported to have taken this approach and are studying their oncology drugs in combination.[6])

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1. Super Spending: US trends in high-cost medication use. May 2015. http://lab.express-scripts.com/insights/drug-options/super-spending-US-trends-in-high-cost-medication-use. Accessed May 19, 2015.

2. Growth of patients with $50K annual drug tabs skyrockets. Fierce HealthFinance. May 17, 2015. http://www.fiercehealthfinance.com/story/growth-patients-50k-annual-drug-tabs-skyrockets/2015-05-17). Accessed May 19, 2015.

3. Gilead’s $1,000 Pill Is Hard for States to Swallow. The Wall Street Journal. April 8, 2015. http://www.wsj.com/articles/gileads-1-000-hep-c-pill-is-hard-for-states-to-swallow-1428525426. Accessed May 21, 2015.

4. High Cost of Sovaldi Hepatitis C Drug Prompts a Call to Void Its Patents. http://www.nytimes.com/2015/05/20/business/high-cost-of-hepatitis-c-drug-prompts-a-call-to-void-its-patents.html. Accessed May 20, 2015.

5. Merriam-Webster Online. http://www.merriam-webster.com/dictionary/synergy. Accessed May 21, 2015.

6. AstraZeneca and Lilly to test new cancer drug combination. Reuters. May 29, 2015. http://www.reuters.com/article/2015/05/29/us-astrazeneca-eli-lilly-cancer-idUSKBN0OE0HU20150529. Accessed May 29, 2015.

Also posted in clinical trials, Data, Health & Wellness, Healthcare Communications, Medical Education, Medicine, Pharmaceutical, Science, Strategy, Technology | Tagged | Comments closed

A Case Study: Unlearning

Blog 6.5.15resized

“Fail, fail again, fail better.” Samuel Beckett

I have this fear of making mistakes.

I find that I’m always second-guessing and triple-checking myself in most things I do because of that fear. When I do end up making a mistake, I find that I spend about 5 minutes scolding myself and wondering how it could have all been avoided. Let me just say that I find about 10 different ways to answer that question.

But isn’t making mistakes a part of life?

Yes. Everyone makes mistakes in life but it is how you bounce back from those mistakes that defines you. I recently listened to a podcast where the focus was on learning and unlearning. To “unlearn” means to let go of what you have already learned or acquired. To unlearn, you have to be open to letting go of what has been pushed on you for so long, pressing the pause button, and relearning all over again—but this time, the right way for you.

After some research, I decided that the time was right for me to start unlearning a few things—therein began my month of renewing my mind. Here is one thing I’ve “unlearned” thus far:

1. All mistakes are bad.

I recently came across an article in the Harvard Business Review about “The Wisdom of Deliberate Mistakes.” Paul J.H. Schoemaker and Robert E. Gunther, the authors of the article, state that “the resistance to making mistakes runs deep, creating traps in thinking and decision making”—a statement that I wholeheartedly agree with. I believe the No. 1 thing that gets in the way of us being our best creatively is fear. I am learning to call my mistakes “experiments.” We live in a world of trial and error, and sometimes the greatest things can come out of simple experiments. As a wise person once told me, “It’s all about where the creative work is taking you and not where you are trying to take it.”

I have come to believe that in our line of work, especially in the creative department, we shouldn’t be afraid of making mistakes. Embrace it because some of the greatest innovations have come from just the simplest mistakes. Don’t believe me? Take some time and research how one of the antibiotics widely used today—penicillin—was created.

I’m still on my journey of unlearning, and if you would like to learn a little bit more, feel free to reach out!

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Learning From a Physician First Hand

Kareem Blog ImageMy name is Kareem Royes and I just completed my first year in medical school. I’ve had the opportunity to return to OCHWW Planning this past summer. Over the past year, I have worked very closely with different physicians in the hospital setting, which has allowed me to gather some new insights that I am happy to share about one of OCHWW’s biggest customers, the healthcare professional (HCP). These insights can drive tactics that will not only improve our customers’ experience, but also maximize our clients’ ROI.

Insight 1: Physicians have an inherent distrust of sale reps

One key insight medical planners and marketers frequently do not consider is that physicians have distrust for the information provided to them by drug sales reps. HCPs do not think sales reps have the medical education and years of clinical practice to tell them how to use a drug. Physicians almost unanimously prefer to obtain information from other physicians who are experts and researchers in the therapeutic area of interest. As such, there is a tremendous opportunity to improve our clients’ penetration into these practices by leveraging more physician experts, also known as “thought leaders” or “key opinion leaders,” to provide detail through webinars to physicians who are not open to speaking with sales reps.

Insight 2: The whole is more important than the individual part

We are currently in the era of using apps to enhance our day-to-day experience and interactions. This is no different for HCPs, most of whom also use smart devices. In tactical planning, we often pitch ideas around creating apps that educate physicians about a drug, or a disease, or help them follow up with care for a patient with only one disease. The flip side to this is that on average, each physician will have 2,000 patients in his or her practice and will treat over a 100 diseases. Therefore, our challenge is to convince physicians that using an app that is niched to provide care for only one disease or patient will add value to their experience. Again there is a tremendous opportunity for agencies to work with their clients to create apps that provide a more holistic experience for the physician. Physicians are more likely to engage and frequently use an app if it will cover multiple therapeutic areas and drugs, or can accommodate a significant portion of the patients in their practice.

Insights 3: Always vow to do no harm

The healthcare industry is currently transitioning to the use of electronic medical records (EMRs). The ultimate goal is to increase proper recordkeeping, increase the efficiency of the healthcare system, and facilitate physicians’ communicating better within different specialties when caring for patients. One of the frequent asks we get from our clients is, how can we penetrate EMRs to keep our products top of mind for physicians? Well there is no simple answer to this question. The technology is relatively new but it has a lot of potential to keep our clients’ brands top of mind. Opportunities exist to provide “pop-up” alerts about a drug when certain information is entered into the EMR. This can certainly help keep our clients’ drugs top of mind when a physician is filling out a patient’s chart. However, because physicians sometimes consider EMRs to be burdensome to their practice, agencies’ penetration into this space should be seamless, without adding any burden to physician practices.

Recently I was able to integrate these findings into the brand plan for a drug in the oncology space. Our client tasked us with developing three big ideas that would drive their business, considering a strong competitive landscape with increases in the barriers to accessing physicians. To address this, we proposed:

  1. Physician expert videos that could be leveraged on the drug website and on a YouTube channel where physicians could learn from experts about the drug. This allows physicians to hear from experts on their own time without adding significant burden to their workday.
  2. Leveraging EMR alerts to inform drug sales rep when a doctor has a new patient. This allows reps to detail physicians about drugs when it is immediately relevant in practices that are amenable to rep visits.
  3. And finally, to help differentiate the drug from its competitor, we proposed an unbranded platform which leverages the use of an app to provide all the relevant information about treating the cancer and all the drugs available for this cancer. This provides a more robust app that physicians are more likely to engage with and use repeatedly.

Overall our ideas were well received, and we are currently in the processing of fine-tuning the ideas to determine feasibility for next year. Stay tuned!

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Curiosity Taught the Cat

6568523“An endless trail of ideas floats in the ether. You will only see them if you are curious.” I read this in The Eternal Pursuit of Unhappiness book all Ogilvy employees know and love. It got me thinking about curiosity—one of David Ogilvy’s eight habits. Is curiosity an important skill to have in the healthcare communications field?

They say curiosity killed the cat, but I believe curiosity taught the cat (plus, don’t cats have nine lives?). From interning at Ogilvy CommonHealth in the summer of 2014, I can see why curiosity is a must skill to have. In the rapidly changing healthcare field, there are so many aspects to be familiar with. For starters, healthcare reform is constantly changing with new laws and regulations. The pharma market is always evolving with new drugs and medications for patients. Also, the aging population is causing shifts in the demand for certain drugs, devices, and medications. There is always something new you have to keep your eye on in this field, so unless you have the curiosity, you are likely to miss current trends in the healthcare field.

Curiosity as a student

Curiosity helps people grow. In college, I’ve learned that curiosity is best practiced by taking chances. Each semester I believe it is important to take a course that is unrelated to a major or minor. It helps students think outside of the box and get a different understanding about various topics. I’ve noticed that the students who take chances like this in college are the ones who build a well-rounded background.

Curiosity at Ogilvy CommonHealth

I believe being curious is important at Ogilvy CommonHealth too. However, instead of just giving my reasoning, I will share the viewpoints of two others here at Ogilvy:

Jamie Fishman, senior account executive in Payer Marketing, believes we can’t be proactive in this evolving market or even provide value to our clients if we are not curious. There is a difference, however, between being proactive and being curious. Jamie states that questioning or looking into what is known is being proactive, while questioning or looking into what is unknown… that is true curiosity. When we research our clients and understand their industry, we are able to be ahead of the game to serve our clients the best. Jamie stays curious by reading about the work she is involved in and sharing articles with others in order to spark their curiosity. It is no surprise that she believes it is an important skill as well.

Jenita McDaniel, EVP director of operations in Payer Marketing, takes the importance of curiosity a step further. “The people that are curious change the world,” she said, “if our ancestors were not curious, we would not even be here.” It goes to show how brilliant minds are curious. In fact, if our ancestors were not curious, would they have taken risks to explore new life? Would they expand their knowledge to explore the world? Jenita also believes great ideas stem from curiosity; it helps us understand our clients and serve them to the best of our ability. Additionally, Jenita went on to say that curiosity is about taking chances, and those who are curious constantly push the envelope.

I’ll end by sharing a few tips I’ve learned from Jamie and Jenita to help you be more curious:

  1. Read. A lot.
  2. Share what you read with others. Including clients!
  3. Ask questions.
  4. Learn (from any opportunity).
  5. Teach.

I’m sure the more these five tips are practiced, the more curious you’ll become, thus achieving greater results, enhancing intellectual growth, and practicing professionalism.

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Pharmacists — New Agents of Change for Improved Healthcare Delivery?

pharmacist and customerIt is becoming increasingly common to encounter new outlets for healthcare delivery within retail pharmacies, big box stores, supermarkets, etc. This phenomenon is not occurring by happenstance. We often hear there is a growing shortage of physicians, nurses and other healthcare professionals. Now, this shortage is likely to be magnified by the large number of newly insured patients entering the market as a result of the Affordable Care Act. These patients will need new places to seek care and new types of healthcare professionals to care for them.

One site of care that is becoming an increasingly attractive destination for patients is the retail clinic, due to the convenience and quality of service for basic healthcare needs. When we examine the average cost of a minor illness visit across different sites of care, we see that retail clinics provide a viable and cost-effective alternative:

  • Retail clinic: $76
  • Physician visit: $120
  • Urgent care: $121
  • Emergency room: $499

Given the reduced burden on the system, we can expect that healthcare delivery will continue to migrate outside of traditional physician and hospital channels, to non-traditional, lower-cost venues like retail clinics. In fact, the number of retail clinics is estimated to grow 25% to 30% annually to almost 2,900 by 2015. But who is primarily responsible for providing care in these locations?

Most often it is pharmacists who play a very active role in delivering care. They have expanded their role beyond drug dispensing to include medication reviews, providing education materials, administering vaccinations, and more.  Furthermore, they are well-positioned to continue to expand their influence on patient care.

As marketers, we should closely examine the potential role pharmacy could play to improve the quality and cost efficiency of healthcare delivery. As one of the key patient-facing allied healthcare professionals, they should be supported with education and tools that go far beyond their traditional focus on drug dosing and dispensing. Pharmacists have training and access to data that uniquely position them to help improve the patient’s journey from the first prescription after diagnosis, through ongoing adherent treatment, to chronic disease management and/or recovery.

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The Key to Effective “Salesmanship in Print”

Mark Clemente ThumbnailI had occasion to be standing on a gas line in the aftermath of last year’s hurricane—red plastic can in hand. Waiting in front of me was a pharmaceuticals sales rep.

Clearly, we had at least a half-hour before reaching a pump to get our allotted five gallons. Our conversation initially focused on obligatory topics: the massive storm, weather-related energy shortages, the impact of global warming, etc. That lasted all of two minutes. It was time for a more productive dialogue—from my standpoint, at least.

I mentioned that I worked in pharma advertising and that I was supporting a major new drug launch at the time. I seized the opportunity to ask him some questions: When doctors look at an MVA, what do they really focus on? How much do physicians truly probe the key clinical data? When all you have is a two-minute meeting in the hallway, what key information do you try to convey?

He was forthcoming and candid. In just a few minutes, I gained extremely valuable insights—much more than I’d gotten from hours and hours worth of reading voluminous market research decks tied to physician feedback and messaging-related imperatives.

I was immediately reminded of the old Chinese adage…

“A single conversation across the table with a wise (person) is worth a month’s study of books.”

So why is this a blog-worthy anecdote? Because it ties to a less-than-positive trend.

I’ve supported several different brands over the past few years, including having worked on two launches. In that time, there have been many client-sponsored sales events, POAs, and other strategic gatherings that would be highly beneficial for creative and account team members to attend. Unfortunately, rarely am I or my agency team colleagues invited to these types of forums.

By definition, advertising is designed for one purpose and one purpose only: to support the sales process. Indeed, promotional communications have historically been characterized as “salesmanship in print.” It stands to reason that the more sales-focused input we get—and the faster we get it—the better able we’ll be to shift gears (when necessary) and develop print and digital content that best serves the immediate needs of sales representatives.

So why am I—and many of my colleagues—not getting as many chances to directly interface with client-side sales professionals today? The reasons range from budgetary constraints (“We can’t afford to have agency people attend.”) to a possible lack of recognition that we’re strategic partners with our clients (“We just need you to write and design the piece; we’ll handle the strategy.”).

Sure, we get to see huge research binders and PowerPoint decks. And we get to “sit behind the glass” in viewing physician interviews. But it’s not the same as having face-to-face discussions with the sellers in the trenches.

It may be time to reinforce with our clients the importance of having direct contact with the sellers we support. This should be addressed in initial project planning—and it should be considered in the budgeting process if cost is a client concern.

In sum, we need to have more interactions with sales professionals in order to deliver effective “salesmanship in print” … and other channels.

“A single conversation across the table with a wise (person) is worth a month’s study of books.”

The benefits are obvious. (Not to mention the fact that we already have enough reading to do.)

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Falling Into Planning and Landing in Medical School

Would you ever think that a career in planning could end with medical school? Well now you know it can!Doctors_thumbnail

I started working at Ogilvy Heatlhworld as a Science and Research Specialist within the Planning Department approximately four and a half years ago, right after completing my Masters of Public Health degree from Columbia University. One quick email of my resume to a craigslist post, and two weeks later I was working at Ogilvy Heatlhworld.

At the time, I worked with two other research specialists, one a scientist and the other a medical doctor. Our main function was to work with the planners who worked on healthcare accounts to provide scientific and strategic guidance that helped our clients achieve their business goals.

Over the four and a half years, it has been a very rewarding experience. I have worked on accounts across several therapeutic categories, including:

  • Depression
  • AD/HD
  • Gastroesophageal reflux disease
  • Postmenopausal osteoporosis
  • Menopause
  • Nosocomial pneumonia
  • Complicated skin and soft tissue infections
  • Transthyretin familial amyloid polyneuropathy
  • Prostate cancer
  • Immuno-oncology
  • Chronic myeloid leukemia

One of the remarkable aspects of my trajectory at Ogilvy Heatlhworld was that I stumbled into advertising and planning as a career. However, over the past four and a half years I was able to learn about how to gather insights and translate them into best-in-class marketing strategy that has successfully created excellent creative that has transformed our clients’ business. One of the biggest challenges I had as a planner was taking the science and transforming it into something conceptual that helped the creatives develop campaigns across these therapeutic areas. Ultimately I have decided that, like fine wine, planning is just something you get better at with time. Today I can now say I see science differently.

My career plans were to eventually matriculate into medical school. It is with great pleasure, but sadness at the same time, that I share that I will be leaving Ogilvy Heatlhworld this year to attend medical school. My years of listening to patients in market research will definitely help me to be a much keener physician who will take a more holistic approach to treating my patients. But in retrospect, as I look back at my time at Ogilvy Heatlhworld, my experience as a science and research specialist has definitely equipped me with the right skills to become a key opinion leader (KOL) in the future. Outside of the obvious—that is, learning and understanding scientific content at record-breaking speed and simplifying it to a third-grade level—I am now able to:

  • Relearn how to pull an all-nighter to get the job done
  • Critically review fair balance for potential adverse events
  • Think of objections to challenge sales rep when they attempt to detail me about a product
  • To say declaratively…I know Ogilvy Heatlhworld did not produce that creative

Finally, without my experience as a planner, I would not have received my acceptance to medical school. It certainly provided me with great conversation points to discuss during my medical school interviews, which ultimately made my interviews stand out amongst other candidates. For that, I am grateful to Ogilvy Heatlhworld.

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The Parent Factor—How to be a Good Daughter and Pharma Marketer

Patient Doctor ThumbnailWhen my mother was recently diagnosed with COPD, I thought I could help her. We had worked on the gold-standard treatment for a decade, knew the data, the leading clinicians in the field and the course of the disease. However, knowing the answers is one thing, effectively communicating them to a parent is quite another.

Two main hurdles hadn’t occurred to me. Forgive my sweeping generalisations, but I think these may apply to a lot of people of her generation.

Firstly, she has entrenched, hierarchical viewpoints when it comes to receiving health information, namely:

  1. Whatever I say is of no consequence—I am not a medic, I’m her child.
  2. Whatever the nurse says is of no relevance—she is “insolent” and shares anecdotes about her own mother’s illness, which is “inappropriate.”
  3. Despite having a “machine” (MacBook Air), searching the web for relevant information, tools or support doesn’t occur to her.
  4. Whatever the doctor says is sacrosanct (hierarchy is everything), but she’s unlikely to remember it.

Secondly, obtaining an accurate account of what had been discussed during her many consultations was almost impossible. Precise questions such as, “Ask them to give you your FEV score” were met with vague responses: “They wouldn’t give it to me, they said they think it’s that thing—emphysema—they explained what the blood tests were for but I can’t remember what they said,” etc., etc.

Trying to interpret patchy feedback from the consultations was frustrating, especially when it was further confused by her misconceptions. At one stage, she said they thought it was asthma, but this was an assumption she had made because they had prescribed an inhaler which she equates with asthma. My mother is an intelligent woman—it’s just hard to listen and remember everything when you are scared and confused. And the more I speak with her, the more evident it is that she doesn’t understand the disease or the need for treatment: “I’m going to go back and find out just how long they expect me to use this medicine” and “What happens if I don’t take it?”

I spend my working week devising new, innovative ways of communicating health messages to patients—via the media, apps, crowd-sourcing communities, videos, Vine, Twitter—you name it, we’ve done it, but what I’ve learned from this personal experience is that sometimes there is no substitute for clear advice provided directly by an HCP.

What my mother needs is a consultation with a doctor in which he or she clearly explains:

  • The disease
  • The role of treatment
  • The consequences of nonadherence
  • The outlook

All could be covered in a short conversation, but this needs to be given by the doctor and backed up with written information.

My final thought is, wouldn’t it be great if there was a network of impartial adults—call them consultation buddies—available to accompany people to their healthcare consultations and take notes on their behalf? Not to aid diagnosis, but to aid understanding by capturing the relevant information in written form.

If anyone is interested in starting a consultation buddy business, call me!

Questions? Comments? You can contact the author directly at blog@ochww.com.
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Experience-by-Proxy as a Medical Decision Making Tool

computerNow that patient-centered decision making is becoming a reality, it begs the question: are we, as patients, really prepared to make life-or-death decisions on our own behalf?

The biggest problem I have making many of the decisions I am faced with in everyday life, not just in health, is that I simply don’t know enough about the options I’m choosing between. I am fully capable of ordering a cup of coffee—I’ve had lots of different kinds of coffee, and on any given day can be trusted to order myself a latte or a grande or whatever.

But if you ask me something I really don’t know much about, either experientially or theoretically, I’m going to be at sea, metaphorically speaking. To reuse an example I wrote about recently, when my builder asked me if I would prefer for him to install flexible tubing instead of traditional pipes for a new sink, I really didn’t have any idea, at all. He’s the expert, so I asked him what he would do. And he did what anyone might do in that situation—he told me what was good and bad about each, but made it clear that, really, flexible tubing was the bomb. You’d be an idiot not to go with flexible tubing.

And it turns out, he’s wrong. It works fine, but the water tastes like rubber, so you have to let the tap run for about 30 seconds before you fill up a cup of water. Not a huge deal, but what happened is, he gave me advice based on what would work best for him; it’s a lot easier and faster to install flexible tubing, so why not suggest it to me? I mean, he did give me the options, and he told me the truth about each in terms of cost, durability…but he never really told me what it would be like to actually live with a sink that produced water that had flowed through, or worse, sat in, flexible tubing. It was a decision he had to execute—it was a decision I have to live with. There’s a really, really big difference.

This lack of context when making decisions is one of the key problems facing patients who are now tasked with the emerging paradigm of patient-centered decision making, that is, the job of making their own health care decisions. Patients lack the experiential knowledge of what it might be like to live with option A versus option B. Doctors and other health care providers, who are much more familiar with the choices being faced, really never live with the consequences of these decisions, they merely execute or observe them. Just like a plumber, their choices are based on their own interpretation of what is best for the patient, which is probably in some measure based on what makes most sense for them, given that they have to carry out the technical aspects of the decision. This is why we are moving towards patient-centered decision making in the first place, so that the patient can make decisions based on what he or she believes will be best for him or her, given their values, their situation, etc. But if we give patients the kinds of information that doctors use to make decisions, or the kinds of information my plumber gave me about ratings, durability, costs, etc, we’re only helping patients understand the consequences of their decisions from the point of view of someone who doesn’t have to live with them—we’re still not helping them understand what it will be like to live with the consequences of different decisions.

A lot of very important medical decisions are made only once by any given individual, so whereas I might have another sink put in some day and be able to make a second decision differently based on the experiences of the first decision I made, sink-wise—in the medical context, you pick your option and you live with it. We may be providing patients information about these decisions, but in many ways it’s hard to say that the decisions themselves are “informed.”

What we need, then, is some way to give patients a window into the possible futures that might exist for them, depending on which choice they make, which option they follow. Like the Ghost of Christmas Future, we need to have some way to show patients what their lives might be like with choice A, choice B, or no choice at all.

This is, in part, the theoretical underpinning of one of Ogilvy CommonHealth’s two South by Southwest (SXSW) core conversations taking place in Austin, TX, early in March.

One of the best tools for achieving this is video testimonial by patients who have been faced with similar choices, and who made one. These patients can talk from experience about what it is like to make such a decision, why they made it, and what it’s been like since then. Another patient may have made a different choice, and can talk about the consequences of that choice from their distinct point of view. And suddenly a patient who was choosing from medical options based on things like survival rates and risk-benefit can now make decisions based on the experiences of people like them, facing the same issues they faced; people living with the consequences of their choices, for better or worse. This we call “experience-by-proxy”—borrowed experience, which allows you to gain knowledge of a path followed before you follow it for yourself.

These experiences-by-proxy won’t necessarily help make the decision for you, but they can make your decision more grounded in reality. If you are unsure if you need a hip replacement, and watch several videos, one of which has a patient saying, “It changed my life, I have no idea why I waited so long,” and another of which says, “It was horrible, I should have waited longer, and here’s why…”, you may still have conflicting opinions. You may still want a better quality of life with a new hip, but fear the consequences of an operation that is never guaranteed to go right. You may still be on the fence…but at least now you have a clearer vision of what it would be like to live with the option to go forward with hip replacement, and to put a face and a life to the theoretical risk and benefit you considered earlier.

To learn more, go to http://schedule.sxsw.com/2013/events/event_IAP7391

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Getting to Know Patient Bloggers

How can we engage with online health activists and patient bloggers? This is a question our pharma clients are asking more and more frequently. But maybe the first question we should all be asking is: Do online health activists and bloggers want to engage with pharma? Increasingly the answer is yes, but there are a couple rules of engagement, as we have learned from discussions with bloggers.

1. It’s OK to listen, but don’t just eavesdrop.

Health activists and bloggers are well aware that pharma companies are listening in social media channels to gain insights into how people view their company and their products. But there is a difference between being listened to and being heard. Bloggers value the response and comments they get from their community, that’s why they do what they do—to be connected. And generally that goes for pharma too—an authentic, personal conversation will usually be greeted positively.

2. They are not journalists, they are people telling stories.

Many bloggers are happy to receive information from pharma companies, but they don’t want to be sold to.  They are not in the blogging business to promote drugs or devices—they got into blogging because they want to tell their personal story because it helps them cope, because it helps them connect with other people. So they might be interested in hearing about a new treatment that can make a difference to themselves or their peers. But they don’t want to be sent a press release; they would rather have content in a format that is appropriate to share with their audience, using the right language, tone of voice and level of detail.

3. Not all engagement takes place online.

Bloggers are social by nature—they are reaching out to networks and communities of people because they want to converse and share. This means that they also like to meet up in person—with pharma as well. The most successful way pharma has been engaging with bloggers and activists is in the real world, via blogger summits. Providing an opportunity for bloggers to get together in person can be transformative, not only for the bloggers who for the first time can get to shake hands with someone they have been conversing with virtually for years, but also for the sponsoring company, which can gain priceless information, insight and goodwill.

At the end of the day, sometimes the most effective engagement is the old fashioned kind: authentic relationship building, where the two parties listen and respond to each other in a spirit of mutual trust.

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