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The 5 big pitfalls to avoid for successful patient support programmes", by Nagore Fernandez, Ashfield Head of Clinical Services in Europe

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Ashfield Head of Clinical – Europe, Nagore Fernandez, presented at eyeforpharma 2017, sharing learnings from Ashfield’s 15 years of experience delivering patient support services. The presentation covers how to design, deliver and measure a truly differentiated patient support programme, as well as practical do’s and don’ts for success.

#e4pbarca #unitepharma, adherence, behaviour change, eyeforpharma 2017, patient enrolment, patient outcomes, patient support programmes, psp,

Published in: Healthcare
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The 5 big pitfalls to avoid for successful patient support programmes", by Nagore Fernandez, Ashfield Head of Clinical Services in Europe

  1. 1. www.ashfieldhealthcare.com The five big pitfalls to avoid for successful patient support programmes Nagore Fernandez Head of Clinical Services - Europe
  2. 2. www.ashfieldhealthcare.com2 : Part of UDG Healthcare plc Adherence: the numbers are staggering Non-adherence costs EU governments an estimated €125 billion annually1 Non-adherence contributes to nearly 200,000 premature deaths a year in Europe1 The top 3areas driving non-adherence costs are diabetes, high cholesterol and high blood pressure/heart disease…2 1 http://www.efpia.eu/topics/people-health/patient-adherence 2 Viewpoint: How NonadherenceIs KillingUs—and What Can Be Done (RobertNease,Express Scripts ) 3 https://www.oncolink.org/healthcare-professionals/o-pro-portal/articles-about-cancer-treatment-and-medications/patient-adherence-to-oral-cancer-therapies-a-nursing-resource-guide 4 CapgeminiReport,2015 Estimated annual pharmaceutical revenue lossdue tomedication non-adherence4 In Europe, 50% of patients don’t take their medicines as prescribed1 Even with the seriousness of a cancer diagnosis, adherence rates can be as low as 20% 3
  3. 3. www.ashfieldhealthcare.com3 : Part of UDG Healthcare plc The problem can’t be solved in the doctor’s office alone 1 Lapane KL, Dubé CE, SchneiderKL, et al. Misperceptionsof patients vs providersregarding medication-relatedcommunicationissues. Am J Manag Care. 2007; 13(11):613–618. 2 Tarn DM, et al. How much time does it take to prescribea new medication?Patient Educ Couns.2008;72:311–319. of patients would never tell their doctor they did not plan to fill the prescription just written for them1 83% 74% of doctors believe their patients are taking their medicine1 On average, doctors spend only 49 seconds discussing all aspects of newly prescribed medications2
  4. 4. www.ashfieldhealthcare.com4 : Part of UDG Healthcare plc There’s no magic switch… …but we want to share our best advice based on 15 years supporting patients
  5. 5. 5 : Part of UDG Healthcare plc www.ashfieldhealthcare.com The five big pitfalls to avoid for successful patient support programmes (PSPs) 2 Working in silos – inside and outside of your organisation 3 Underestimating how difficult it is to change behaviour 4 Managing channels and data in isolation 5 Designing a fantastic programme – but no patients enrol!
  6. 6. www.ashfieldhealthcare.com: Part of UDG Healthcare plc6 1 Failing to demonstrate return on objectives Two main reasons why this is a common failure Because the objectives were not right in the first place Because we failed to have the systems in place to capture or report on the objectives,in the right way 1st 2nd
  7. 7. www.ashfieldhealthcare.com: Part of UDG Healthcare plc7 1 Failing to demonstrate return on objectives Let’s consider… Other stakeholders’ journeys Product lifecycle Health outcomes Therapy failure points Patient journey Quality of life Value per patient Define the objectives upfront – why a PSP?
  8. 8. www.ashfieldhealthcare.com: Part of UDG Healthcare plc8 1 Failing to demonstrate return on objectives Return on investment Cost-efficiency Sales performance Market share Performance indicators Quality Productivity Clinical Commercial Patient reported outcomes e.g. QoL Clinical outcomes Length of time on treatment Adherence and persistence Drop-off rates Site enrolment Patient enrolment Service uptake by patient Patient satisfaction HCP satisfaction Compliance ADE / PTC reporting Decide how you will measure success
  9. 9. www.ashfieldhealthcare.com: Part of UDG Healthcare plc9 1 Failing to demonstrate return on objectives Regulatory dossiers e.g. post-marketing surveillance studies Pricing and reimbursement Scientific publications Generate data that drives value
  10. 10. 10 : Part of UDG Healthcare plc www.ashfieldhealthcare.com 3 Underestimating how difficult it is to change behaviour 4 Managing channels and data in isolation 5 Designing a fantastic programme – but no patients enrol! Failing to demonstrate return on objectives 1 The five big pitfalls to avoid for successful patient support programmes
  11. 11. www.ashfieldhealthcare.com: Part of UDG Healthcare plc11 2 Working in silos – inside and outside of your organisation Engage with your internal stakeholders – why a PSP? Who are your internal stakeholders?
  12. 12. www.ashfieldhealthcare.com: Part of UDG Healthcare plc12 2 Working in silos – inside and outside of your organisation Medical department HEOR department Commercial department Engage with your internal stakeholders – why a PSP?
  13. 13. www.ashfieldhealthcare.com: Part of UDG Healthcare plc13 2 Working in silos – inside and outside of your organisation Medical department HEOR department Commercial department Engage with your internal stakeholders – why a PSP? What does success look like to them?
  14. 14. www.ashfieldhealthcare.com: Part of UDG Healthcare plc14 2 Working in silos – inside and outside of your organisation Brand recognition Medical department HEOR department Commercial department Health outcomes Quality of life Reimbursement Demonstrate product value Adherence to medication Market share Safety information Control of adverse events Publications Switch prevention Rx sales Added value Engage with your internal stakeholders – why a PSP?
  15. 15. www.ashfieldhealthcare.com: Part of UDG Healthcare plc15 2 Working in silos – inside and outside of your organisation Payers/ health systems Nurse Caregivers Prescribers and HCPs Patients Patient groups Pharmacy Support Help Empowerment Disease education Human interaction Simplicity Administration Care Coordination Cost- effectiveness Value Access Real world data Adherence Support Help Simplicity Human interaction Value Care Access Coordination Patient monitoring Time saving Real world data Adherence Care Disease awareness Disease education Access Disease education Care Adherence PSP Engage with your external stakeholders – why a PSP?
  16. 16. 16 : Part of UDG Healthcare plc www.ashfieldhealthcare.com 4 Managing channels and data in isolation 5 Designing a fantastic programme – but no patients enrol! Failing to demonstrate return on objectives 1 2 Working in silos – inside and outside of your organisation The five big pitfalls to avoid for successful patient support programmes
  17. 17. www.ashfieldhealthcare.com: Part of UDG Healthcare plc17 3 Underestimating how difficult it is to change behaviour Meet Alan and Ben envious | stubborn | critical impulsive | industrious | intelligent This example is taken from research conducted by Solomon Asch and discussed in Thinking, Fast and Slow by psychologist Daniel Kahneman. intelligent | industrious | impulsive critical | stubborn | envious Alan Ben
  18. 18. www.ashfieldhealthcare.com: Part of UDG Healthcare plc18 3 Underestimating how difficult it is to change behaviour Now, let me ask you a question: who do you like better, Alan or Ben? This example is taken from research conducted by Solomon Asch and discussed in Thinking, Fast and Slow by psychologist Daniel Kahneman. If you are like most people, you viewed Alan much more favourably than Ben Now look again at their characteristics; they are identical but in reverse order. It makes no rational sense envious | stubborn | critical impulsive | industrious | intelligent intelligent | industrious | impulsive critical | stubborn | envious Yet in formal psychological studies, people time and again prefer Alan to Ben. The first traits in the list influence the interpretation of the traits that appear later This isn’t logical, but people are not always rational and their decision-making is complex We need to be sophisticated about how we understand behaviour and try to change it.
  19. 19. www.ashfieldhealthcare.com: Part of UDG Healthcare plc19 3 Underestimating how difficult it is to change behaviour The key ingredients to successfully change behaviour
  20. 20. www.ashfieldhealthcare.com: Part of UDG Healthcare plc20 3 Underestimating how difficult it is to change behaviour Nothing can replace insights from real people
  21. 21. www.ashfieldhealthcare.com: Part of UDG Healthcare plc21 3 Underestimating how difficult it is to change behaviour Use a tried-and-tested behavioural change model – we use COM-B Work with experts in behavioural change and health psychology Create segments and personas to make sense of the insights – and provide something tangible to design solutions around Turn the insights and data into something meaningful to inform tailored PSP design
  22. 22. www.ashfieldhealthcare.com: Part of UDG Healthcare plc22 3 Underestimating how difficult it is to change behaviour Design Insight Feedback loop Embed behavioural change into every aspect of programme design Individual care plans Patient data Communication channels Frequency Messages Delivery Operational Clinical Behaviour change ExpertiseInput
  23. 23. www.ashfieldhealthcare.com: Part of UDG Healthcare plc23 3 Underestimating how difficult it is to change behaviour “How important is taking this medication to you?” “Tell me about the benefits of taking your medication and any problems…” “That sounds really tough especially when nobody in your family has this” Make every touchpoint count – nurse training
  24. 24. www.ashfieldhealthcare.com: Part of UDG Healthcare plc24 3 Underestimating how difficult it is to change behaviour Make every touchpoint count – the look, feel and messaging of patient materials
  25. 25. 25 : Part of UDG Healthcare plc www.ashfieldhealthcare.com 5 Designing a fantastic programme – but no patients enrol! Failing to demonstrate return on objectives 1 2 Working in silos – inside and outside of your organisation 3 Underestimating how difficult it is to change behaviour The five big pitfalls to avoid for successful patient support programmes
  26. 26. www.ashfieldhealthcare.com: Part of UDG Healthcare plc26 4 Managing channels and data in isolation The disadvantages of managing channels and data in isolation PATIENT Telephone calls from Call Centre Connected devices (e.g. wearables) In-home administration /education by field nurse Educational printed materials Pharmacy intervention Hospital administration and training by field nurse Patient and HCP web portal Email/post communication Reminder text service Mobile app DATA DATA DATA DATA DATA DATA DATA DATA DATA DATA
  27. 27. www.ashfieldhealthcare.com: Part of UDG Healthcare plc27 4 Managing channels and data in isolation The disadvantages of managing channels and data in isolation PATIENT Telephone calls from Call Centre Connected Devices (e.g. wearables) In-home administration /education by field nurse Educational printed materials Pharmacy intervention Hospital administration & training by field nurse Patient & HCP web portal Email/post communication Reminder text service Mobile App DATA DATA DATA DATA DATA DATA DATA DATA DATA DATA No single view of patient Nurse/care coordinator role is limited Patient experience can feel disjointed More difficult to measure success Suboptimal operational efficiency
  28. 28. www.ashfieldhealthcare.com: Part of UDG Healthcare plc28 4 Managing channels and data in isolation COLLECT, STORE AND ANALYSE REAL-WORLD DATA DATA The vision for integrated, multichannel PSPs PATIENT
  29. 29. www.ashfieldhealthcare.com: Part of UDG Healthcare plc29 4 Managing channels and data in isolation An integrated platform provides live data and real world evidence Global reporting capability Data can be filtered or drilled down Data trends and BI analysis All data can be converted into reports Reports delivered across multichannel devices
  30. 30. www.ashfieldhealthcare.com: Part of UDG Healthcare plc30 4 Managing channels and data in isolation Benefits of a single platform and single provider Benefits of a single platform Single view of patient Empowered nurse/care coordinator and patient Seamless patient experience Proven PSP value Operational efficiency
  31. 31. www.ashfieldhealthcare.com: Part of UDG Healthcare plc31 4 Managing channels and data in isolation Benefits of a single platform and single provider Benefits of a single provider Service provision and scalability Expertise and experience Relationship management Strategic partnership Local country compliance and global reporting
  32. 32. 32 : Part of UDG Healthcare plc www.ashfieldhealthcare.com Failing to demonstrate return on objectives 1 2 Working in silos – inside and outside of your organisation 3 Underestimating how difficult it is to change behaviour 4 Managing channels and data in isolation The five big pitfalls to avoid for successful patient support programmes
  33. 33. www.ashfieldhealthcare.com: Part of UDG Healthcare plc33 5 Designing a fantastic programme – but no patients enrol! Commercial field force Prescriber and HCP Patient Clear benefits statement Time saved per patient Feedback loop Not competing but complementary Buy in from KOL Minimise enrolment information / actions for HCP PSP embedded in strategy PSP as an added value tool Equipping and training the field force Utilise customer service team Tailored messages and imagery Multichannel opt-in options On-pack information Patient education / association link Easy consent process Break the barriers to enrol…
  34. 34. 34 : Part of UDG Healthcare plc www.ashfieldhealthcare.com I attribute my success to this; I never gave or took any excuses Florence Nightingale “ ”
  35. 35. www.ashfieldhealthcare.com Thank you www.ashfieldhealthcare.com @AshfieldCM @nagofdez Nagore.Fernandez@ashfieldhealthcare.com

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