Partnerships for prevention: Biopharma, patients, and digital technology
Anthropy23 returned to The Eden Project in Cornwall for its second year in November, once more bringing together cross-industry companies and individuals united in a shared goal: to seek sustainable change, both in Britain and globally.
With this mindset, the Adelphi Group sponsored a panel of experts across the biopharmaceutical industry and healthcare. This year’s focus – as chair of the panel, CEO of Adelphi Group Stuart Cooper, noted – was the incredibly topical theme of prevention, which has become a governmental and nationwide issue in terms of higher quality lives, better use of resources, and improved financial investment. In particular, the panel explored how a healthier society can be created through prevention strategies that biopharma collaborates in and supports across the stakeholder spectrum.
Included within that discussion was the socioeconomic impact of healthcare systems that currently do not operate preventatively, and the benefits that nations and societies stand to gain if the cause of prevention is truly taken up and tangible action implemented now. No longer can healthcare as ‘sick care’ be permitted to remain: now is the time for a health-promotive system.
As discussions revealed, what this requires is organisational strategy that brings together biopharma with healthcare and with patients, also. It is a system shift, a restructuring to encompass the crucial factors of prevention, yes, but also patient advocacy, digital technology, and collaboration. In short: purpose, vision, and strategy put into action now, with and for patients.
Prevention: A ‘whole-of-society’ approach
So, how can biopharma work with these other bodies and approaches for better prevention?
The World Health Organization (WHO) is clear on the criticality of prevention when it comes to pandemic-preparedness, and it is equally clear on the role of preventative measures when it comes to primary healthcare, stating that it requires a ‘whole-of-society’ approach to effectively organise and strengthen national health systems to bring services for health and wellbeing closer to communities – including “empowering individuals, families, and communities to take charge of their own health.”
The rationale, then, is clear, including the economic argument and that of resources, in addition to personal arguments of individual health. However, this is not only in terms of “primary prevention” (acting across the population to reduce risk of disease), but also “secondary prevention” (halting progression to more serious or burdensome consequences).
While this sounds logical and simple, there nevertheless seems to be a roadblock to change. So, what else is needed? Philosophically and societally, Helen McDowell, Head of Government Affairs & Global Public Health at ViiV Healthcare comments that, “We look at preventative healthcare as a cost, rather than an investment for future healthy societies, economic growth, and prosperity.”
ViiV Healthcare is a pharma company 100% focused on HIV, with a target to end HIV and AIDS as a public health threat by 2030. Still over a million infections a year away from target, that means investment in prevention is critical. But, looking broadly at Organisation for Economic Co-operation and Development (OECD), high-income countries, they invest less than 3% of public health spending on prevention: public policy and institutional positioning around prevention are needed.
A shift is needed away from such a dominant focus on treatment, which systems are traditionally set up for , to focus on prevention as well, McDowell says. The biopharma industry plays a role developing preventative innovations and catalysing and enabling, systemic change through research and pilots. It will therefore take significant collaboration, that harnesses the power of partnership with community groups, policy makers, healthcare providers and other stakeholders, to not just accept a “50-year-business-as-usual-, treatment-focussed approach to healthcare.”
For McDowell, then, prevention is an openness to engagement and having difficult conversations: “It’s not always comfortable, but it’s productive and drives change and progress. If you don’t stop to understand the realities impacting preventative healthcare, you’re operating in a silo.”
Dr Sebastian Vaughan, CEO of Phytome Life Sciences, cites Western cultural beliefs as a major challenge in preventative healthcare. He notes as individuals, communities and healthcare systems around the world face rapidly escalating complex chronic conditions of the mind and body, the patient cannot be disempowered by the service or assumed “well” until presenting at clinic. Pathways toward health, wellbeing, and human flourishing remain underappreciated within conventional practice among the biomedical, public health, and policy communities. Dr Vaughan believes there is a critical mindset shift in both the healthcare system and the public it serves to achieve the full potential of prevention.
It is also clear that certain botanical medicines reliably induce valuable psychological, immunological and neurological effects that can generate positive effects on health and well-being. Both traditional knowledge systems and illicit patient usage can be rich sources of ethnobotanical expertise and signals of therapeutic efficacy that can enable safe, efficacious and financially viable breakthrough prescription reimbursable medicines and treatment modalities to be developed.
Dr Vaughan proposes a much bolder agenda for botanical medicine research in the UK that engages with patient knowledge and leverages our world-leading life sciences expertise across the plant and biomedical sciences.
The patient is fundamental and, when choosing therapy to prevent progression, quality of life is often far more important than striving for cure, something which is often overlooked in Western attitudes to medicine. Vaughan referred to a past experience in oncological research, seeing cancer patients bed-bound on opioids, who, when moved to cannabinoid-based medicines, were able to go home and “walk around and enjoy their lives.”
For Vaughan, prevention is a means by which quality of live is fundamentally improved: “Healthspan is more important than pure lifespan at any cost.”
Patient advocacy: Driving the prevention agenda forwards
How, then, can patient advocacy play a more proactive role in preventative care?
Patient advocacy increases the voice, agency, and visibility of people living with or impacted by preventable diseases to secure support for and design and deliver prevention services that are integrated into public services and settings (beyond clinical settings). According to McDowell, it will help to drive demand and uptake and empower people to take preventative actions: “In HIV, we work with the community to design programmes that use the language, approaches, and channels that will appeal to people who can benefit from them.” If pharma isn’t using patient language, and using only medical language, then it won’t work.
Meanwhile, Vaughan insists that deep engagement of patients at every stage of biopharma development and deployment of medicines is critical to achieve a quantum leap to recognising and valuing patient-centred experiential cures. After all, the lived experience is a vital element, and patients must be front and centre, and on the team. There has been a sea change in how they’ve been regarded historically, and are known and recognised now for their insights – driving the overall agenda forwards.
Dr Sophie Castell, CEO of the charity Myeloma UK explains the increasing role played by patient advocacy groups, not just in providing support for patients, families, and carers, but significantly in advocating for access to treatment for patients, working with industry partners and healthcare providers to propel investment in this. Their in-house applied health research and advocacy teams use their knowledge of patients’ lived experiences, combined with an understanding of the basic biology of myeloma to provide a more complete and informed view of emerging and unmet need for myeloma patients. In short, Myeloma UK are experts at the heart of a collaborative process, their ethos driven by the needs of that specific community.
Myeloma is an incurable, relapsing-remitting blood cancer. In terms of prevention, the focus has historically been secondary prevention: early diagnosis and prevention of disease progression. There is a lot of evidence of the damage myeloma can do if not caught early enough. For example, patients who are in remission from their myeloma, but who have already suffered renal damage requiring daily dialysis. This highlights that, in spite of this being an incurable condition, early diagnosis is incredibly important to individual quality of life – and the socioeconomic benefits connected with that. One challenge of secondary prevention in a relapsing condition is the need for a consistent pipeline of innovation.
Castell believes that groups like Myeloma UK, which provide expertise in the lived experience of a condition, can assist in prevention of a condition in two specific ways, therefore: early diagnosis, by understanding people’s experiences and downstream, by identifying the barriers to the implementation of a screening or prevention programme, for example cultural or access issues which drive many inequalities. Castell’s advice is to engage early: “Engage patients and patient organisations as early as possible, so that you build prevention strategies off the best insight and enable effective implementation.”
Digital technologies in the spotlight
In conjunction with these, how then can digital technologies be adapted for greater success in the preventative pathway? Many have deemed technology as the silver bullet for prevention, but there is limited evidence and still some way to go.
In terms of prevention in the early stages of digital revolution in healthcare, Fiona Campbell, Head of Communications, Public Affairs, and Science & Sustainability at Bayer UK notes that there are, however, already some 350,000 healthcare apps available and five million people downloading healthcare apps every single day. It’s clear there is an opportunity to reach people at scale in a way that is difficult for healthcare systems to mirror, she says. Indeed, there’s the potential to reach 13 million people at risk of diabetes in a way the healthcare system just can’t.
Healthcare systems have always really struggled to treat a person holistically, instead of one condition at a time. So, digital and AI solutions have potential to aid healthcare systems in putting the patient at the centre. AI can potentially help in conditions where treatments are available, but where early diagnosis is vital to successfully arrest the degenerative effect of a disease – finding patients early is essential for making the treatments a success. Much of AI product development is in diagnostics, as the diagnosis pathway is often the bottleneck that AI could help to unblock.
The best investment in AI and digital for biopharma is for industry to work in partnership with digital technology experts, rather than employing their own. The digital tech partner, looking at the other side, also needs biopharma in order to understand how to conduct patient trials and the navigation of licensing systems and the regulatory landscape for medical interventions, as well as navigation of the healthcare system for uptake of innovation.
Significant opportunity also lies in digital solutions that help the patient and physician to work together. Vaughan suggests leveraging technology to deliver personalisation in the patient-healthcare system feedback loop. An example of this is Bayer’s work on a companion device in chronic kidney disease, which can log information on the patient’s condition such as test results for urine and kidney function, and medication adherence via an app. In the future we can imagine that HCPs could have access to the data and intervene when the patient requires medical attention, which could address one of the biggest challenges – adherence to treatment – and potentially improve outcomes.
As Campbell notes, digital solutions need to be user centred, but also require a trusted quality control system to enable healthcare professionals to ‘prescribe’ them and advise patients. Healthcare professionals also need training to identify patients where digital tools are appropriate and not masking or exacerbating health inequalities. The Treasury and the Department of Health and Social Care need to work with industry to create the funding models to stimulate development of scalable prevention tools, taking a long-term perspective on ROI. Additionally, digitally enabled solutions regulation needs to facilitate the ability to refine algorithms and models based on real-world outcomes and feedback through regular assessment of the effectiveness of AI-based preventive interventions.
Collaboration and courage
What is clear is that biopharma must work in partnership with healthcare systems and with patients to embrace and advance the prevention agenda as a priority to get ahead of disease together. This is what was emphasised and made clear at Anthropy23. It will require a shift in organisational strategic focus, it will be a challenge, but embracing change is the essence of what the industry does.
This is the call to action, then. As Stuart Cooper, CEO of Adelphi summarises, it requires cross-nation and international alignment and long-term continuance. Collaboration, partnership, between all stakeholders, state and regional leadership, healthcare systems, biopharma and patient groups – undertaken with courage and determination – is the future framework.
A healthy community is a healthy economy: enough words, now is the time for action.
This was one of three sessions on the future of our health needs, including robotics/AI and the role of charities with healthcare providers, supported by Adelphi at Anthropy.
About the session chair
Stuart Cooper is CEO of Adelphi Group, which comprises ten businesses based across Europe and the US specialising in the healthcare sector and providing services across the strategic drug development and launch lifecycle. Prior to his current role at Adelphi, Cooper was MD and founder of Adelphi International Research, and chairman and founder of Adelphi’s JV health outcomes enterprise Mapi Values (now Adelphi Values), as well as MD of Adelphi Communications. He holds a BSc in Economics and Politics from the University of London and is a member of the Leaders Council of Great Britain and the Royal Society of Arts on behalf of Adelphi. Additionally, Cooper is chairman of Ambassadors of East Cheshire Hospice, widening impact on later life care. Adelphi Worldwide are a global healthcare network and part of Omnicom Group Inc.
About Adelphi Group
The Adelphi Group provides a wide range of strategic support services and consulting for global pharmaceutical clients. Adelphi is dedicated to the healthcare sector, providing services across strategic marketing, marketing and business intelligence, real-world observational research and disease-specific programmes, health and economic outcomes, market access, pricing and reimbursement, value insight, multi-channel health communications, scientific services, medical education, and strategic product development consultancy. Headquarters are located in Manchester, UK and New York with network offices throughout Europe and the US. The Adelphi Group employs over 1,100 people worldwide.