Behaviour science: the new capability every pharma company should be building

Mark Lightowler takes a look at why medical interventions are evolving beyond drugs to also help patients change behaviours that impact their disease.

The industry is going through huge, rapid changes at the moment, with digital tools replacing many traditional communications activities and even acting as dedicated therapies – with the resulting Big Data sets requiring companies to build dedicated data science capabilities.

Another related trend is to hire engagement specialists – people who can connect the digital capabilities, their data and the insight they create to build better engagement across the pharma communication spectrum.

However, it is still uncommon to find pharma companies targeting the very nature of what their strategy demands. It seems strange that there is still a lack of capability towards understanding human behaviour.

Our understanding of human health has improved through in-depth knowledge of anatomy and biochemistry. However, to make healthcare accessible, we have developed a view of health that follows a relatively simple, serial approach when thinking about the causes of disease and their treatment.

The reality is that health exists in parallel complexity with biochemical changes being affected by the environment and patient behaviour. Many systems are interacting together to create and resolve health issues.

This more holistic view of health is helping us gain a greater appreciation of how to improve health outcomes. For its part in the healthcare system, behavioural sciences are tackling big questions like how to improve medication adherence, physical activity, nutritional choices, smoking cessation, vaccination, and keeping appointments, amongst others. Health outcomes are often improved by a system’s ability to detect change early in its course. Our ability to get data from patients through PROs and connected devices is limited by our ability to provide engagement tools that improve uptake of these methods.

A deeper look at many diseases shows that patients' behaviour before the disease begins during diagnosis and initial treatment though to maintenance and treatment changes is a contributing factor behind the success and failure of medical interventions. Sometimes this is conscious behaviour, but very often our behaviour starts beyond our conscious control. If we are to make the best of the advances in human health and disease control we must understand how we can make the choices that optimise our chances as patients of a positive outcome.

There is a key behavioural component in many diseases. In asthma, compliance and adherence determine long term outcomes. In diabetes, food and nutrition choices are as important as blood glucose regulation, and for many behavioural change programmes may help patients avoid or delay pharmacotherapy. There are disease-monitoring behaviours that promote better outcomes in cancer, many dermatology diseases and mental health that are all showing promise in improving patient outcomes.

It is not only patient behaviour that is under investigation regarding how their behaviour affects outcomes, though. Physicians, nurses and payors all have contributing behaviour that affects patients. Bringing these insights together with researched ways of creating interventions to enable positive behaviour change looks to be a promising way of improving outcomes.

Brand teams therefore need to have people whose role is to understand patient behaviour, why they do and do not follow medical advice and how best to help them make better health decisions. These people will go beyond traditional market research to uncover the basis of behaviour and plan how to positively influence it. We will see them start to work with research teams early on in drug development, employing skills from ethnography, anthropology, linguistics and digital technology to build better pictures of patient choice. Armed with this they will begin to influence the design of clinical trials using behavioural insights as drivers to study the effect of combined drug and behaviour change interventions.

With this ongoing research, pharma companies will be able to design digital therapeutic offerings with and without pharmacotherapy. As with the recent trend for companies like Pear Therapeutics, prescription digital therapeutics will become reimbursable.

Developing capabilities in behavioural science will underpin pharma companies' need to help physicians and patients make changes that improve health outcomes. These capabilities can be useful for supporting positive change in health behaviours like taking medicine at the right time.

Behavioural science can also be used to assess brand strategy and tactics. Analysis of brand plans using a behavioural science lens often shows disconnects between the two, with the majority of pharma brand tactics unable to support the behavioural change the brand strategy demands for success. Audits of brand plans show an overwhelming reliance on education and information. While there is a role for these in behavioural change, there are many other aspects that should be taken into consideration for sustainable change to occur.

It is easy to see the current lack of understanding concerning the importance of employing behavioural science to health outcomes in medicine. A quick look at pharmaceutical communications, websites, apps, packaging, patient information and medical exhibitions shows little consideration for the need to change human behaviour in their planning. Building these new capabilities into the heart of pharma companies as a core capability will help them address this gap and help them improve health outcomes in a way that chemistry on its own cannot.

Like most industries, pharma must evolve to remain relevant, and this is one direction the industry will have to look at in the near future.

About the author

Mark Lightowler is the CEO of Phorix, a behavioural change design agency. They work with patients, physicians and pharmaceutical companies to improve health outcomes through behaviour change design and are based in Basel and London.