Broadening the RWD conversation

There can be few pharma CEOs who are not acutely aware of the data revolution exploding around them and the need to enhance their data analytics capabilities. But technical expertise is only one aspect of a much broader conversation that more people within pharma need to take part in. Jacky Law reports.

The imperative to make healthcare dollars more accountable is gathering pace at an alarming speed, on various fronts and in countries around the world. Data in its myriad forms is leading the charge. As Kingsley Manning, chair of the UK’s Health and Care Information Centre, recently said, “The use of data is likely to be as important in healthcare in the 21st Century as the pharmaceutical revolution was in the 20th.”

In these early days of utilising digital data, the real-world picture of healthcare is emerging from highly nuanced perspectives. Everyone has their own reasons to explore it. Pharma wants its products to have the best positions on formularies and a green light from healthcare technology assessment agencies. Payers want the lowest prices, providers want the best health outcomes and patients just want to be well at the least cost to themselves.

“Work continues apace to construct information highways capable of linking disparate datasets to drive changes”

Meanwhile, work continues apace to construct information highways capable of linking disparate datasets to drive changes in care protocols, in how physicians are assessed, in identifying best practices and, ultimately, in ensuring money follows value rather than the mere provision of goods and services. This is already happening and can be seen in, for example, the US Centers for Medicare & Medicaid Services recently releasing reimbursement information to providers and asking physicians to justify high-spend practices.1 There are many other examples.

At the same time, new and powerful players such as Google are entering the fray. These technology giants have radically different ways of thinking about healthcare, as well as the means and incentive to shape how treatment evolves in a digital age. Then there are the patients who, via the mobile phone and the tech companies, have prompted a whole raft of new technologies that is shattering conventional understandings about medical authority and influence, about where patients should be treated, how they should be treated, even what it means to be well.

Pharma companies recognise the changing healthcare landscape but adjusting is not easy. As the consultancy McKinsey & Co pointed out recently, “The reality is that today’s organisations were simply never designed to change proactively and deeply – they were built for discipline and efficiency, enforced through hierarchy and routinisation. As a result, there’s a mismatch between the pace of change in the external environment and the fastest possible pace of change at most organisations. If it were otherwise, we wouldn’t see so many incumbents struggling to intercept the future.”2

“Pharma should be thinking in terms of the impact of RWD on whole health economies rather than simply about how they can get their medicines on to formularies”

Companies naturally focus their efforts to make sense of real-world data (RWD) on immediate interests such as market access. But at a time of such transformational change this only confounds efforts to grasp the bigger picture and make the appropriate operational adjustments. Simon Hammett, CEO of Monitor Deloitte Europe, articulated this well in a report entitled Reality Medicine where he was quoted as saying that pharma should be thinking in terms of the impact of RWD on whole health economies rather than simply about how they can get their medicines on to formularies. “We hide behind products and how they are assessed but there is a huge amount to learn about patient care,” he said. “The technology platforms are there but we should be thinking in a 20-30-year time frame. We need bigger ambitions.”3

Those ambitions concern how pharma companies can revolutionise themselves for an entirely new world. That world will be shaped by the treatments and practices that lead to the best patient and population outcomes. Companies, like everyone else in healthcare, are being led by data revealing what works best towards that end. While that certainly raises the demand for data analysts it also suggests more bridges need to be built between the commercial and R&D sides of the organisation so that everyone appreciates, and can contribute meaningfully to, the general effort to source RWD and derive maximum value from it.

That value is only partly in getting drugs reimbursed. In the bigger picture it is about effecting real cultural changes in how the medicine business works in a digital age. The strongest message of the Reality Medicine report is that everyone in pharma needs to be involved, that efforts to embrace these new and abundant flows of digital data should work to break silos, not create new ones. This, as it happens, is also the exhortation of the McKinsey consultants who argue for a change platform defined as “one that allows anyone to initiate change, recruit confederates, suggest solutions, and launch experiments”. How that is achieved is anyone’s guess but opening up the RWD conversation to everyone in the company is certainly a step in the right direction.

References

1 (November 2014) A digital prescription for pharma companies. McKinsey & Co. Retrieved at: http://www.mckinsey.com/Insights/Health_systems_and_services/A_digital_prescription_for_pharma_companies?cid=DigitalEdge-eml-alt-mip-mck-oth-1411

2 (October 2014) Build a change platform, not a change program. McKinsey & Co. Retrieved at: http://www.mckinsey.com/insights/organization/build_a_change_platform_not_a_change_program

3 (June 2014) Reality Medicine: How payers, regulators and pharma are working with real-world data. Pharmaphorum.

About the author:

Jacky has been writing about pharmaceuticals since joining Scrip Magazine in 1998, before becoming a regular columnist for Pharmaceutical Executive. From 2010 to 2013 she wrote industry reports for FirstWord.

At pharmaphorum Jacky is leading the production of unique and insightful research reports covering the key issues impacting the global pharmaceutical industry.

You can follow her on Twitter here.

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