How pharma can support patients: Dr Tony Dhillon

Jacky Law talks to consultant clinical oncologist Dr Tony Dhillon about how pharma companies can better support patients with rare cancers.

In the latest in a series of interviews with Doctors.net.uk members about pharma's role in supporting patients, Dr Tony Dhillon highlights the role of education.

Interview summary

JL: Can you describe the biggest challenges in your therapeutic area in terms of how pharma companies might be able to help?

TD: I work as a medical oncologist in a district general hospital that is also a cancer centre in the south-east of England. My focus is on relatively rare cancers such as GIST (gastronintestinal stromal tumour) and NET (neuroendocrine tumour) where the drugs are expensive and the underlying biology is still not well understood. I would like to see pharma companies working to improve our understanding of the biomarkers involved in these diseases so that when they organise clinical trials they can find candidates who they know will respond to treatment. Without this research, patients are wasting their time being on the trials and a lot of money is wasted.

JL: Is there anything pharma companies can do to improve adherence rates to treatment?

TD: The literature says that there is an 80% compliance rate in my areas, which means around 20% of patients are not adherent. But I am not sure I am convinced by these figures. People with serious diseases tend to take them seriously, which means they take their drugs.

JL: Is there a role for pharma in helping to educate patients about their condition? What are companies doing? Do any stand out?

TD: There are a quite a few companies working in these disease areas and a couple that fund useful information for patients. Lilly, for example, provides a DVD on what they need to know. Patient information is probably the best way that companies can help patients.

JL: How do your patients regard the industry and do any companies stand out in terms of reputation?

TD: Patients don't care about the industry. They know the drugs they want but couldn't name the companies that make them. To be honest, I would be worried if they came in asking for a drug from a specific company.

JL: What kind of joint working projects with the NHS would you like to see pharma companies getting involved in?

TD: I am a bit sceptical about this. In the past companies have provided cancer nurses, which is useful, but they tend to pull the funding after a year. Maybe it's a PR thing from the companies' perspective but these things need to be thought about long term. It is easy to think a year's funding is better than nothing but what happens is that we become reliant on the nurses and put in a proposal to the hospital for replacements but nothing happens.

JL: What is the single biggest thing you would like to see pharma doing to make your job easier?

TD: To produce cheaper treatments. The data on a new oral drug, regorafenib (Stivarga), for example, shows it can delay the progression of advanced GIST in patients who are resistant to treatment. I would like to use it but it has not been found to be cost-effective.

To be honest, apart from providing information to patients I feel uneasy about drug companies moving beyond their role of providing treatments. Their job is not to provide healthcare. I know I am not alone in feeling slightly sceptical about their motives in this area.

JL: Do digital channels have a role to play in improving best practice in your therapeutic area? What kind of online resources are most valuable?

TD: Time pressures mean that often it is not possible to attend conferences in person. Digital channels can be useful in that regard since they enable doctors to watch conferences live online or after they happen. Also, there are a few specialist websites that I really value.

About the interviewee:

Dr Tony Dhillon is a consultant clinical oncologist specialising in rare cancers such as GISTs (gastronintestinal stromal tumours) and NETs (neuroendocrine tumours).

Closing thought: How far should pharma companies move beyond their remit of providing treatments?