Tag Archives: Patient

Why would anyone think engaging patients is not good for healthcare?

Conversation between doctor and patient/consumer.

Conversation between doctor and patient/consumer. (Photo credit: Wikipedia)

Patient Recognition Month Poster

Patient Recognition Month Poster (Photo credit: Army Medicine)

Almost everyday in the media and on websites around the world someone, somewhere, comments and discusses the importance of engaging patients. As if this is something surprising and new!

What is surprising to me, is that the topic continues to be debated, and commentators continue to try to persuade non believers and key healthcare stakeholders that this has real benefit. And, it’s true, not everyone is convinced it’s a good thing.

The concept has been around for years, and there as many success stories as there are failures, but commentators seem very quick to want to throw out the concept without completely understanding that it is the ‘how’ that is most likely at fault. Clearly, not every patient wants to be engaged, but certainly many of them do. Just look at the number of folks who look at health related topics on the internet – a recent study by Pew Internet found that 80% of internet users, or about 93 million Americans have searched for health related information on line. That is a lot of interested healthcare consumers!

So it is definitely the ‘how’ that causes the problem. Each of us have a different view about how we want to be engaged, be it in healthcare or anything else. So flexibility is the key, and what I see so often is that engagement is clinical code for compliance: ‘we need to educate this patient so that they understand their condition and follow their treatment’. But, to be honest, it simply does not work like that. Clinicians still have that scientific, data driven, clinical view of the world and continue to struggle with the idea that they are working with people, most of who have a strong notion of what health means to them. And it may not agree with accepted clinical thinking. But it is their health and their body, and clinicians need to better understand that a good outcome for one patient may not be good for another in some cases.

So, as with all things in healthcare, when we are speaking about engaging patients it needs to fit the individual patient’s view of what engagement means to them. For some, light touch, for others more information and data, while others may just want to feel heard. Anyway, patient engagement is not one size fits all, and if we are to engage patients in any meaningful way we need to work with all stakeholders to change behavours and rewards, and actively encourage patients to become more involved in their health management.

If we can do this, we will have better health outcomes for patients while driving down the cost of healthcare. For pharma, it may even have the benefit of improving adherence and increasing their profitability.

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Big pharma’s pricing strategy for new medications continues to put profits before patients.

OK.

I know the dust has not settled yet, and there is no concrete decision in this latest example of profits before patients. But there is a lot of discussion right now in healthcare circles about pharma’s continued poor behavior in this area.

The latest example comes from our friends at Sanofi and their rare disease division Genzyme.

Global headquarters of Genzyme.

Global headquarters of Genzyme. (Photo credit: Wikipedia)

Seems there is a drug on market, branded Campath, used in the treatment of leukemia and blood cancer. But has been successful in the treatment of MS patients.

Good news I would say.

But, it seems that there is more money to be made in MS, and so Genzyme is looking at a new pricing structure for Lamtrada – as it is going to be called. One that is 20 – 30 times more expensive than it is today. It is only scuttlebutt, but one would need to question the thinking process behind this.

Why would Genzyme even be contemplating such a move? I can only think of one reason, and it has much less to do with patient outcomes than it does with profit.

Healthcare providers, and, I guess, patients as well, are very unhappy about this. And so they should be. It is not wonder the motives of big pharma are so often challenged and they suffer from a severe case of ‘lack of trust’ by their customers.

Two things need to happen.

The first. Pharma needs to take a long hard look at itself and address this type of thinking that seems so ingrained within the industry. There is nothing wrong with making money, but I guess they have not heard of the concept of ‘bad profits’.

The second thing is that the regulators need to take clear and decisive action to stop this behavior.

I wonder which will come first?

I thought healthcare was supposed to be about you and me……

Hands up if you are a clinician.

How about a medical researcher or in academia? What about if you are working in healthcare?

Why do I ask? Well I just had something of a ‘lights on’ moment. I was watching a great presentation about health literacy from a very prominent and thoughtful clinician and researcher. She had a great presentation – very thought-provoking and also insightful – a great combination.

But listening to her – and let me say that she really ‘get’s this stuff’ that’s clear. But. She get’s it as a clinician. The way she spoke, the terms she used, and the research driven, data based approach to things made it clear to me that one of the biggest issues we have is that healthcare is more about the science and the healthcare practitioners than it is about you and me.

The big debates. Key issues and questions all led by industry insiders. naturally enough taking a science based approach. Where is the expert input from you and me?

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Everyone is talking about Patient Adherence

OK. Maybe not everyone.

But certainly all of pharma! And then much of healthcare – payers, insurance companies, private medicine, even some doctors, although not all.

Notice what’s missing?

Patients! Patients aren’t talking about adherence!

So what is going on here? We all know big pharma is facing a very uncertain future. Lots of big – read profitable – products going off patent, and, of course, the rise in the use of generics, so where to go to continue to grow profits. Of course, everyone is looking to emerging markets, but even there it is becoming clear that the future is not as promising as it once appeared to be, with strong price pressures from governments, massive competition from within big pharma and a market that does not want to be dominated by big international players. So patient adherence is growing in importance.

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