Decoding the patient journey with RWD
Patient real-world data contains a wealth of potentially valuable information for life sciences commercial teams, if they can filter out the noise
There’s so much information out there today about what makes consumers tick with significant value for any who care to gather an analyse it. Just ask any mass market consumer company.
It the same for healthcare. Combining RWE with insights from interviews and social listening can help pharma better understand the patient journey.
But what other industries do as a matter of course today, pharma is only starting to think about. “In healthcare, compared to other industries, there's still a lot of foundational gaps in terms of the role of marketing,” says Gizem Ozbay, Global Head of Marketing, Integrated, Abbott. “Truly understanding the patient journey and mapping that out, using that as your guideposts for all your decisions related to innovation, is a relatively new concept.”
From defining unmet need through to sizing the opportunity, RWD is of inherent value to life sciences commercial teams. “RWD is where reality hits possibility,” says Andrea Bartzen, US Commercial Brand lead, Keytruda, Eisai US.
“When you're planning, you're projecting towards the future to see what is possible based on new science and mechanism of action. RWD informs you along the way to crystallise the possibilities in a very pragmatic, practical sense. You see where patients are now or where they have been in the past, so it gives you a map to see where you're tracking.”
And the potential of RWD has particular resonance given the shifting sands of the past year. “It's so timely while there's less physical connectivity to stakeholders,” says Casey Harris, Director, Global Oncology Marketing, Value, Access, Strategy, Operations at Novartis Oncology. “Leveraging data is an opportunity to be as precise as possible when you think about launches and go to market strategies.”
RWE’s strategic role
“RWE is becoming one of these core pillars in commercialising products,” adds Harris. Where RWE once filled data-gaps post launch, it’s now being generated earlier, “identifying burden of disease, understanding economic viability of products, and the epidemiology of a disease.”
He sees this being useful in two main ways. First as a means of understanding the patient journey to support patients, clinicians and caregivers and second as a way to generate data to secure coveted marketed access across different territories.
“Marketing leaders are going to start including RWE as a big component of their brand and marketing planning,” he says. “In Novartis, it's not looked at as a bolt-on but as a proactive part of strategy.”
As clinical studies are being developed, RWD can also help identify patient cohorts. Marketing, brand and launch teams can use it to look at patient cohorts, map out different patient journeys over time and target physicians appropriately.
RWE offers the opportunity to blend disparate data sources to analyse everything from comorbidities through to referral patterns, pharmaceutical claims and socio-economic factors.
Art versus science? In favour of human nuance
But the RWE data landscape is a complex one. The sources of data are fragmented and owned by multiple stakeholders, including health record systems sitting in isolation from one another and payers, providers and even now patients using medical devices owning their own datasets.
“That gives you a challenge and an opportunity to take this unending supply of information and prioritise and focus,” says Harris. “Otherwise a lot of strategists and marketers end where they began, which is rich on data and poor on insights.”
Becoming rich on both data and insights requires human creativity. “Can you put together a team that can filter out the signals from the noise?” asks Harris. “It really is this perfect fusion of science and art. You need to have the scientific methodology to get to an insight, but then you also need to have the artistic ability to interpret and bring the insight to life.”
“Data itself really only gives you the black and white information,” says Bartzen. “It's important to three-dimensionalise that information to understand the story behind it.”
From here, it’s then possible to see gaps in current medical practices, such as being late to diagnosis, or co-morbid conditions and challenges in getting to treatment.
From layering in psychological insights to analysing what other dimensions are affecting datasets, it’s multi-dimensional work which generates accurate insights that can drive the market. “In order to create a blockbuster brand, you have to create the future faster than your competition. If you're only relying on data, you're not going to be in front,” says Bartzen.
The patient journey in full colour
The value of marrying data with patient journeys was clear to Bartzen when working on the launch of cancer treatment Keytruda. There were two distinct patient types for head and neck cancer – HPV patients and those who typically had a history of alcoholism or smoking – each with different patient experiences and outcomes. Understanding the distinct patient subsects and journeys gave her the “full colour view” for launch.
Starting with RWE and then layering on insights gleaned from patients, caregivers, payers and policymakers gives you a holistic picture and makes it possible to identify the “moments that matter,” says Harris.
“These are milestones or really critical moments in a patient journey, where a patient may be at risk of discontinuing therapy because of out-of-pocket costs, or is ready to switch a drug because of a side effect. Getting as precise as possible allows us to support not just the patient, but in turn downstream helps the overarching healthcare ecosystem. You get better outcomes at a lower cost.”
For commercial and marketing teams, data needs to be viewed as a “moving marker,” says Bartzen. “Data today isn’t the same tomorrow. A lot of people think they can make strategic decisions based on the past and the present. That's not enough – you have to envision the future.”
On the Keytruda launch, Bartzen saw the pace of change up close. “Huge breakthroughs in science are very, very fast,” she says. “We were gathering qualitative research in real time, because the insights and learning occurred so quickly that we had to constantly track that evolving perception. It was a moving yardstick – as we were changing it, it was also changing.
“As we were creating that future and that knowledge about immuno-oncology, what was true one month was different the next month. If you're being effective as a marketer, that goal post should be changing quickly.”
The real-time data processing capabilities this demands, in turn calls for a shift away from manual analysis towards automated solutions, which can be refreshed for the latest insights for commercial and brand teams. Increased alignment and automation of datasets also removes some of the barriers in getting to patient-centred outcomes, says Harris, allowing for “more time discussing insights instead of digesting data.”
A further challenge is how to build meaningful pictures using more than one source of RWD, which alone doesn’t offer a full picture, says Bartzen. “It’s like the iceberg principle – you see what’s poking out, but that’s maybe 10%. It gives you a hint of what’s lying underneath and points to where you need to dig deeper.”
Social media increasingly offers longitudinal insights into patient populations that can be layered over RWD. “You take this type of social listening and this type of qualitative feedback, and you couple it with some of the quantitative data that exists in the databases, and you can really add some colour to those insights,” says Harris.
In order to really make the most of RWE’s potential, organisations need to ensure their entire teams are data literate to meet the needs of RWE-centred workflows – from CIO to product marketing specialists, not just data scientists. “The language of big data, artificial intelligence and what’s possible from a data integration perspective is such a new language,” says Ozbay. “One person cannot drive transformation. It needs to be a whole change management effort.”
A shift towards longer-term planning will also prove beneficial when integrating RWE, says Bartzen. “You’re thinking about the sales for that quarter or that year, but there isn't enough projection for that three to five-year plan, the life cycle of the brand or projecting forward for the portfolio and pipeline.”
Harris also hopes to see regulators opting to use RWE as a major factor for approvals or line extensions or for formulary decisions. In the oncology space, regulatory approvals remain primarily based on single arm, placebo-controlled studies.
“Regulatory bodies like the FDA are using RWE as contextual evidence in conjunction with clinical trials to designate approvals and indications,” he says. “We're curious to see RWE graduate from supportive evidence to key evidence.”
The future is hopefully one of streamlined datasets driving actionable insights that change the paradigm in healthcare.