Flying The Flag For Patients
The Chief Patient Officer is pharma’s face of patient-centricity but how is this relatively new role shaping up?
Patient-centricity rose like a phoenix from the ashes of the blockbuster era. After decades of focus almost entirely on the prescription pads of physicians (we even supplied the pens!), it was only a handful of years ago that pharma companies felt the winds of change on their faces. Many tacked to catch those winds in their sails.
However, turning a vessel as large and unwieldy as a multinational corporation is no easy task. Getting sales reps, marketers, medical affairs, health economists, clinicians, scientists and senior managers to stop asking, What do HCPs need? and start asking, What do patients need? was always going to be a long and slow process.
In truth, what’s most surprising about the patient-centricity revolution is the remarkable speed with which it has come about, due in no small part to its standard-bearers – the Chief Patient Officers.
Since the appointment of the first pharma CPO in 2012, the new role has appeared at many major companies, attracting talented people from diverse backgrounds and with a broad range of skills.
To discuss this crucial role, how it has evolved over six short years, and where pharma is with the patient-centricity revolution, we spoke to Dr Anne Beal from Sanofi – the first CPO to be appointed in a top-10 pharma, now Global Head of Patient Solutions – and Isabelle BocherPianka, Chief Patient Affairs Officer at Ipsen.
How do you see your role now?
Bocher-Pianka: My main purpose it to help my organization to understand that patients and patient organizations are key stakeholders, and to support operational teams to work together directly with them.
However, there are two key components. The first is cultural change; for many years our industry worked mostly with physicians and other HCPs, so my role is to show colleagues the evidence that working directly with patients and listening to their perspective is valuable – along the entire value chain.
The second component is to influence my organization, particularly senior managers, to help them support operational teams that are starting to work with patients.
Cultural change is important but so is a change in process and managers need to counsel, facilitate and encourage others.
Beal:There are two answers; one for the industry and one for Sanofi. Across the industry, the purpose [of the CPO] remains fundamentally the same – ensuring a strategic focus on the patient and recognizing that the patient is our key customer. However, this has manifested in different ways in different companies, with some more focused on patient engagement in R&D, others much more on the commercial side. What companies need is to develop and implement an end-to-end strategy that involves the patient all the way from research through development to commercialization.
At Sanofi, we started out with a broad view but have since scaled that back to focus much more on Commercial and specifically, within the Medical function, around our work in real-world evidence.
The good news is that there will always be a role for patient focus in every part of the organization, but the downside is that there is still work to be done to implement a truly end-toend strategy.
How important is the CPO as a figurehead?
Beal:In my view, it is very important. It is similar to the role of the Chief Medical Officer, who manages the end-to-end strategy around working with physicians. We’re very comfortable with this concept of an end-to-end strategy for HCPs, and it’s essential that we now have something similar for the patient.
Bocher-Pianka: A Chief Patient Affairs Officer signals to the entire company that the CEO and executive leadership team puts these cultural and process changes high on their agenda. This role is very much a transformational one, and a clear direction from the leadership team is required to drive the topdown and bottom-up collaboration needed to work better with patients and patient groups.
The CPO role is also quite new so we need these signals from our leaders to help educate everyone about what the role is and what impact it will have. The role is also essential in federating efforts across the organization so that everyone is pulling in the same direction and that every employee has the patient in their line of sight.
Where should the CPO ‘sit’ in an organization?
Bocher-Pianka: It is critical that I have a home and my home is global medical affairs, which is part of the R&D organization. However, it is equally critical that we work across the entire organization and at every stage of the value chain.
It makes sense to be part of R&D in the first instance because of the importance of engaging patients early; for example, if you are a researcher working on pain models, you would be in touch with global medical affairs to understand unmet patient needs.
When you start the development of a new compound, you always have medical affairs colleague on the cross-functional team, who can emphasize the importance of involving patients in protocol design, for example to better anticipate recruitment and retention hurdles.
Moving on, we need to work closely with HEOR colleagues to to seek patient input in defining patient-reported outcomes, for example, and then, when a product reaches commercialization stage and launch, we need to address whether the patient understands their disease and the ‘why’ of their treatment and their condition.
Beal: The medical function is the natural home for a lot of this work but, at the end of the day the opportunity and ability to demonstrate impact and outcomes might rest more on the commercial side and the work that goes through some of our patient-focused programs. So, the CPO needs to be in both.
What is your greatest challenge right now?
Beal: Across the industry, there have been a lot of very good experiments but what we need now is to look for the evidence of what works and what doesn’t, and really think about KPIs and the question of the return on this effort – whether that’s return on investment, on impact or on strategy. We also have a lot of great pockets of activity, so the big challenge now is joining them up into that end-to-end strategy I’ve already mentioned.
Bocher-Pianka: My greatest challenge is to help colleagues truly understand that working directly with patients will lead them to develop better and more complete care solutions. It can be difficult to see the value of a patient advisory board, for example; colleagues might think it will just slow down their program. Until we reach that point where patient input is systematic and part of our SOP, my challenge is navigating this intermediate stage, which is particularly tough if people don’t perceive its value. Training is critical here – it was one of my first challenges and it is not finished yet as we’re a global organization and you have to reach different projects in different parts of the world at difference stages of maturity.
Guidance is also essential; it’s not a challenge as such but it is a ‘must’. We must encourage colleagues to start to work with patient groups but they must do it in an ethical manner, and that means helping colleagues to understand this increasingly critical stakeholder. To do so, early on we developed (along with our ethics and compliance colleagues) guidance for interactions with patient organizations and individual patients. Training is a key dimension and it must go step by step, which takes time.
How do you see the cpo role evolving?
Beal: My title has changed from CPO to Global Head of Patient Solutions because part of what we’re trying to do is really focus on how our products works in the real world. However, this means we need to understand the role of the patient – around patient knowledge, patient empowerment, patient activation – if we are to improve the performance of our products. As an industry, we view this through the lens of ‘adherence’ but I prefer to call it ‘optimal utilization of our products’.
So, we’re thinking about what we can do to really understand patient needs and priorities, and then develop evidence-based programs that really address them, in order to help patients manage their conditions.
Bocher-Pianka: My wish is that one day we will not need a Chief Patient Affairs Officer any more because patient-centricity is so embedded into the daily functions that there is no need to have someone emphasize it at the start. We are not yet there but we will get there.