Succeed with patient support programmes

The healthcare system is under pressure

According to research²⁺³, only about half of patients typically take their medicines as prescribed. Some even stop it altogether earlier than recommended by their doctor. Moreover, healthcare personnel have never had less time per patient⁴, while patients increasingly start to take ­ownership of their own condition due to digitalisation and easier access to information⁵. Finally, downstream players (wholesalers, ­distributors and dealers) are consolidating and putting pressure on prices and ­margins. In our experience, the winners are those closest to the patients.

Focus and source of viewpoint

This viewpoint is based on Implement Consulting Group’s insights from developing
and ­implementing PSPs with three leading players within the global life science arena
in 15+ ­markets during the past seven years.

The viewpoint focuses on:

• The life science industry, in particular pharma and medtech companies
• Patients with chronic diseases, for example, diabetes, cancer, cardiovascular diseases,
  MS, hearing loss, allergy, obesity etc.

PSPs drive stay time and ­product usage

In our experience, PSPs that focus on both design and implementation can help patients to better follow their treatment and thereby improve both their physiological and emotional health and well-being.
Specifically, we have seen that PSPs can have significant impact on leading patient adherence drivers such as:

• Patient average health increase of up to 50% over the duration of a 4-month programme¹
• Prescription fill rate increase of up to +25%
• Patient staying on treatment increased by up to +20% on average¹

What is a patient support programme?

A patient support programme (PSP) provides emotional and functional patient support in the first troublesome time after being diagnosed with a chronic care disease or after undergoing surgery related to it.

Support is typically provided across channels such as nurse support via phone, email, SMS and web content and is tailored to the needs of the individual patient.

Six building blocks are needed to build a PSP

To build a strong PSP, you always start by having the patient and patient ­journey in focus.

In fact, a PSP is not much ­different from a strong customer loyalty ­programme such as Lufthansa’s Miles & More or Starbucks® Rewards and is fundamentally built around the same principles and goals, i.e. to give patients the best end-to-end customer ­experience possible, thereby improving their health and the likelihood that they will stay with you.

Still, a patient is not like a ­traditional consumer, which increases the ­complexity of building a PSP versus
a traditional loyalty programme.

Hence, if you want to build a successful PSP, you need the following six building blocks to be in place (see figure 1):

1. Set your strategic objectives

First, you need to establish a common view on where to play and how to win. Typical choices for a PSP include which patients to focus on, which products to include, how to involve HCPs, patient health objectives and commercial objectives, among other things.

For pharma and medtech companies, it is typically a new thing to move towards direct patient ­engagement, and it ­requires involvement of ­multiple ­stakeholders from many layers of the organisation. Therefore, it is often a challenge to be aligned on a clear direction from the beginning. In our experience, the right thing to do is to run dedicated strategy workshops with stake­holders from senior ­management, digital marketing, medical ­marketing, sales, IT and legal to set a clear ­direction before starting up your PSP journey.

2. Focus on enrolment

How do you get patients to sign up? In simple terms, you will not have a PSP if you do not get anyone to sign up, regardless of how personalised your programme is. It is the single most important building block, but also the most challenging one, as you need to win the hearts of the HCPs, who are typically the main drivers of ­enrolments. Ironically, most­ companies often struggle with this, as they tend to focus more on creating strong ­personalisation algorithms and content rather than ensuring that they get patients to sign up for the programme.

If you want to win the hearts of the HCPs, you need to engage your sales force, which is best done through PSP training sessions, integrating the PSP into the existing meeting cadence, PSP enrolment competitions and ­ongoing performance tracking.

3. Get your platform and ­communication channels in place

This building block is often quite ­resource-intensive, but it is necessary in order to run a PSP.

It is the foundation of storing ­patient data properly and handling your ­marketing automation touchpoints such as email and SMS, which are all essential if you want to enable ­personalised communication flows.

Companies often underestimate the complexity of this building block. As this is often the first time most ­ companies deal with patient data rather than HCP data, it requires a ­fundamentally new way of ­thinking about data storage, data fields, processes and how to best integrate the PSP platform into the existing IT infrastructure.

4. Move from product-centric to patient-centric content

Most life science companies focus on communication towards their key ­decision-makers, i.e. HCPs. This
­typically means that they use a ­language that is very condition-, ­product- and technically ­oriented,
which is very different from the ­language of a patient.

If you want to ­create new and relevant patient ­content, you must start by enabling a new and more outside-in way of ­thinking about communication. To do this, you must do market research and have strong customer-centric ­content skills.

5. Measure and track

Just like when you do change ­projects, you must also be able to ­understand and track whether the
PSP is ­performing as intended. ­However, since this is a relatively new discipline, most companies must do more ­development work, because they often start from scratch. This includes defining new KPIs, methodologies, data handling processes and building new ­dashboards. We have learnt that you need to view PSP insights as a project in itself.

If you want to build the right foundation from the get-go, you need a strong co-development plan, involving multiple stakeholders from performance management, ­customer insights, product marketing, CRM and sales as well as people from the ­management team.

6. Get the organisation and capabilities in place

You need a dedicated PSP team to make a PSP sustainable and get it anchored in the organisation. The best PSP organisation is one that is centred around patient journeys with all roles working with patient ­engagement.

This is the best way to enable seamless patient journeys with as little ­friction as possible. Note that it requires strong organisational design and internal stakeholder management skills – something that only increases with the size of your company.

Thus, make sure that you assign a senior person who has ­experience with customer experience and ­organisational design if you want to increase your chances of success.

What characterises companies that succeed with their PSPs?

The best PSPs work as integrated parts of the healthcare system and are recommended by HCPs to chronic patients as support or even as part of a treatment regime. The key to success is establishing trust in the programme for the key players: patients, HCPs and internal stakeholders. We call this the “win-win-win triangle” (see figure 2).

In our experience, companies that ­succeed in building a PSP can ­ answer “yes” to the six questions in the “­ win-win-win triangle”. If you are not able to answer “yes” to all of them, you are most likely not going to succeed with your PSP.  

1. Is there a clear and strong ­value proposition and a simple ­enrolment process for patients? 

It is important that you make ­programme enrolment as attractive and easy as possible for both the ­patient and the HCP. To do that, you need a value proposition that is easy to understand, provides value and ­closes a real gap in the ­healthcare ­system seen from a patient ­perspective. This could be additional HCP support, access to out-of-pocket treatment-­related products or similar.

Secondly, you need to make enrolment as simple as possible for both patients and HCPs – something most companies often underestimate. To achieve that, you typically need detailed design workshops covering enrolment channel selection, IT and enrolment process mapping, and relentlessly ­communicating about the process to HCPs, as they are typically the ones recommending or “prescribing” the PSP to patients.

2. Have you prioritised human ­support channels as part of your PSP?

To deliver true support and value to ­patients, we strongly recommend that you prioritise human support channels such as phone support provided by ­internal nurses or similar.

We see human channels as the key to understanding individual patient needs and providing emotional and functional support on top of the additional content of the PSP programme. Due to the high degree of emotional turbulence a new chronic patient is faced with, human support will also result in higher engagement and treatment results, as it significantly increases trust in the programme. 

3. Are the global and local ­leadership teams truly behind the initiative from the beginning?  

It is important to ensure that the ­implementation of the programme ­becomes a key priority across the whole business and especially for the marketing and sales organisation. A PSP is often a new go-to-market ­approach for a company, and it is crucial to get buy-in and support from both the global and local ­management teams.

Even the best intentions and a stellar PSP are not enough if the global and local organisations do not buy into it. Often, what happens is that you will not get the necessary ­resources to drive both the design and ­ implementation phases and ­ensure that the PSP gets anchored in the ­organisation. If they are not ­behind it, you risk your PSP being just ­another global project with short-term ­impact. Therefore, make sure that you prioritise this before you move to ­implementation.

4. Is the field force motivated to get enrolments fast? 

It is essential that you build up ­momentum for the PSP in the ­critical first launch period. ­Creating ­ momentum highly depends on ­integration of the PSP into the sales team’s ­day-to-day ­business. We often experience ­companies trying to drive enrolments fully digitally.

However, you will not ­succeed in getting enrolments if you are not able to create trust in the ­programme and win the hearts of the HCPs, which is best established by ­face-to-face introduction meetings ­carried out by the sales force. Also, when involving salespeople, for some odd ­reason, most people often ignore the fact that salespeople are driven by sales and monetary value.

On top of that, you are trying to introduce a new service to the market, which has not proven to have an adherence impact yet and which is an intangible service ­offering that the salesforce has never sold before. Hence, it will be difficult to get commitment from the ­salesforce if you do not include some form of ­ monetary incentive (when legally feasible) to begin with. Finally, the PSP needs to be integrated into the existing sales meeting cadence to ensure that you share best practices and discuss enrolment performance in the team.

 5. Have you won the hearts of the HCPs – ideally before launch?

It is key to get patient enrolments fast and build confidence in the ­programme for the sales organisation. A ­ differentiator here is to share patient impact results with HCPs to enable trust and reduce any barriers they might have towards providing patient names to your PSP.

Prior to launch, you should therefore identify local HCP decision-makers and involve them in the design and localisation process. By doing this, the HCPs will become ambassadors for the programme. You can do this, for example, by inviting them for co-creation workshops where you present your ideas for the PSP and open up for feedback and dialogue from the HCPs.

 6. Is the compliance team an ­integrated part of your project team?

Since PSPs operate in a highly ­regulated industry, and the aim is to help patients with sensitive and private healthcare-related matters, it is a must that you involve your global and local compliance teams in both the design and implementation of the PSP. ­

Typically, national regulations differ when it comes to what content is acceptable, how to store data securely, what data you can collect and how you get patient consent. Although this can be quite a time-consuming exercise, we have learnt that there is always a way to get up and running as long as you adapt the PSP for local market ­dynamics and involve key compliance team members from the beginning.

You need to have the right competence mix and implementation approach

To be able to answer “yes” to the six questions in the “win-win-win triangle”, you typically need two fundamental things to be in place when you start up:

1. The right mix of competences
2. A strong project management approach

Close to 70% of companies typically fail to achieve full PSP impact when moving from design/conceptualisation to implementation. Typically, the reason is that project teams are too heavy on the conceptualisation resource side and tend to neglect the critical need for strong implementation competences during the implementation phase.

People working on the design and conceptualisation phase often have a natural flair for strategic ­thinking and thrive when working at a ­conceptual level. People working in the ­implementation phase are typically strong in execution and have a natural flair for working at an operational level.

The point we are trying to make is that if you want to set yourself up for ­success, you need to ensure that you have the right mix of competences in place from the get-go in both the design and ­implementation phase (see figure 3).  

Even-so it can still be a time-­consuming­ exercise to build a high-quality PSP. We have found that a strong project ­management approach, consisting of three key principles, can ­substantially reduce the time needed to go from design/scope to ­implementation. The three principles are the core of what we call the Half Double project ­methodo­logy (see figure 4).

How to apply each principle is outlined here:

Impact: Focusing on PSP impact means that the project is based on an impact case (typically ­adherence drivers like stay-time and ­product-­usage) that is aligned with the steering committee and is designed to deliver impact as fast as possible, which drives momentum.

Flow: Focusing on the flow of a project means allocating enough resources to enable a continuous workflow. It also means setting up a fixed work rhythm, typically of sprints separated by visual planning sessions and ­steering ­committee meetings with active ­participation.

Leadership: While leadership is often an abstract notion, in this context it is very concrete. It means securing needed resources, being physically and mentally present to show that the project is important, facilitating needed collaboration with people outside the project team, accepting that design processes are messy – and showing that it is okay. Finally, making sure that everyone understands why they are important to the success of the PSP project creates strong commitment.

In conclusion, we have learnt that when you get the right competence mix in place and apply the Half Double project methodology, you will be able to design and implement PSPs up to 50% faster and with higher impact than industry benchmarks (see figure 5).

Are you ready to make a game-changing choice for your company?

To win in the market, you need to give your company a competitive advantage. A strong patient support programme can be such an advantage.

To build a successful programme, you must make key strategic choices – bold choices. You should ask yourself questions such as “are we ready to become a patient-centric organisation?” and “are we spending our resources in the right way to create trust for the key players involved?”.

We know from experience that those who can answer “yes” to these questions will outperform the market, build even stronger HCP relationships and increase quality of life for patients.