Expert comment: Companies need to identify stakeholder needs and understand what constitutes value
In the era of value-based healthcare, where Sustainability and Transformation Partnerships (STPs) in England are striving to reduce unwarranted variation in care, there is little doubt that the commercial models of UK pharma companies need to change. The Efficiency Plan outlined in the Next Steps on the NHS Five Year Forward View (FYFV) cited the need for NHS organisations to get the best value out of medicines. However, recent research shows that NHS spending on medicines is growing at a faster rate than the total NHS budget. The King’s Fund says that if the trend continues it could threaten patient access to innovative treatments. Clearly, despite sector-wide efforts to strengthen market access capabilities and demonstrate value, pharma has not yet designed the optimal approach. To progress, and to help NHS providers deliver value-based care, perhaps companies need to think more holistically.
The FYFV is about more than medicines optimisation. It mandates NHS organisations to reduce unwarranted variation, minimise avoidable demand and improve patient flow in acute care. Thankfully, pharma can help here too. With a broader focus beyond demonstrating product value, companies can help providers address wider efficiency challenges and, in the process, unlock meaningful value. However, to get there companies need to reimagine NHS engagement. Why? The development of sustainable models of care are not about products – they're about pathways. The most successful companies will therefore be those who think beyond the pill and take a pathway-led approach to designing services that meet their customers’ needs. The question is: how?
Service redesign has become a hot topic in UK pharma as companies recognise the value of collaborative engagement with NHS partners. However, despite efforts to carve out new ways of working with customers, companies too often revert to the traditional default of product-based detailing, fuelling engagement that’s misaligned with stakeholder needs. It’s understandable; companies boast great innovations that can alleviate disease and transform lives – why wouldn’t they place them at the heart of their engagement strategies? It all boils down to being customer-centric in defining value. Too often, the ‘solution sell’ is built on a narrow definition of value that doesn’t resonate with all stakeholders along the care pathway. It typically falls short.
To drive worthwhile change, companies need to understand what value means to all stakeholders. That definition will vary depending on who you are talking to and where they sit within the pathway. Companies must therefore map these stakeholders, identify their needs and understand what constitutes value in their environment. Moreover, they must use this understanding to develop dynamic stakeholder engagement strategies that address value in multiple ways – at the same time – to drive meaningful outcomes.
The rationale for pathway change is well understood. However, it can sometimes be poorly executed. So where do you begin? The key is to mirror the work of NHS commissioners and establish a dispassionate, patient-centred view of the pathway. This is fundamental to redesigning services. It’s where all thinking should start – laying down a baseline of current performance, what success looks like and how it can be measured.
Put simply, the patient pathway is a map of time and resources that patients consume when receiving treatment for their condition. It can be visualised as a flow diagram that illustrates the different activities at every touchpoint along the pathway. In most diseases, the optimal ways to treat patients are well established, with organisations like NICE and the Royal Colleges recommending standardised pathways of care. However, the dynamics of healthcare mean there are always gaps between gold standard pathways and the reality at the local level. Variation in resources and population needs, along with complex socio-economic factors and regional drivers, mean that companies need to look beyond NICE guidelines to design pathways that respond to local needs. Sustainable pathway change therefore depends on adopting a three-step process.
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Step #1: Understand and prove the pathway
The first step is to develop a granular, end-to-end understanding of the patient pathway in your disease area to identify problems and opportunities. This primarily requires engaging with all the stakeholders along the pathway – not just the usual suspects. For example, recent work to redesign cataract services in Leicestershire was built around insight not only from ophthalmology consultants, clinicians and service managers but also theatre nurses, porters and receptionists. What’s more, it involved patients, pharma and device companies too. To be effective, stakeholder mapping must be open, collaborative and comprehensive.
It must also be supported by evidence. Developing the business case for pathway change requires establishing a robust benchmark of present-day performance and using that data to model new pathways. The industry can draw on huge datasets to understand and prove the patient pathway. For example, ICD and OPCS codes show the diseases and treatments assigned to individual patients in secondary care, whilst HRGs show the treatment costs to the NHS.
Primary care data is also crucial. GPs record diagnosis and activity using READ codes, though this can be harder to access. The challenge is to identify and integrate data from all these separate coding systems to develop a detailed picture of the current pathway.
Step #2: Develop models and simulations
The next step is to use intelligence captured in the mapping phase to develop simulations for new pathways that minimise waste and inefficiency. Ideally, companies should be thinking about this during Phase 3 development. An effective simulation will demonstrate how a remodelled pathway can drive positive change. However, it should focus on delivering value to the patient – rather than the institution delivering the pathway. Unlike institutions – which, as we’ve seen with PCTs, SHAs and now ACSs, fluctuate with policy – patient pathways are stable and provide common ground for all stakeholders. Simulations must be built using currencies that provide value to all these stakeholders, with everything converging around the patient. Robust simulations are a key component of evidence-based decision-making.
Step #3: Implement change through joint working
The final step – implementation – is crucial. The best-laid plans are often scuppered by passive behaviours where companies expect change to happen automatically. It never does. Pharmaceutical companies should be prepared to provide management capacity throughout the change process. This begins with developing and proving the business case for change and should evolve to support stakeholders through the communication and implementation phases. The development and management of a structured project plan is essential. A good implementation plan will detail the systems, resources and processes required in the new pathway – and connect actions and responsibilities with appropriate stakeholders. It will be underpinned by a commonly understood purpose and clearly defined metrics.
Collaboration is the key to success; joint working is about pursuing shared goals, openly and transparently. For pharma, this may also mean collaborating with independent partners that can help bridge the gap between industry, NHS stakeholders and patients. The best partners will have experience in NHS commissioning and service redesign – as well as robust simulations that evidence high-value pathway change.
However, you approach it, the message is simple: to unlock meaningful value, pharma must shift its focus from product-led detailing to pathway-led models of engagement. Ultimately, success is all about the pathway. And the pathway to value starts by walking in your customers’ shoes.
How can the healthcare industry build trust with consumers?
One of the many ways the pandemic has impacted society is that it has firmly cast the healthcare industry in the public spotlight. From producing ventilators and PPE to developing life-saving vaccines, consumers have looked to pharmaceutical and healthcare companies to keep us safe and find a way out of the Covid-19 crisis.
As a result, healthcare companies have an opportunity to build upon this and utilise their marketing to drive greater engagement and trust with consumers. When it comes to effective marketing, it’s vital to remember the important role which visuals play. Consumers increasingly engage with brands through the visual communications and storytelling they absorb while online or browsing through media channels. These visual communications can have a huge impact not only on consumer purchasing decisions but also the relationship between brands and customers.
At Getty Images, we work with healthcare companies throughout Europe to advise them on their visual content. This study forms part of the research for our insight platform Visual GPS, which looks at the key factors affecting consumer decision making and how that impacts their visual choices.
In partnership with YouGov, we surveyed 10,000 consumers globally and have been tracking this consumer sentiment for the past two years. This latest deep-dive into the healthcare industry is part of our wider on-going research, and aims to better understand how consumers in different regions are interacting with the healthcare sector and what motivates their visual preferences.
Our research revealed that many companies are not using visuals as effectively as they could. In the UK, for instance, the vast majority of consumers do not feel represented by the visual communications which businesses are producing – only 7% of British respondents to our global Visual GPS survey say they felt represented. That is even lower than the global average of 14%.
This latest deep dive into the healthcare industry has uncovered some important insights that can help us better understand how consumers in different regions are interacting with the healthcare sector.
Mental health should be centre stage
A key finding shows that mental health remains a highly relevant issue for consumers. Over nine in ten British consumers think it is important to talk about mental health and put it on an equal footing with physical and emotional health. Not surprisingly, 55% of British consumers believe that more people are being diagnosed with depression due to the Covid-19 pandemic.
There is a growing awareness of the importance of mental health across Europe. Health and pharmaceutical companies should acknowledge this in their visual communications but do so in an empathetic and compassionate way. Only five years ago, visuals around mental health often depicted people alone, isolated and expressing feelings of shame, whereas now we are seeing a more empathetic and supportive approach to visualising mental health - with an increasing number of positive visuals showing support groups, or individuals proactively seeking and finding support.
Visual communications that show support for mental well-being in a meaningful way will resonate deeply with consumers.
A more holistic approach
Another key finding is that consumers want to focus more on holistic health. Our survey found that the majority of UK consumers place an almost equal importance on emotional, physical and mental health, and almost three quarters (73%) placed the health and well-being of family as a top priority.
It’s important that healthcare companies reflect this. Our research paired with ongoing image testing revealed that consumers want to see visuals that humanise healthcare, so companies should consider visualising inclusive care across intersecting factors such as age, ethnicity and gender. Brands can help establish trust with their customers by highlighting a collaborative relationship between medical professional and patient, as well as ensuring that their visual choices feel genuine.
Technology and innovation in healthcare are gaining traction
Thirdly, eHealth and purposeful innovation was another key finding. Consumers want innovation that will meaningfully support their care. Particularly in Europe, the older generation will pay more for brands that use technology to provide advice and recommendations, while Gen Z & Millennials are willing to pay for self-service capabilities. It’s important therefore for healthcare companies to incorporate purposeful innovation in their visual communication and demonstrate consumers at the centre of accessible eHealth.
Given these insights, what visual content do consumers expect to see from pharmaceutical brands? Our research highlighted three key themes.
- Consumers want to see how healthcare companies fit into people’s lives. Accessible health services are a key factor here. Decision makers should build trust by showing consumers at the centre of a holistic healthcare ecosystem.
- Consumers want to see the emotional rewards others get from using a healthcare company. This can be achieved by building brand loyalty through empathetic and inclusive visual storytelling.
- Finally, consumers want to see people who are similar to them and their lives. British consumers want to see people that look like them and reflect their lived experiences in advertising and brand communication. Decision-makers should ensure that their visual communication is inclusive and authentic and represents the diverse population of the market in which they’re operating.
Ultimately, the key to successful visual storytelling for pharma and healthcare businesses is to ensure that they understand what matters to their audience while establishing trust of care. An important element of this is authentically representing the full spectrum of the population. That means representing all ethnicities, ages, abilities, body shapes, sexuality, religion and genders, to ensure patients of all backgrounds feel included and represented.
Healthcare brands should bear in mind that, as a result of the pandemic’s impact on healthcare systems around the world, consumers may be feeling anxious about whether they will be able to access care if they need it. The healthcare industry has an opportunity to reassure customers and build greater engagement and trust by showing them that they matter through inclusive visuals that represents them authentically at the heart of brand storytelling.