Pharmaceutical Commerce - May/June 2017 - 6

Emphasize patient interaction in patient support programs
Hubs and other patient services need to stress the personal
By Dyan Bryson, Inspired Health Strategies

Pat i e n t s e r v i ce s
h u b s a re m o r e a n d
more common.
Althoug h the recent
growth in patient
services hubs is due to
the growth in specialty
products, there is room
for growth across every therapeutic area. For
example, I worked at Merck-Medco in the
mid-1990's developing and implementing
disease management programs to help
manage high cholesterol. Medco also had
active programs in congestive heart failure,
diabetes and smoking cessation. The
goals of these programs were much like
the hubs of today-appropriately increase
drug access, improve adherence rates
and improve healthful behaviors. These
programs utilized all the services hubs
have today-healthcare staff, algorithms to
identify and escalate patients when needed,
and a call center.
However, we went further than the
typical hub of today-we interacted with
patients routinely with personalized efforts
to support the needs of the patient. This
last piece is what is missing in the typical
hub today. This is where I see a missed
opportunity. Access-this is the main
goal of today's hubs. Recently, this journal

provided a comprehensive review of hub
evolution,* which highlighted four key
1. A greater emphasis on assisting
prescribers in helping their
patients, especially regarding prior
authorization (PA) paperwork
2. The rush to develop comprehensive
data platforms
3. The drive to one-stop shops offering
growing number of services
4. The effort to broaden hub services
to lower-cost or even retail pharmacy
drugs, a so-called "specialty lite" effort
There is very little evidence of industry
efforts to go after the opportunity to create
two-way communications with patients
or towards behavior changing initiatives,
although there is a lot of discussion about
doing exactly this.
After having worked with hubs, I see
this focus on only access as a missed
opportunity to build strong relationships
with patients and learn more about their
lives. If these "beyond the pill" services were
implemented, it would mean opportunity
to solve other looming issues in pharma,
such as:
* With the advent of performance-

based contracting, we have learned that it
is tremendously hard to define milestones
for the performance. The hub is in the ideal
place to collect patient-reported outcomes
(PROs). The PROs would serve as realworld milestones that could contribute
to defining the success of these contracts,
both in costs and health outcomes.
* Improving adherence rates can easily
take place within the hub with behavior
change initiatives. While collecting the
PROs, we would learn the behav ior
patterns in the patient's lives; we could
easily address the barriers and motivate for
positive behaviors.
* In clinical trials, we have increasing
pressure on recruiting diverse populations.
Through the hub, there could be strong
recruitment and retention efforts, Also,
with the clinical trial model evolving to
include remote monitoring, the hub is the
ideal place for that monitoring.
The hub concept is a growing trend;
another recent article, in the Harvard
Business Review,* discussed the process by
which one large pharmaceutical company
did two significant things:
* Realized the need for a change in
business model. The route to growth via
R&D is slowing. This company realized
there are other opportunities for growth

* 2017 Hub Services Report, accessed at
** How to Get Ecosystem Buy-In," by Martin Ihrig & Ian MacMillan; accessed at

if the company refocused its efforts on
* The pharmaceutical company started
making steps towards providing services,
beyond access, to support patients. The
efforts they have decided to pursue are the
same as I have described above.
The goal of the article is to describe
a process to help a company identify
opportunities and get internal buy-in for
the opportunities. It is interesting that, as
the leadership went through the exercises,
they realized they need to refocus the
business on enhanced patient services-
services beyond access to drugs.
Access has been low-hanging fruit but it
is no longer enough. We need to take this
to the next level and put in place services
that can not only support the traditional
acquisition lever but can also support
retention, an aspiration in pharma.
Dyan Bryson, the owner of
Inspired Health Strategies, LLC (www., is passionate
about building comprehensive patient
services hubs and helping companies
becoming more patient-centered. Dyan
utilizes her 20+ years of experience on both
the client and supplier sides of the industry
to help her clients understand and exceed
the needs of their customers.

Defining the digital opinion leaders (DOLs) in healthcare
By Gregg Fisher and Kevin Michels-Kim, The Stem

A s h e a l t h b ra n d
teams elevate their
digital marketing
sophistication, one
channel that frequently
remains an afterthought
is: the Digital Opinion
Leader (DOL).
DOLs are influential members of an
online community to whom others turn
for advice, opinions and information. Their
influence flows from their reach within
a community (how many followers they
have), their resonance (how much their
content is shared) and their relevance (how
relevant their content is to a particular
objective). The DOL is a new player in
healthcare, born out of social media and
technologies that didn't exist until a few
years ago. Their distinguishing characteristic
is their use of social media to either create or
amplify messages.
Few DOLs begin with the intention of
becoming an "influencer;" most turn to the
online world out of necessity: to seek advice,
accomplish a task, share information or

connect with others. Consequently, health
DOLs are a varied bunch, ranging from
healthcare providers and researchers, to
patients and caregivers, to journalists and
In the medical world, DOLs include
clinicians exchanging opinions on therapies,
discussing presentations from medical
conferences, and sharing practical advice on
disease and patient management. A further
group of researchers and academics are
exchanging knowledge around models of
disease understanding and the implications
of the latest studies.
In recent years, DOLs with professional
backgrounds have converged around
Twitter as a medium for publicity and
public discourse, particularly around major
medical conferences, while simultaneously
turning to closed healthcare provider (HCP)
platforms for peer-to-peer discussions. In
the patient world, DOLs include patients,
caregivers and patient groups. Health
bloggers and so-called e-patients taking an
active role in their healthcare have amassed
large online followings. Some have leveraged

6 Visit our website at May | June 2017

their influence to form nonprofits, online
media companies or patient associations.
Traditional patient groups have also
joined the fray, seeking new ways to reach
audiences with their missions and messages.
Patient DOLs utilize a variety of online
channels and, notably, are not beholden to a
single medium, but continue to experiment
with new channels such as Instagram or
The opportunity
" Ke y O p i n i o n L e a d e r ( KO L )
management" has been a staple of life
sciences business strategy for decades.
Commercial and medical teams routinely
identify and engage KOLs for tasks such as
research, publishing or speaking. Patient
advocacy teams regularly partner with patient
associations or support groups on mutually
beneficial projects. Few industry executives
question the value of these activities.
Yet, few firms have adequately responded
to the rise of the Digital Opinion Leader.
DOL identification efforts tend to be
fragmented and often fail to yield a

repeatable process that can generate rich
and actionable profiles. DOL engagement
is often constrained to one-off projects,
such as blogger summits, versus a sustained,
con t i nu o u s pro ce s s of re l a t i on s h i p
building. The lack of clear organizational
roles and guidelines within life sciences
companies also limits potential impact.
continued on page 30

Gregg Fisher is founder and managing
partner at The Stem (
Gregg is a thought leader with more than
20 years of experience at the intersection
of strategy, marketing and technology. He
is passionate about reinventing healthcare
customer engagement through technology,
and this has been his primary focus as a
consultant, executive and speaker over the
last 12 years. He can be reached at gfisher@
Kevin Michels-Kim is a lead social media
analyst at The Stem. He is also a partner in
Merakoi, a social analytics firm based in Basel,

Table of Contents for the Digital Edition of Pharmaceutical Commerce - May/June 2017

Table of Contents
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Pharmaceutical Commerce - May/June 2017 - Table of Contents
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Pharmaceutical Commerce - May/June 2017 - Cover4