Photo credit: BICENTENNIAL EYE CLINIC/Creative Commons

In recent months, Astellas Pharma and Merck have created patient-centered roles in their companies. These moves speak to pharma’s continued effort to further bring the patient voice into its business model and upend its traditional, provider-focused way of thinking.

Merck elevated Dr. Julie Gerberding in July to chief patient experience officer, while Astellas created a new patient experience organization in November.

The move to be more patient-centric isn’t new for drugmakers. Starting in 2013, the concept of “patient-centricity” or being “patient-centric” became the topic du jour for pharma marketers. At the time, experts agreed that drugmakers needed to put patients at the front and center of everything they do, and that the model of discovering, developing, and commercializing therapies would be better served with more patient input along the way.

See also: No More ‘Patient-Centric,’ Please

Years later, it’s unclear whether that evangelizing has translated into significantly better support for patients or a better experience with their brands. According to industry executives, progress has been slow and incremental, and pharma still struggles with defining and understanding what it means to deliver a better experience for patients.

Doug Noland, the newly appointed head of Astellas’ patient experience organization and former senior marketing director, said this is something the company is grappling with right now. “What does it mean precisely to deliver on a better patient experience and that we’re committed to patients?” Noland said. “We’re literally defining that right now with our senior leadership to share across the organization.”

Amy West, Novo Nordisk’s director of patient-centric marketing, said the industry has yet to clearly define what it means to be patient centric. “It’s what we want to do, the essence of it is there, but it’s making sure we put our money where our mouth is. It’s about how … we position the benefit of a product with our services that are going to make it easy to engage with patients so they have a better outcome.”

See also: Patient-Centricity: There’s Always Room for Improvement

At the Partnering for Cures conference in mid-November, Gerberding shed some light on why she thinks the industry continues to struggle with engaging patients.

“This idea about what the patient needs seems obvious, but we’re not built for it,” she said, noting that companies like Merck were built around the provider as its primary audience and changing that focus will be a difficult transition.

Attitude and culture also remain a significant obstacle, West pointed out. She said there is “a lot of skepticism and fear in this [kind of] change. In some business units, being patient centric is counter intuitive to being a profitable venture. We’re not a non-profit, but our success lies in the success of patients, so [in that way] we’re inextricably linked.”

See also: to publish patient reviews of drug effectiveness

That’s not to say that drugmakers haven’t made strides in this area, said Hensley Evans, a principal at ZS Associates, particularly in terms of what patient services pharma now provides. “Historically, the majority of patient support programs were co-pay cards, or financially oriented, or they were about access,” she said. “Now, there’s been acknowledgement that there’s a huge set of other needs that patients have and where manufacturers can play a role.”

Evans pointed to programs like Mango Health or HealthPrize — two companies that work to create healthy habits and encourage positive outcomes through gamification principles. “These programs are showing good results for patients in terms of outcomes and good results for manufacturers in terms of engagement,” she said.

In fact, more comprehensive patient services may represent the industry’s best avenue of approach when it comes to driving better engagement and, subsequently, a better experience with patients. West pointed out that providing better service starts with creating meaningful engagement.

See also: J&J CEO: Patients have higher expectations

“The salesforce is about delivering a clinical message to doctors, but if you want engagement, just prescribing a medicine doesn’t help someone start or stay on the medicine,” she said. “It has to have a service wraparound, and that requires a patient-centric approach: ‘How do we position the benefit of this product with other services that are going to make it easy to engage, so you have a better outcome?’”

Outside of more ‘beyond-the-pill’ services, industry leaders say that pharma needs to do a better job at listening and cultivating feedback with patients. “While patient research is built into the marketing process,” Evans said, “I think industry needs to figure out new methodologies that allow you to have a more consistent dialogue with patients,” adding that it needs to be done “without fielding studies that cost six figures every time you want patient input.”

That constant feedback is critical for drugmakers who may lose sight of all healthcare stakeholders when focusing on individual aspects of the commercialization process. “We get so focused on the task at hand you forget the voice of the patient a little bit,” West said. “You have to continue to infuse the patient voice through everything you do, and while you might know you have a good product, if the patient doesn’t see the value or we don’t make it easy for them to understand that, then we’re just pushing our brand and that’s not going to be successful.”

See also: Boehringer Ingelheim launches gamified support program

To West’s point, Noland’s role at Astellas is completely outside the commercial process. “I have no responsibility for selling medicines, which was important for tackling [this issue] in a meaningful way,” he said. As executive director of the company’s patient experience officer, he said he will work with disparate parts of Astellas to help them understand what it means to align their work with the patient perspective. “When we talk about patient focus as an organization that has a different meaning to a lot of different folks depending on their background or function,” he said. “Operationally, how are we leveraging new patient insights? That’s where my role picks up on their good work.”