Why pharma needs honest patient dialogue

Astellas Pharma US president Percival Barretto-Ko talks with Dr Paul Tunnah about drug pricing, collaboration and improving the patient experience.

What are your key ambitions in your current role?


Without question, diversity and inclusion is something that I’m very passionate about – not just from an employee perspective but making sure that we truly represent the society we serve, and that we conduct clinical trials that are well-developed and are truly representative.

Starting with our leadership team, we’ve improved the gender balance over the last year by 50%. I believe diversity is a business imperative. When we have diversity of thought around the table, diversity of ideas and diversity of backgrounds, it benefits our company and the patients we serve in the long run.

Another key objective for me is access. I don’t think this diminishes our focus on innovation. Innovation continues to be what we’re proud of and what we’re focused on, but for me, access is equally as important. Not just focusing on access once the product is finally available, but rather looking at it from the get-go, from drug discovery onwards, so there’s always clarity of thought there.

There has always been pressure on drug pricing and access, but it’s particularly profound at the moment. Do you have a sense of where that’s going to take us in the next couple of years?


When the discussions on drug pricing came about, the industry, in general, was quite taken aback. I don’t think it’s something to shy away from. I think it’s something that’s real and something that patients experience daily when they receive their bill for the out-of-pocket costs they have to pay. I think the industry, Astellas included, needs to be part of the discussion. It’s important to make sure that we ground ourselves in the truth, in an objective, rhetoric-free conversation on what actually happens to the flow of money.

When we’re talking about, for example, rebates, what exactly are rebates? Who benefits from them? Who loses out? At the end of the day, what does the patient receive? When we’re talking about list price versus out-of-pocket costs, what does that really mean?

It’s very important to have open discussions about this, including with our employees. We’ve held town halls with all Astellas employees to talk about access and pricing, so we can have a transparent dialogue about the US healthcare ecosystem and our employees can be educated about these challenges for the industry and the broader healthcare landscape.

How are you as an organisation engaging with external customers and patients? I certainly think we’ve seen a massive change in the last ten to 15 years from didactic messaging to softer conversations. How’s that playing out for Astellas?


Partnerships and collaborations are key for us. Over the last year and a half, our patient centricity organisation, in particular, and our commercial and medical organisations have done wonders in terms of partnerships. For example, we’ve partnered recently with the Academy of Oncology Nurse & Patient Navigators (AONN+) to develop an acuity tool specifically focused on identifying the support that patients need as they go through the cancer care journey. This initiative is intended to enhance the oncology navigator’s effectiveness through patient-centric evidence-based methods, which may have the potential to decrease the overall cost of care.

Another collaboration is with an organisation called WiserCare, that helps support shared decision making at very emotional times – for example when making complex health decisions or preparing for a health procedure. Through this collaboration patients can consider who needs to be involved in their care and the role of patients, caregivers and physicians.

At the same time, within Astellas, we’ve initiated several interdepartmental collaborations. We have something called a 90-day results accelerator, which is a Dragon’s Den/Shark Tank-style initiative where we bring together different individuals from different groups and departments. The first thing they try to determine is what is the problem, what are the needs and gaps that need addressing?

They then have 90 days to pitch an idea to a committee – not just to propose something, but to actually come up with a solution. It forces them to take a step back and say, “Are we being too ambitious here? Can we really whittle it down to something doable and something practical for the patient?”

It led to us considerably changing our consent forms – as well as how we operate our call lines. We used to have about 75 numbers that patients can call in, so they got stuck in a land of voicemail that could be frustrating for patients. How many companies call their own lines to check their systems for a patient who wants to learn more about a clinical trial?

It’s these kinds of things that may seem so basic but, at the end of the day, actually have a big impact on patients.

How do you define the value of doing patient experience well from Astellas’ perspective?


It’s multi-factorial for us. One is direct value to the real patient experience. As patients go through the process, do they feel that their needs are being cared for?

Secondly, it’s frankly just good business sense. When you have patients who feel their input is being considered and that they’re at the heart of a company’s DNA, it translates into good business for the organisation.

I oftentimes scoff at folks who say that patient experience is just a ‘feel good, nice-to-have’ thing and that really, there’s no connection to the business. I would say, to the contrary, that while in the past it had been a competitive advantage, now it’s a basic foundational need that you must put in place to get results.

Finally, it certainly helps reputation as well, not so much from a brand recognition perspective, but from the confidence of patients and stakeholders that they’re working with a company like Astellas who really does care about the patient.

What qualities do you like to see in people within the organisation and what kind of behaviours do you encourage?


One of the things that’s very critical to me is a clarity of purpose. It’s very important that every single person, including myself, has a clear idea of why we’re going to work every single day. Or else, you can go across the road and go to a different company and be okay. We like to ask people, ‘What is your why?’

Another thing is the concept of kindness. Last year, at an employee town hall meeting, I ended my talk by saying “Let’s be kind to one another”. It wasn’t scripted, but it caught fire within the company. People started talking about it. Sales reps from Florida and California started sending me t-shirts with “be kind” printed on them. It really struck a nerve. You can still demand high performance, and expect the best from your team, but there is a good way to do it and there’s a nasty way to do it. Life is too short to be nasty.

You’re only a year into your current role. Is there one thing you would pick out within that year as something you’re particularly proud of that the organisation has achieved?


One of the things I’m most proud of is last year’s US launch of a therapy that we have in acute myeloid leukaemia, XOSPATA, which was a landmark moment for our oncology programme and offers patients with a certain type of AML a treatment option when they are often told they have maybe two to three months to live.

The drug was launched and made available within 48 hours of FDA approval – we had the supply chain team in the warehouse at 4 am just to get it out because we knew that every bottle corresponded to a patient who was waiting for it.

I’ve always seen Astellas as very collaborative in nature. It was a beautiful example of everyone pulling their weight together in such a short amount of time.

About the Interviewee

Percival Barretto-Ko is president, Astellas Pharma US. In this role, he is responsible for the operations for Astellas Pharma across the US. Previously, he led Astellas’ businesses outside of the United States including senior vice president, head of international. In addition, Barretto-Ko held prominent roles for Astellas while based in the UK including head of EMEA corporate strategy, business development, and corporate communications, as well as EMEA head of immunology and transplant. Before joining Astellas, he held senior commercial positions with the Roche Group.

About the Author

Dr Paul Tunnah founded pharmaphorum in 2009, which is a content and communications company offering industry leading publications (www.pharmaphorum.com) and a strategic consultancy (www.pharmaphorumconnect.com). He is a recognised author, speaker and industry advisor on content marketing, communications and digital innovation, having worked with many of the world’s leading pharmaceutical companies and the broader ecosystem of healthcare organisations.

Connect with Dr Tunnah at Linkedin or email paul.tunnah@pharmaphorum.com.

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