Patient-partnered drug discovery: vision or reality?

pharmaphorum’s Paul Tunnah talks to Anthony Yanni, newly appointed senior vice president & global head of patient centricity, Astellas, about why partnering with patients is the cornerstone for change throughout the drug development lifecycle – from early discovery through to market. Here he reveals how, in his new role, he will use this defining principle to reshape the very foundations of the organisation

What do you think when you read the words ‘patient centricity’?

While few can dispute the inherent sense behind pharma shouting about patient centricity from the rooftops, this sentiment has – until now – lacked authenticity and many companies have failed to define how having a patient-first focus is either commercially beneficial or sustainable.

Now, however, enlightened companies are waking up to the reality that ‘nice to have’ has become ‘must have’ and are putting patient centricity firmly front and centre of their future vision and strategy.

“Understanding patients’ hopes, values and expectations in the real world helps us contextualise our approach from a business perspective and ensures we address the entirety of the patient need beyond the medicine.”

“The evolution for me began eight years ago,” says Yanni. “At that time, there was minimal engagement with patients and a lack of clarity around how patients can have a positive impact in medicines discovery, research and development. Eight years on and there is robust effort regarding patient engagement.”

As a recent arrival to Northbrook, Chicago, where Astellas’ US headquarters and some of its global functions are located, Yanni has been tasked with leading the organisation’s global patient centricity strategy following a long-held role as global head, patient insights, solutions and outcomes at Sanofi Medical in New Jersey. It was during his time there that Yanni led the creation of one of the first systems to integrate patient and clinician perspectives and deploy this knowledge in prioritising early research and development portfolios.

From an organisational perspective, Yanni notes, placing patient centricity at the heart of the business means focusing in on the patient as a valued partner throughout the drug development continuum.

But how does this ethos showcase itself day-to-day? “Patient centricity will be embedded into all core disciplines and workflow – from initial engagement, to insight gathering and R&D decision-making,” says Yanni. “It means instilling these values across all functions of the organisation to acknowledge every employee’s importance in helping bring new and clinically meaningful medicines to patients.

Making sense of patient centricity

Patient advocacy, whether through advocacy groups or individuals, is all about working collaboratively to shape the environment, for example through disease awareness or policy change, to support better outcomes
Patient experience is the focus on truly understanding every aspect of what it’s like to live with a specific condition – in terms of diagnosis, treatment, medical and emotional support, information and technology
Patient engagement is about how and where you interact directly with the patient to improve that experience, often also necessitating advocacy, either through additional interventions beyond the pill or direct input/co-creation of solutions
Patient centricity includes them all – and all have a role to play

Where next for patient centricity? Check out Paul Tunnah’s recent blogs on pharmaphorum.com here and here

“In this context, and for Astellas, patient centricity becomes our core: integrating deep understanding and insight and utilising this knowledge in the research and development of new medicines.”

The next step, says Yanni, is to move from listening to action; to connect patient learnings and insight to the infrastructure changes that will transform the way medicines are developed.

Putting the patient first

Without doubt, patient centricity has become somewhat of an overused phrase in pharma. Consequently, stakeholders have become cautious and – in some quarters – downright sceptical that organisations are living and breathing the patient-first approach.

“Yet, patients and practitioners don’t make treatment decisions based on science alone,” Yanni observes. “They make decisions based on how the science delivers clinically meaningful benefits to them.”

With this in mind, understanding the patient need, their insights, values and expectations and weaving this into both the scientific discovery process and expected real-world application of new interventions is critical. “Providing the insights and the expectations of patients and practitioners to teams from discovery, for instance, provides a valuable roadmap and supports decision-making across the spectrum,” Yanni explains.

Understanding the patient journey

Like every good story, we need to start at the beginning. We need to delve into and truly understand the patient journey whether we are in discovery phase or in the real-world setting, Yanni adds. “Understanding patients’ hopes, values and expectations in the real world helps us contextualise our approach from a business perspective and ensures we address the entirety of the patient need beyond the medicine.

“The common thread throughout the product lifecycle is – and has to be – the patient,” he stresses, “but each stage and stakeholder is associated with a different method of engagement, understanding, integration and impact within the developmental cycle.”

However, there is equal danger in connecting a larger opinion to an individual patient as in connecting an individual patient’s experience to a broader group, says Yanni. In contrast, having a broader perspective using multiple modalities – whether it’s individual interviews, panel interviews or Real World Data – provides robust insight over time. There should, he says, be linkage in the same way we shepherd a new drug through a process: we should be capturing, engaging and partnering along that same continuum.

Smart communication and sharing of information are also equally important. “A critical part in my view of enlightenment,” Yanni observes, “is to develop best practice that allows us to explore the commonalities that exist for patients across therapeutic areas. This would allow us to better relate to our patients and utilise that information in our internal processes to avoid reinventing activities every time we engage and, indeed, replicating past failures. It is as important to learn from where things go wrong as it is from our successes.”

A laser focus on outcomes

Ultimately, of course, it is outcomes where the laser focus ends for all stakeholders in the healthcare ecosystem, whether they are payer, practitioner or regulator. For industry, however, it becomes about aligning the requirements of these multiple stakeholders to ensure outcomes are translated into a meaningful benefit for patients.

“We want innovative medicines that have meaningful impact and meaningful outcomes. The question we’re facing in the industry is how to best make the transition from this understanding and alignment into operational processes that are able to impact decision-making in a responsive and robust way.”

But what do we mean by outcomes? And how do you bridge the gap between what is a good outcome for the patient, with what is a good outcome for a physician, or payer or pharma?

To Yanni, it takes collaboration, patience and an ability to create processes and the right vehicles to deliver on insights and inform decisions. “It’s never going to be black and white; it’s never going to be simple,” he adds. “In fact, the more successful we are at engaging and integrating knowledge earlier on in the process, the more complex it will be.”

For pharma, we need to understand what outcomes are important to patients so we can prioritise our path to success based on what patients and practitioners are telling us. Then we need to understand how we work with regulators to better align our understanding and measure outcomes in a meaningful way using mutually validated tools.

Any lack of alignment in this process, Yanni stresses, creates an obstacle for patient access to medicines.

Not all headlines and bright lights

Without doubt, the depth of the vision Yanni has for Astellas will require hard work and commitment. “It requires an openness to change and an ability to share best practices. So, when we look at impacting the work we do, infrastructure change will be key moving forward.

“In terms of patient centricity, we’re just beginning the upslope in making this knowledge and understanding actionable. That’s not exciting, but it’s necessary. In the midst of all that change – not all of it is headline – but that’s what we should be talking about moving forward.”

So, what does the future look like for patient centricity at Astellas?

First, Yanni is building a framework and infrastructure that supports engagement with patients, care partners and healthcare practitioners throughout the lifecycle strategy, whether that is discovery research or late development.

Second, this will allow it to make those critical business and organisational decisions early on to adapt and refine its approach based on what patients need and healthcare systems can support.

“Everyone agrees that engaging patients and developing sustainable relationships is essential for future success. The next step is how to integrate those insights into the drug development decision-making process in an industry that, ten years ago, didn’t involve the patient or the practitioner’s perspective. Then, internally, building on an internal culture where the patient continues to be our primary motivation. The two are inherently connected,” Yanni adds, “because if you create change before you create the message, it fails. It is critically important to deliver on what we’re promising, both internally and externally.”

So, as the hype around patient centricity subsides – and pharma’s rush to cover itself in glitter wanes – defining precisely how this ethos contributes not only to improved innovation, access to medicines and patient outcomes, but to commercial benefits for pharma, is critically important. And having this deep understanding of how carefully planned patient centricity is good for the industry, health systems and patients is key to a sustainable future.

Astellas Pharma US is an afiliate of Tokyo-based Astellas Pharma, a top 25 global pharmaceutical research company. Astellas is committed to turning innovative science into medical solutions that bring value and hope to patients and their families. Keeping our focus on addressing unmet medical needs and conducting our business with ethics and integrity enables us to improve the health of people throughout the Americas and around the world.

Paul Tunnah

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 on Linkedin or email paul.tunnah@pharmaphorum.com.

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