Look behind the lecture: Innovations derived from PROs

In this interview, Stephane Regnier (Novartis, Basel, Switzerland) discusses his presentation from ISPOR (18—22 May 2019, New Orleans, LA, USA) concerning innovations derived from patient-reported outcomes (PROs).

Aug 27, 2019
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Please can you introduce yourself and your institution?

I am the Global Head of Health Economics and Outcomes Research (HEOR) Excellence at Novartis (Basel, Switzerland); a center of excellence to support my global HEOR colleagues and their franchises. Our group focuses on innovation, health economic modeling and patient-reported outcomes (PROs).

What does innovation mean to you?

Innovation is about new methods of gaining insights and demonstrating drugs’ value. This includes finding new ways of analyzing data, new types of data, or new ways of improving data efficiency. For instance, we can spend a lot of time conducting literature searches; innovators seek to optimize this process such that we gain more insights from the research we do or achieve these insights in less time. Newer insights ought to be more efficient.

Automated devices/wearables: are these devices like Fitbits, or is there an added level of complexity to them?

The term ‘wearable’ does not exclusively refer to devices such as Fitbit, wearables can assess metabolic parameters as well. A sensor that is worn whilst travelling to track your sleep and stress levels, for example, counts as a wearable.

“Newer insights ought to increase efficiency.”

I am personally always cautious with wearables because the information they provide does not replace patients’ experiences. Revisiting my sensor example; if a sensor tells you that you did not sleep very well one night, yet you woke up feeling well rested, you may not pay too much attention to the sensor’s information. Similarly, if a sensor tells that you had undisturbed sleep one night, yet you woke up feeling exhausted, what is important is that you are tired. The device’s information should complement, not substitute, the patient’s experience. Hence, patient reported outcomes should remain key.

Many people already have wearables; in this age of connectivity and data collection, how do you balance data privacy and data ownership concerns, with using wearables to make informed decisions for patients?

Data privacy is fundamental.  In my opinion, we must strive to protect this fundamental right while providing benefit to patients derived from their information. Pharmaceutical companies want to learn about patients so that they can develop new therapies and help patients better understand their treatments and treatment options. As we develop wearables and look to gather more data, we must always be thinking about what the immediate and long-term benefits for the patient are.  The industry must be innovative and employ more behavioral economics to use the data that we gather to positively impact on patient’s behavior. We need to demonstrate benefits to patients from those devices while maintaining patient privacy.

“The device’s information should complement, not substitute, the patient’s experience.”

Do you think that pharmaceutical companies overlook variables, such as patient behavior, as being beyond the necessary considerations they should be taking into account?

The ultimate goal for most pharmaceutical companies is to deliver a drug to patients that improves their health. Part of achieving this goal is physically supplying a drug with robust clinical data but the other aspect to achieving this concern is ensuring positive patient behavior and good patient compliance. Pharmaceutical companies have an interest in ensuring the best outcomes and patient behavior. However, due to regulations – such as pharmacovigilance requirements – it can be more challenging for pharmaceutical companies to run studies aimed at improving behaviors than for other actors, including Google or Apple. Hence, I think the next frontier will be about the collaboration of pharmaceutical companies with healthcare systems to help manage patients in the best way. 

What do you think the roles of big pharmaceutical companies in patient management will be in the future?

I think, going forward, the role of pharmaceutical companies will be in sitting at the table with healthcare system leaders. The pharmaceutical companies should look to help identify the pain points in healthcare systems’ patient management schemes and consider how their data analytics capabilities and expertise can help with these. In the pharmaceutical industry, we have specific capabilities and resources that may complement those of local healthcare systems. Again, I don't think pharmaceutical companies should look to be ‘patient managers’, necessarily, but, pharmaceutical companies should be somewhat involved, because, ultimately, their aim is to improve patient outcomes.

“…I think the next frontier will be about the collaboration of pharmaceutical companies with healthcare systems to help manage patients in the best way.”

 

Financial and competing interests disclosures:

Stephane Regnier is an employee of Novartis AG and owns Novartis stocks. The views and opinions expressed in this article do not necessarily reflect the official policy or position of Novartis or any of its officers.

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