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Who Is The Customer?

A grey area has emerged regarding who the customer truly is in the pharmaceutical manufacturing supply chain. Is it the health service, the GP, the pharmacist, the caregiver, the end patient, the provider of advanced analytics or mobile technology, the manufacturing community itself, or could it, in fact, be all of the above?

The answer can only be established once the role of each of these stakeholders is understood and evaluated in the context of both rapidly changing patient (or consumer) expectations and the smarter ‘connected world’ in which we live.

The Connected World

Before considering who the pharma manufacturer’s customer really is, we first need to look at the ever-changing and developing surroundings in which we live, and how these are altering the relationship between the stakeholders in the pharma industry, from production right through to the end patient.

It is hard to read a publication these days without stumbling upon an article about the ‘connected world’. Rightly so, in many ways, because our rapidly changing and ever-more digital lifestyles have altered, and will continue to alter, our consumer experiences and expectations across the board. But what exactly is this connected world in pharmaceutical terms, and what bearing does it have on identifying the manufacturer’s customer?

Stakeholder Roles


To understand the parts played by each stakeholder, it will be useful to take an example of a commonly used class of drugs – statins – and consider these roles one by one. It is estimated that over 30 million Americans and nearly 10 million Britons take statins, and the global consumption figure is far greater than that. They are widely manufactured and used, involving all supply chain stakeholders on an ongoing basis.

Statins are prescribed to lower the blood cholesterol level in those with, or at risk of, cardiovascular disease. The drug should be taken daily and the patient needs to be monitored regularly – traditionally, by visiting their healthcare provider to test and track their cholesterol levels, to ensure the treatment is working effectively, and monitor liver enzyme levels to check the medication is not harming the liver. While administration of the drug is straightforward, the procedure for making sure the medication is appropriate for the patient involves many different players.

All patients react to drugs in diverse ways, and a patient may even react to the same drug differently at various stages in their life, so there can be a need to change statins periodically – thus, responsible stakeholders include:

Manufacturers
Pharmaceutical manufacturers must continually evolve the drug so that it is suitable for each patient’s changing needs.

Health Service
The health service has a responsibility to ensure that ongoing trials can prove the drug is safe and fit for purpose.

GPs
A patient’s GP has to be certain that the drug they are prescribing is the most suitable for their current requirements.

Pharmacists
The pharmacist’s task is to make sure the right prescription is physically given out in the correct prescribed quantities.

Caregivers

Responsible for monitoring the patient, the caregiver must check that they take the right drug at the recommended times.

Patients/Consumers

Each end patient also has a duty towards their own care to ensure, if they can, that they are consuming the correct medication and dose, and that they are proactively monitored at regular intervals to guarantee that the drug is working and not causing them any harm.

Technology Providers
There have also been indications that providers of advanced analytics and new technologies will join this chain. Their aim will be to present more accurate data and develop solutions that simplify the responsibilities of the stakeholders, as well as go some way towards shifting the burden of monitoring and administration onto the patient – taking away the need for many of the steps in the current process.

Advances in Technology

Today’s technology market is constantly advancing its interoperability standards. It cannot be too long before developers will be able to implement a variety of novel, innovative solutions – and perhaps one day the patient will be able to monitor, as well as administer, their prescription requirements themselves.
 
There are many affordable and simple connected devices already available that allow seamless transmission of data from connected devices to personal computers, telemedicine hubs or mobile phones. This eliminates the need for manual data entry burden on users, enabling usage tracking and reducing device cost. Moreover, data can be transmitted directly into electronic medical records or personal health records available online, thus creating an efficient and automatic feedback loop.

Going back to the statins example, this novel technology will have the ability to change the role of the stakeholders in the supply chain and, in doing so, potentially change the answer to the question, ‘Who is the customer?’

Data Sharing


Within the new connected world, let us imagine that after consultation with their GP, a patient is prescribed statins. Instead of following the traditional path of taking their prescription to the pharmacist to collect their drugs and then being monitored by the caregiver, the patient is fitted with an electronic device that not only reminds them of when to take the statins that have been prescribed, but also monitors blood cholesterol and liver enzyme levels. These statistics could then be transmitted wirelessly to become available to the relevant traditional stakeholders in the chain, thereby efficiently managing the patient’s medication and condition.

Details of the prescription drug could be transferred into electronic medical records or personal health records, which would then be passed to a third-party provider of subscription commerce, where the regular supplier of the drug to the patient ensures the right amount of medication is delivered to him or her, wherever he or she is in the world. The monitoring information could be automatically sent electronically to the GP, thus enabling a feedback loop directly between them and the patient.

Arguably, this information could also be transmitted directly to the pharmaceutical manufacturer to help guide future R&D, as well as interacting directly with the GP to make recommendations for a different form of statins that might suit each individual patient better. In turn, the pharmaceutical manufacturer could be seamlessly integrated into a subscription commerce provider, so that the physical packs of drugs are delivered straight to the end patient – thereby making the whole process more streamlined, efficient and less dependent on as many stakeholders.

Making a Difference

The adoption of connected devices opens doors to endless opportunities: reminder systems for patients; customised emails or text messages to caregivers based on patient behaviour; coaching and education tools; participation in community or peer groups; direct or indirect incentives for both patients and caregivers, and much more.

Perhaps the question ‘Who is the customer?’ should be reworded to ask: ‘Which stakeholder(s) can make the biggest difference to the efficient manufacturing and administration of drugs?’ The answer may be the stakeholder that brings technology, automation and more effective and streamlined procedures to the table, particularly if the use of wireless communications and proliferation of the internet make it possible to bring patients into the loop with their caregivers, GPs and a wider social structure.

It will only be a matter of time before connected devices are in the hands of patients, allowing them to measure physiological parameters, deliver medications and track compliance. With the added service of ensuring the right prescriptions are delivered to the right patient at the right time, and at their convenience, the end patient is truly empowered. The pharmaceutical manufacturing industry is firmly involved in guaranteeing R&D is based on solid, concrete patient needs and, thus, pointing in the right direction towards progress. This is in addition to making sure patients gain trust and, ultimately, brand loyalty as a result of more effective drugs, a more efficient service and beneficial outcomes all round.


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Alan Cox is the founder and Chief Executive Officer of The Indigo Lighthouse Group, a company he set up almost two decades ago after identifying a gap in the market to change contact lens retailing. The business now provides UK and European companies with a marketleading plug-and-play outsource solution for subscription loyalty programmes. Prior to this, he established and developed his own national chain of optical retail outlets called Opto Total Eyecare, which was purchased by The Dolland & Aitchison Opticians Group in 1996. Alan holds a BSc in Optometry from Glasgow Caledonian University.
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