I was having a flick through the bestselling pharmaceuticals of 2021 (as one does) and was interested to see that after the Pfizer/BioNTech COVID vaccine, Abbvie’s Humira continues to dominate the sales charts despite the availability of their next-gen oral sequel, Rinvoq, since 2019.
Of course, no doctor would change a patient’s treatment plan if they are responding well to therapy and thanks to Abbvie’s significant investment in the ‘Complete’ PSP offering, patients are likely to achieve improved adherence, treatment satisfaction, and QoL on Humira. What’s interesting though, is that Abbvie have done a near ‘copy-paste’ of the Humria PSP offering to Rinvoq despite Humira’s regular injectable administration vs Rinvoq’s convenient one-a-day pill. Coincidence? I think not.
PSPs can be defined as enhanced self-management support programs (e.g., individualized medication counseling, training, support, and virtual reminders) to improve medication-taking behavior, disease management and reduce complications. They were ‘born’ to facilitate compliance and adherence to complex therapeutic regimes – so what could and should they look like now that many of these medicines have been transformed into convenient oral ROAs?
Well, let’s go back to first principle and explore the patient unmet need. A recent systematic review by A. Gast & T. Mathes (2019) found that oral adherence is heavily influenced by socioeconomic status, social support, age, and depression vs therapy- and disease-related factors which suggests that PSPs should actually be catered to the individual instead of being designed around a product.
This isn’t hugely practical advice for a pharmaceutical company that looks for high utilization rates across their PSP offering to ensure ‘bang for buck,’ but becomes more feasible if a portfolio- or even company-level view is adopted where a company offers a wide variety of ‘opt-in’ services, enabling a patient to personalize their PSP according to their needs. Now if we return to Abbvie, they have successfully applied this thinking through their (in)famous Nurse Ambassador program that transcends their immunology portfolio, successfully enabling human-level personalized support to cater to diverse patient needs.
Another important consideration is that within these offerings, a patient should be empowered to select their preferences for how they want to interact with the program. For example, selecting between receiving medication reminders via app, text, phone call, or email, is straightforward for pharma to execute and can make all the difference from a patient utilization perspective. The ‘winners’ in this model will likely be pharma companies that can accelerate the adoption of digital solutions to streamline this customization. Read our take on what pharma can learn from tech companies in crafting customer experiences.