Help us help them

Editor's note: Amr Mansour is managing director at Infomine Healthcare Research, Cairo, Egypt. 

A PPSP is a patient-physician support program, typically designed by any concerned organization for the welfare of patients and mostly by pharmaceutical companies to give back to their communities. Although variations exist, there are three main types of PPSP: on-site patient early screening for disease programs (and optional call-center follow-ups); patient affordability programs (through call centers and medicine distributors); and patient education programs (also with optional call center follow-up).

Why do PPSPs exist? Three main reasons.

Screening. PPSPs help in early diagnosis of disease in at-risk patient populations and raise the awareness for early detection. The proactive screening provides patients with a better chance to treat themselves when they catch their condition early. Also, not all physicians are equipped with the latest and sometimes quite expensive detection devices. In addition, assessments are augmented by medically approved disease-specific questionnaires to determine more about the patient’s journey in his/her disease. The tools, equipment and personnel are provided free of charge to support patients and their treating physicians. 

Affordability. PPSPs help to provide a channel to reduce costs and increase accessibility to costly drugs through sponsored programs where patients are assisted to help in the cost of medications.

Education. PPSPs help busy physicians provide patient educators, who give time explaining the dos and don’ts of lifestyle choices and coping strategies for the patient, who is searching for answers and support. The patient educators are sponsored and no fees are levied on either patient or physician.

Need was created

Traditionally, the PPSPs were always provided in-house by the pharmaceutical companies sponsoring them. However, with the advent of stricter compliance guidelines removing the pharmaceutical company from any type of direct communication or contact with the patient, a need for third-party vendors was created. The vendors are not allowed to send any identifiable patient information and provide a barrier to prevent any influence from the pharmaceutical company. 

Why are health care marketing research now getting involved? In the ecosystem of pharmaceutical companies’ vendors, specialized health care research agencies are a close partner to reach for, both for their specialized knowledge, personnel and relationship and also for the fact that the capabilities needed – fieldwork and call centers coupled with data analysis and reporting – are typically part of a health care market research agency’s offerings.

What synergies are there with market research? There is a lot of scope in collecting anonymous aggregated data that can be used to determine how much impact on the welfare of the community the sponsor company is achieving and how it may improve. Furthermore, PPSPs give agencies more exposure to patient populations and physicians, understanding their main respondents better. Moreover, a deeper understanding of disease and therapy areas is acquired through the course of PPSPs, equipping agencies to approach their market research projects with more expertise.

Not easy

PPSPs are not easy. They require a huge investment in infrastructure, technology, training and personnel and are heavily regulated with regular compliance audits. 

The must-haves include zero tolerance to any delay in adverse-event reporting, 100% proper documentation of all source documents and timely and accurate reconciliation. In addition, refresher trainings are not to be missed and updates to the program are periodically needed to be taken onboard rapidly and assimilated for immediate implementation. Furthermore, dealing with patients and physicians in this type of setting requires a special skill set, with good decision-making while in the field or on the phone, sticking closely to the policies, guidelines and pre-approved scripts and scenarios.

Additional requirements include: a laborious and iterative program for design and approval of every minute detail, sometimes taking months or even up to a full year – nothing is taken for granted or left to chance. Afterwards, the program cycle would typically include the main events of interactions, either with the health care professional or the patient, each of which needs to be documented and logged in an interaction, whether it be verbal, written, by e-mail or hard copy, SMS or call. The reporting is rigorous and is only for the very analytical and detail-oriented – reporting is daily, weekly and monthly. Internal quality checks are conducted by the agency on its own operations daily/weekly and sponsor-company quality checks are performed at least monthly – with every six months to a year a full scale. There can also be week-long external audits from the compliance departments of the sponsoring company for things like confidentiality, document retention, access control and archiving as well as on-site inspections of infrastructure for things like flood- and fireproof storage, backups, disaster recovery procedures, business continuity policies and procedures.

If all of the above sounds like a lot of work, it certainly is. But the rewards are immense for the research agency, client and community, in spite of all the effort and cost involved.

The community is served by better access to medicines, diagnosis and information. Awareness campaigns are conducted through the life of the program which alert patients to silent or dormant diseases that enable them to have a better chance of quality of life and treatment when dealt with early. One such famous awareness campaign was Amgen’s 2019 “Break Records Not Bones,” which won the Guinness World Record for most osteoporosis screenings in one day across nine countries – a huge number of people were assisted and made aware of osteoporosis and its early detection.

A big indicator of the value and commitment of these programs (also additionally to the agency) is how long-term they are. A typical program will run into an average of seven years at least. 

There are many other high-profile programs such as screening for retinal diseases by temporarily stationing at hospitals and medical centers with mobile equipment that is staffed by trained professionals to combat blindness and help in early detection. Or removing the guesstimates of whether someone has diabetes or is pre-diabetic/metabolic syndrome by having mobile units with the highly accurate HbA1c glycated hemoglobin tests, as well as weight scales and tape measures for waist circumference, also placed where normally these tests would not be available. Yet another would be accessing remote and hard-to-reach areas with low-weight spirometry devices to measure lung efficiency thereby providing access to patients who would otherwise suffer before detecting chronic obstructive pulmonary disease or asthma.

Many more types exist and variations abound on how client sponsors are proactively seeking to bear their corporate social responsibility and care for the community.

The client is served by contributing back to the society, whether through providing lower-cost access to its medications, screening for early treatment or educating patients how better to deal with their condition. 

The research agency is served in that it is exposed to deeper understanding of therapy areas, patient populations and physicians as well as touching the lives of those that health care marketing research agencies ultimately serve through their studies and reports. After all, ensuring everyone has proper diagnosis, access and information to be treated is why most of us are in the health care business.

Lives a deeper purpose 

Patient-physician support programs are an integral complement to the health care system. Cost, information and early detection have always been on the forefront of all health care stakeholders. With the advent of more stringent guidelines on distancing away from direct contact from the patient and physician, pharmaceutical companies have turned to third parties that can implement strictly confidential and privacy-maintained programs. The natural vendor in the ecosystem of the pharmaceutical companies is the health care market research agency, which deals naturally with fieldwork, call centers, data analysis and reporting. Although synergies exist, PPSPs further require a huge commitment on behalf of the agency to maintain an operationally excellent and compliant program. Ultimately, not only does the sponsoring company give back to the community and the agency lives a deeper purpose but the patient population is the biggest beneficiary with additional support from the physicians in whose care they are or will be.