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The Digital Payer: Fact or Fiction?

Our experts, Sue O’Leary, Senior Vice President Prime Access, Jenny Blackham, Vice President Client Partnerships and Head of Digital Solutions Michelle Collins recently led a webinar with the team at NetworkPharma and MedComms Networking. Discussing ‘the digital payer – fact or fiction?’ the webinar was a brilliant platform to discuss perspectives and share ideas about about evolving payer communications in the changing digital landscape.

Watch the webinar here or read the transcript below.

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Webinar: the digital payer – fact or fiction?

Peter:
Hi everybody, thanks for joining us! For those of you who don’t know me, my name is Peter Llewellyn, I run the services of http://www.medcommsnetworking.com/ providing information services and resources for the global medcomms community. We’ve got a good audience in today and I’m absolutely delighted to have the guys here from Prime Global!

Sue:
Hi, thanks a lot, Peter! It’s great to have the opportunity of meeting with you all today on the webinar. To start off with let me introduce myself; I’m Sue O’Leary, I head up the market access team at Prime Global. I’m a pharmacist by background, spent time in
the health service, plenty of time in the pharma industry, and now consulting as part of Prime Global. Enough of me, over to my team!

Michelle:
Hi guys, I’m Michelle Collins, I’m a digital strategist here at Prime Global. I spent the last 10 years working within the industry and in mainly med affairs, with six years before that in the consumer industry so really looking forward to having a fun discussion today.

Jenny:
My name is Jenn Blackham and I’m the VP of client partnerships, I support Prime Global with business development and partnerships. My expertise is in the payer space and I’ve been in this space for over 12 years so I’m really looking forward to this conversation today about what’s changed and what hasn’t changed.

Sue:
Thanks both. This session is entitled “The digital payer – fact or fiction?” and we’re going to present both sides of that and see where we see where we land. The medcomms space at the moment is absolutely awash with talk about digital transformation, moving to disseminating data in new innovative ways – podcasts, webinars, gamification, social everything! But let’s be honest, I’ve worked in the payer space for a long time, and you know the market access deliverables and all of the evidence dossiers don’t naturally lend themselves to some of these communication vehicles so I don’t actually believe that in this transformation we’re going to be throwing away the dossiers and moving on to wholesale different formats. I’m not ready for it and I’m not sure the world’s ready for it! I think what’s really interesting is that evidence is key in the payer market access space and I want to explore a little bit more about how keeping that in mind, we can move forward. I see maybe a little transformation; Michelle, you see me as one of life’s laggards on technology so as a digital strategist, talk me through your own view about how this is moving.

Michelle:
I’ve been in the industry for 10 years and the rate for digital adoption has really accelerated within that time, especially amongst HCPs and patients. When we look at all of our audiences that has really been an acceleration due to COVID-19. As we’re all aware, we’ve had to move from an offline to an online format and if we just have a look at this slide here, in terms of that rate of adoption of the channels that have been introduced to our world in pharma, our first blog was launched in 2005. As you’ll see here, we have really as an industry embraced digital and online formats, and there are new channels launching every day, such as Clubhouse. Twitter is something that’s really been embraced by HCPs, that is a real hotbed for peer-to-peer conversations. When we look at all these channels, it’s really important that we take a step back and think about how we can reach our audience so we’re reaching them on the right channel at the right time but doing it in a compliant way, and in a way that our audience feels comfortable. It would be interesting to see how we can do this with our payers and this is something that we’ve got great experience with in the last year or so, engaging payers within this
environment.

Sue:
So, how is all of this going to translate into the payer space? Let’s go back into that whole world of evidence-based medicine, everything set up with templates and structures, I’m thinking about how we communicate with our reimbursement authorities and health technology bodies.

Michelle:
Within the payer space, digital adoption hasn’t accelerated as much as it has for HCPs or patients. However, something we’ve experienced in our projects is LinkedIn, in terms of engaging payers and disseminating content to them. That’s a channel that they feel more comfortable, as opposed to Twitter.

Sue:
Thanks Michelle. Jenny, your based in the US and you’ve been discussing both first-hand with payers and also with the pharmaceutical companies around communicating with impact. Tell me whether you’re seeing from a US perspective that same adoption
and also how that relates to your European experience in terms of payer comms.

Jenny:
So, we are not seeing the same rate of adoption in the payer space as we’re seeing with HCPs and patients, however we are seeing some movement and this movement has actually been confirmed in a recent study that we did with 40 global payers. I would like to share some of our results from this research. We did a survey to gain insight on payers’ behaviours and preferences for digital media now and in the future, and what we found was that the majority of the payers reported high comfort levels in using digital media for professional purposes. As a result of fewer face-to-face interactions, over 50% said that their confidence level with digital interactions has actually increased.

Payers are already receiving a variety of evidence from the industry in a combination of traditional so the PowerPoint and the publications but also digital, which we define here for the sake of this survey as short video and podcasts.

We went on to ask if the digital formats are effective and impactful in their decision making and again the majority of the payers said ‘yes’, because it lets them access information on the go, it helps them learn new information and also reinforces information. So for me, I would say that the digital payer is a fact, though there might be a plot twist! When we asked about the future, they actually wanted a range of communication platforms, they didn’t just want traditional and they didn’t just want digital, they want both. So, one of the key messages backed up by our research is that we do need to provide a mix of the traditional and the digital in a multi-channel approach; this is how we’ve been supporting our clients in the last year.

Sue:
Thank you for sharing that information, Jenny. What I’m hearing you say is that there is opportunity but that the payers do like that purity of evidence and keeping that link back to the publications. I think that that fits with my experience of talking to them; sound bites are okay but they always want that link and we need to observe that.

Jenny:
Definitely, that came out in our research too, the importance of the data. The data needed to be published, if not published then data on file, but they definitely preferred the former. If we are creating those short videos or podcasts, we really need to link it back to that source of evidence with the exception of a patient voice, which you know is really about that real unmet need that comes directly from the patient. As I mentioned, this was a global study and we actually saw some nuances between the regions. I’m not going to go deep into this because that could be a whole other webinar, but we saw that in the EU region, behind clinical trials, the payers wanted more real-world evidence and HEOR, where in the US region, behind clinical trials they wanted the unmet need and burden data. So, there is that slight nuance that we need to take into consideration when we’re working with our market access and payer evidence teams.

Sue:
Ok, thanks Jenny. So, there’s a place for innovation but we have to get it into the right space. Michelle, your background is more in that physician transformation and you’re also working in the payer space now, how does being described relate to what you’re
seeing with physicians and how that’s moving?

Michelle:
I think the commonality is that data and the purity of evidence. Physicians aren’t different in terms of when they want to get knee deep in that data, they want to interact with that data so, for example, a podcast wouldn’t be applicable as a source if we’re talking about data and we really want to get our physicians interacting with and immersing in that data. What we really need to look at is the story that we want to tell and then understand what format is right for that right person and also really understanding how we can reach that person. When you look at physicians versus payers, one of the clear things is that payers in our experience are more comfortable in an environment like LinkedIn as opposed to Twitter, but also where Twitter is that hotbed for physician peer-to-peer conversations, it’s not the case for payers. The question is, where is the actual payer digital home? We’ve found LinkedIn very successful in previous campaigns, but it will be really interesting
is to see how that payer environment evolves because. as Jenny said, the payer environment is becoming more and more comfortable with digital formats.

Jenny:
I do think in the future, we will have a digital home for the payer – stay tuned on that!

Sue:
Thanks for that. I want to shift a little bit because you know we talk directly to payers but also a lot of the communications we have are with global pharma companies, talking to affiliates. In my experience that whole communication between global and affiliates is also open to new technologies. A lot of people in countries now have to get their heads around a lot of new technology, complex brands that are coming out, new types of therapies when they’re working across portfolios and I’m just thinking about my time in an affiliate and how these technologies might be more helpful in that perspective. Jenny, I know you you’ve been on the ground talking to people, what’s your thoughts on that?

Jenny:
The narrative is definitely changing with the industry. When I think about when I started my career in the US as a field associate on a payer team and then talking to multiple affiliate groups in consulting over the last 12 years, digital was not part of our lexicon. It was not even a word that we talked about, but now it’s becoming more prevalent and it’s actually coming up in every single meeting we’re having with our client. Sue, you mentioned earlier about how we as a market access payer evidence team are required to use these structured templates for launches, you know the AMC dossier or a NICE submission or another HTA requirement. The written resources that we currently do for our teams need to stay because they help the affiliates do their job effectively in a compliant way and that’s not going to go away, at least not now. However, where we’re seeing that shift in the digital conversation is helping the affiliates prepare for payer conversations; this is currently happening on platforms like zoom, where we’re at today. These affiliates are covering multiple disease states, they can be covering up to five or six drugs, and they need to be able to articulate the value story, what differentiates the product, and be able to really articulate the nuances that you might see with the MOA or the study design. What we’ve found is that digital component, having them listen to the unmet need or the burden or see that short video where they look and see the MOA and how it works, actually gives them more confidence and effectively equips them to have more impactful payer conversations. That’s where we’re seeing the digital come in with our clients.

Sue:
That’s clear, some of the new drug advances, there’s a lot of complex mechanisms, there’s a lot about targeted therapies, and they are difficult to write in a paragraph of text to help people understand what it actually means. I look forward to a day when we can actually present videos at a technology appraisal committee or the voice of the patient, I think that’s not quite there yet but I see your point within the training and learning and development. Michelle, I’ve seen some of the learning tools that you’ve been doing in the medical affairs space, what’s your thoughts on those tools and the learning and
development side?

Michelle:
When you look at training from a digital lens, I have four key principles. The first one is really simple in terms of keeping that user in mind, so what we need to do is before we create this great e-learning or training strategy is to approach the affiliates and really understand what works for them. The second thing is keeping it simple, engaging, and interactive. The third thing and I think it comes back to what we’ve been saying here on this webinar is that purity of evidence, making sure that it’s scientifically credible. The fourth one is ensuring that we have robust KPIs assigned to our digital training tactics to ensure that we’re continuously looking at what’s working, what’s not working, so we can work agilely and then use them to inform future strategies.

Sue:
That makes sense, moving things to digital is an investment. We’ve already said you need to have the traditional so this is an add-on and you know we need to be able to measure, we need to be able to validate that success. Jenny, in terms of some of the delivery, I know you’ve been looking at podcasts, recordings, voiceover things, what are some of the activities you’ve done that have resonated well with clients?

Jenny:
A few topics come to mind, I spoke already about MOAs, it’s a great topic to use in short videos, even talking about how your MOA is different than your competitors. We do a lot of work in oncology and you know oncology is becoming a crowded market, you need to be able to differentiate and an MOA is a great way to do way. Also a study design, again they’re getting way more complex. When I started in the industry, study designs were pretty simple; now, they’re definitely not simple! Those are two different topics that we’re using a lot with our clients.

Sue:
Michelle, patient voice has become a big thing you know both within Prime Global but also within the payer space, there are more opportunities to get that burden and unmet need into that whole value story. What’s your view on how to capture that patient voice in market access?

Michelle:
Where we’re looking at that patient voice, it can be done through a short video where a patient talks about their burden of illness but also what’s really nice and effective is actually a podcast where a patient can talk about that burden of illness. The good thing about a podcast is it’s something that a payer can listen on their commute into work or while they’re walking the dog etc. and where they don’t really need to get in deep into the purity of evidence. Bringing it back to what I said earlier, we really need to understand the story we want to tell and then select the right format, but podcasts are a great way of bringing the patient voice to the payer.

Jenny:
Just to add that when you actually hear a patient talk, it brings out that emotion, it really brings out the light of what’s happening versus reading it in a publication. You can show what’s going on with a patient and also being published, I think that will have even more impact when you go out and talk to the payers.

Sue:
I’ve been to a few HTA advisory boards and I have seen how when any patient representative is there, it actually changes the whole feeling in the committee. They might have been looking at numbers and data and suddenly you have a patient perspective and it does change things. It’s how to harness that in a way that you don’t have to have the patient in the room, because obviously that’s challenging for a lot of committees and across the globe it is varied. We are seeing the patient perspective taken more and more into account in value decisions but it’s not universal.

I’m conscious with time, there’s one more topic to ask about, you quite often talk about gamification and I’m kind of on the other end of the spectrum of this being something that is of interest to market access teams…

Jenny:
We are actually having conversations with affiliate teams on gamification, so they are saying this is a great way not to teach the science, but they help the affiliates enforce what they have learned, it helps them be able to recall the key data points from objection handlers which we all know are very important because the payers they always have a ton of objections when you’re trying to get your drug approved or get access for the patient. At the end of the day, we’re all here to help patients and then also have a little fun – who doesn’t like a game?

Michelle:
From our experience we know gamification works for training, communicating with the affiliates because it’s back to that second point i mentioned earlier in the four criteria; it’s immersive and interactive and keeps our audience engaged. We’re overwhelmed with the amount of information in front of us so this is really something that can be a little bit different but fun, and also something that we’ve seen work with HCPs, especially congresses.

Sue:
Thank you both. I’m going to wrap this up so we can move on. We do have different perspectives but it’s clear that we have the traditional and the tradition is going to stay, it’s definitely in the payer and the market access space but actually as the world is transforming there may be opportunities. We may be able to append a podcast to our HTA submission or things in the future but at the moment we’re going through this transition and that actually we could try things out with some of the affiliates, and certainly in the training cascade. Keeping that link to the evidence space is going to be key on anything that we do. Thank you!

Peter:
I found that fascinating actually for several reasons and forgive me because I might be a bit rude at a couple of points in this now but I thought that was a fascinating discussion. One of the things that struck me right to begin with was that I’d be one of the people that says crikey, medcomms has still got a way to catch up with digital. I don’t have that much direct contact but from what you’re saying payers as a group are even behind HCPs and medcomms, and part of your argument was they like the purity of evidence but there’s nothing to stop you providing purity of evidence digitally, have you got any more reflections on what makes payers different to HCPs?

Sue:
A couple of things come to mind. I wouldn’t like to collectively bucket payers, they are not a homogeneous group but what is common amongst payers is that they are all tied to a process and a structure, and changing processes of assessment takes time. Evolution is really slow in that space so I think some of the methods that payers have to work within are still quite traditional. Moving forward as well, there’s much less opportunity for affiliates to have that face-to-face communication than historically so there’s opportunity to try new things. There are liaison people that go out still with technology that they can share but that really does vary and compliance in all of the countries is all a bit different, so it’s quite difficult to roll out if you’re sitting in the European global office to say, go out and talk to your payers in Germany, the UK, France… people can’t. It’s not quite as free in terms of the the conversations and people are cautious when we try and recruit payers for research, there are a lot of compliance hurdles and it is just not such an open dialogue.

Jenny:
Also, payers don’t always trust the industry as much as HCPs, one of the things that came out in the research was that they don’t always know what’s being put out and the social media is really not biased or if it is really published data. Sometimes they question the source and they sometimes also like to do their own research and they have their own internal groups. Their roles are very different than the HCPs, too.

Michelle:
To Sue’s point, it’s not a blanket approach, payers have different levels of rates of adoption for digital for different reasons in the same way as HCPs do. What really interests me, Peter, was your question on us as an industry and our rate for digital adoption. I personally think where we’ve come in the last 18 months has been amazing and with the resources that we have available and the minds within our industry. I think we can go even further and I’m really excited about what the future is going to have. I do hold my hands up and think that yes, we are behind in certain aspects to other industries, especially the consumer-facing industries, but we’ve definitely got the resources to really push ourselves further so it’s going to be a really exciting time for HCP, patient, and payer engagement in a digital environment.

Peter:
It is very exciting! Part of this discussion hinges on what we mean by digital. In the survey, you define digital as podcasts and short video, which seems a very specific definition of digital and some of what you’ve been talking about sounds a bit like you’re talking very much about social media and i would say well digital is way bigger than that?

Jenny:
To your point, Peter, digital is such a big word and it means different things to all people, so we had to define it to help the payers understand what we meant by digital. With formats, we defined that as short videos and podcasts and when we talked about social media we defined channels like LinkedIn, Twitter, Facebook, Clubhouse, and even TikTok. As Michelle said, payers did prefer LinkedIn the most of the social media channels, and they also said in the research is that there’s not a consistent social media channel that they can go to and get reliable published data so I think we have some room to grow there. It’s positive that they at least they acknowledge that and they are using social media to get some information.

Peter:
Okay, the LinkedIn point also intrigued me – is it that LinkedIn is the preferred platform or is it that was just a very quick and easy way to set up a closed group and actually it’s the closed group part that works and it could be on a completely different platform?

Michelle:
It’s really LinkedIn. What we’ve really used it for is that dissemination of content and how to reach payers, because LinkedIn has really great targeting abilities where you can target based on their profession but also their location. To Jenny’s point, the survey showed that payers actually preferred to interact with content on LinkedIn, possibly because they’re more on LinkedIn versus twitter.

Sue:
It was also that they see LinkedIn as a professional network, that it was repeated several times when we gave people free text opportunities in the survey. There was an astounding zero on TikTok and only one or two would consider Facebook, so it was distinct that they see some channels as professional and some as not. It was quite black and white.

Peter:
Is there not a payer’s closed community platform out there in the way that you do with HCPs, is that just a gap in the marketplace?

Jenny:
I ask that question every day and I don’t know the answer, no one really can answer that question so I think that’s a gap in the market.

Peter:
George asks if payers need to come out and provide guidance on how the digital materials should be produced. I presume you do get do you get payers involved in the sort of development of these sorts of projects, is there more room to get them more involved?

Sue, Jenny, and Michelle:
Yes!

Peter:
Ok, another question is if you’re in a market access role globally, would you spend money on delivering payer tools in a digital format, which I suppose gets to the heart of this. Would you be pursuing this actively, are they just slow or are they going to be very very slow to adopt these sorts of activities?

Sue:
We’re quite often asked this, you know is that worth the investment. Peter, you asked about why we picked out podcasts and short videos and the reason is that’s the most tangible for companies at the moment, because we haven’t gone into a full transformation yet. Jenny, in terms of bang for your buck, what would you be doing if you wanted to dip your toe in the water in the digital space for payers without but you have to go up and present it to management?

Jenny:
This is a daily conversation I’m having with the clients that we work with, how do we help them show the return on investment and help them be effective in investing in digita. We always tell our clients, let’s start small. Let’s do a pilot, let’s pick a topic on that unmet need, burden, or the patient voice and maybe do a series of podcasts or a short video and roll it out um internally and then if you’re going to roll it out externally, we always want to get the end users’ feedback. If you’re doing any kind of digital platform you’re always want to test it with the end user to make sure that it’s working, so that’s how we work with our clients.

Peter:
Okay, I don’t want to go on my soapbox here but…metrics. You know we’re talking digital activity, let’s take podcast example, what sort of issues do you face on the metrics front, what are people asking for, what can you actually deliver, would you agree that a lot of the time people aren’t measuring, tracking, and using that data properly or am I being unreasonable in that aspect?

Michelle:
You’ve come to my favourite subject, Peter! In terms of assigning robust KPIs and metrics to these tactics, it’s dead simple in terms of how you do it and how you can keep on top of it. You can use a free software called Google Analytics that gives you real-time results on that. The more subtle type of metrics that we also look at capturing is that behavioural change and understanding it from an affiliate feedback point of view but also from a user point of view. That’s something that’s a little bit more difficult to do and you have to think about it a little bit more in terms of how we do that, but what we like to do is we like to look at something called the hard metrics in terms of what the behaviour is, what the person’s actually doing, but then the softer one in terms of that perception measurement, what they’re thinking and how it’s impacting on them.

Sue:
There’s a few questions coming in around the patient on the chat, which is great because we are passionate about value capturing the voice of the patient. You know cost-effectiveness and economics is one thing, but what we’re really trying to tap into is how we can get that patient perspective much more reflected in that whole appraisal. Sometimes what we’re finding now is that products that do get approved but there isn’t the pull through, so the patients still aren’t getting active access. It’s not even that it’s being blocked maybe at a national level but it’s not being prioritised locally and I do think that is where access more locally can be driven through patient advocacy. We’ve been creating materials and tools to help that sort of value comms to patient advocacy groups so that they can go out and cascade. From a market access perspective, maybe reimbursement is traditional but actually, human behaviour about access to medicines is a little bit softer and I think that that’s probably the angle where some of the local countries can do more.

Peter:
This takes us away from the digital theme but let’s just finish on the sort of patient voice aspect of things, which could be digital or could be a patient standing in front of a committee let alone anything else. Jenny, do you have any views from the US perspective?

Jenny:
Definitely, I mentioned that I was in the field for eight years and from my experience when I was talking to a US payer, if they had a family member or a loved one that actually had the disease, the conversation was very different. They understood the pain points through the patient journey and they understood the importance of this new product. We are now seeing fewer face-to-face interactions with payers, pharma can’t get in as much and especially with just the pandemic and lack of travel, there’s limited interaction so this is where I really see the patient voice becoming very valuable. On a podcast, you are able to provide that information to a payer that they can listen to at their own time. As someone
mentioned in the chat, it really makes it human and you know not all payers have had loved ones who’ve had these different diseases, especially rare diseases, so it’s a very different conversation. These patients go through such crazy journeys and we really need to bring that to life and help payers understand why we’re bringing these products to the market or  why patients need to be able to access them.

Sue:
There’s a comment on the chat around that we’re talking a lot about podcasts and is this a US thing and having looked at the survey, I was really surprised that the UK respondents were even more positive than the US ones about some of these. Countries are moving in different ways at different paces and obviously in a small sample, it depends who you ask but we did try and get a spread of people. This is talking about payers, it’s not talking about affiliates so I think there is appetite maybe people that are more at that local payer level where they’re trying to get their heads around new products coming into the market and where having those types of media is useful.

Jenny:
Most of our clients are global clients that support the different affiliates and we are seeing the podcasts actually being used from a global perspective not just the US.

Peter:
The title of this was “The digital player – fact or fiction?”, in 30 seconds what’s your final comment before we wrap this up?

Michelle:
Of course, Peter, I think it’s fact! I also think that it’s not just going to be only digital as we’ve said, it’s very much going to be a multi-channel approach and one of the things that popped up in the chat and the conversation is that digital is all encompassing. Yes, it is but what we really want to do with our audience is walk before we run, so therefore we’re starting with more digestible formats like short videos and podcasts, channels that they’re engaging in. I do think it’s going to be a very exciting time in terms of how this is going to accelerate and evolve.

Peter:
Thank you very much to the audience for joining in but particularly to the panellists, thank you very very much. I think we’ve covered some really interesting points.
Thanks and stay safe everybody, bye!

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