Gaining first line reimbursement for an oral innovation in IBD
Problem context
Our client, a US based biotech, had developed an oral innovation for IBD to be launched in Europe. The client had already conducted payer research. This had indicated that the product was likely to achieve restricted reimbursement, being saved as a ‘last resort’ for when other treatments failed. One reason for this was the low perceived unmet need among payers for new options earlier in the treatment journey. We were approached to identify if any patient groups were under-served by the current treatments, and who could benefit from receiving the clients’ product early.
Our approach
Three aspects underpinned our approach:
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Close collaboration with cross-functional teams. We knew that the potential answer could take a number of forms (for example, the argument to the payers could be based on clinical facts, financial reasoning, or ‘softer’ patient factors) and so wanted to ensure all the aspects were covered. We ran a number of upfront sessions with the Market Access lead, the Medical Director, the Patient Advocacy team, the Marketing Director, and the Vice President.
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Approaching the question from both a physician and patient perspective. Rather than relying solely on doctors’ perception of the unmet need, we hypothesised that speaking to patients could reveal pockets of unmet need of which the doctors were unaware. Our research design comprised 19 gastroenterologists and 30 patients across Italy, Germany and France
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Using ‘in the moment’ research to elicit deeper insights. Given the exploratory nature of the objective, we conducted in-depth interviews. We engaged patients in a week-long online ethnography exercise, where they were asked to record their daily experiences and partake in a number of projective exercises. The doctors were given a diary to record all the patients they saw in a two-weekly period in an anonymised manner, and evaluate their suitability for the product in question. This allowed us to get real patient profiles as opposed to theoretical ones.
As part of the online ethnography exercise, patients were asked to create collages to demonstrate their views on different treatments. These helped demonstrate the need for new options
Insights and Impact
The findings from the project helped develop an argument to take to payers demonstrating the need for new products early in the treatment pathway. Given below are examples of insights:
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There are were six distinct patient groups who were under-served by current treatment options. Three of these groups were particularly suitable for the client’s product, and were chosen as the core group for positioning and communication
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These patients experienced a much greater impact on life relative to what doctors believe, and what they themselves realise. The very act of maintaining a diary drew attention to many nuances of their suffering which they would ordinarily forget. This insight highlighted the importance of developing mechanisms for patients to capture their experiences frequently so these could be relayed to the doctors. Insights on the patients’ pain points have also been used to inform the client’s patient support programme
The client now has a clear understanding of the patient need and is equipped with the evidence needed to engage with payers.
