We encounter multiple situations in medicine where drugs, therapies or devices are saved as a ‘last resort’ despite the fact that early use could improve patient outcomes. Often, this is not a considered treatment decision, but is instead based on a broader heuristic such as ‘saving the best for last’. One example of this is antibiotics.

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Antibiotic resistance is one of the most pressing issues facing the global community. In a recent statement, former UK Chief Medical Officer Sally Davies claimed that antibiotic resistance “could kill humanity before climate change does” [1]. When new antibiotics that can help fight resistance are developed, it is of the upmost importance that they are used in the most appropriate and effective manner. However, fear of resistance often leads physicians to save new antibiotics as a ‘last resort’, vetoing potential opportunities to provide appropriate care by selectively using the drugs earlier.

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Our client has developed a pioneering new antibiotic for the treatment of highly resistant hospital infections and came to Insight Dojo for help positioning this product in the European markets. The problem posed was a difficult one – how can we ensure appropriate early use of a drug to improve patient outcomes rather than letting it be saved as a very last resort? Antibiotic treatment decisions occur in situations of low information and high pressure, where doctors are faced with clear and rapid patient deterioration, so solving this problem required an understanding of highly expert decision making.

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Components of the solution

Our solution to encourage appropriate early use had four components; elements that we believe are applicable across multiple therapy areas.

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1. Recognising the ‘hot states’ early in the patient journey – We identified pre-existing situations early in the patient journey where physicians are in a difficult situation and have an unmet need for a new antibiotic (e.g. when encountering a difficult pathogen).

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2. Identifying ‘on-the-ground change leaders’ – In the complex and highly protocolised area of antibiotic treatment, not all physicians are equal in their ability to recognise the ‘hot states’ and use new antibiotics appropriately in them. We identified two types of physicians who have the necessary expertise to use a new drug in an early, appropriate manner.

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3. Identifying hospitals that were best set up to facilitate use – Hospital factors such as size, diagnostic testing equipment and recent adoption of other new antibiotics determine whether a hospital is likely to adopt and use our client’s product.

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4. ‘Welfare mapping’ the strengths of the product to fit physicians’ real unmet needs – The client’s product has several clear objective strengths (e.g. high tolerability) over competitor products. However, we uncovered that these factors are not always a clear driver for choice of the drug. We ensured the products strengths were linked to a clear benefit for the physician in each ‘hot state’.

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Approach

Whilst this particular example pertains to antibiotics, the approach we took is not limited to this treatment area. From women’s health to oncology, Insight Dojo have created similar solutions to answer complex problems. In this case, we developed a multi-faceted design using techniques including ‘naturalistic’ qualitative research, quantitative research based on hospital stratification, non-conscious methods, and machine learning. As in all our projects, to ensure that our insights were implemented within the client’s overall business strategy, we carried out cross-functional working and learning sessions with insights managers, brand leads, the medical team, and even the CEO.

To hear more about the intricacies of the methods we used to approach this challenge, please contact me on daniel.rayner@insightdojo.com.

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Daniel Rayner is a Senior Associate at Insight Dojo. Follow Daniel Rayner and Insight Dojo on LinkedIn. 
 

[1] https://www.telegraph.co.uk/news/2019/08/29/antibiotic-resistance-could-kill-humanity-climate-change-does/