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Pharma Strategist’s Blog: The Health Paradigm Shift

Is it time to move away from ‘changing the treatment paradigm’ strategies?

Authored by Maxine Smith, Managing Director, Uptake for the PME Pharma Strategists’ Blog

In this article, Maxine discusses the treatment paradigm. Describing this level of change as a ‘treatment’ paradigm change does a disservice to the scale of change required and raises false expectations of what is achievable and by when.

They suggest continuing with a working example of bringing in more effective medicines earlier in disease management, then using strategy to build on the foundation created.

Most healthcare systems are trying to create a health paradigm shift, to preserve health and well-being and be pre-emptive, to slow and limit chronic conditions to afford the pressures of an ageing population.

Read below or click to access the published version

It’s confession time. Hands up if you have ever found yourself in a meeting discussing how you and your team are going to ‘change the treatment paradigm’? I am very confident that there won’t be many of us who haven’t raised our hands.

So why as an industry are we so fixated with this strategic approach? What do we mean when we use the shorthand of ‘changing the treatment paradigm’? Is this still a strategy that we should be pursuing as an industry? Are we clear on exactly what we mean by this or are we being slightly lazy by using such an all-encompassing phrase to describe our strategy?

A quick Google search provides links to change the treatment paradigm for a whole raft of diseases: Parkinson’s disease, type 2 diabetes, acute myeloid leukaemia, metastatic breast cancer, multiple sclerosis and more. The term appears in clinical papers, on patient organisation websites, in care management guidelines – the list is endless. But what do we mean when we use this phrase? The Oxford Learner’s Dictionary describes a ‘paradigm-shift’ as ‘a great and important change in the way something is done or thought about’. These health and treatment ‘paradigm shifts’ certainly seem reasonable when we consider we are talking about making great and important changes in the management of a disease.

My challenge to this, however, is that the umbrella term of ‘paradigm shift’ dilutes the specificity of strategy. We use the term to describe our long-term approach, but use it in such a high-level and generic way that it loses its impact. All pharma and biotech companies seek to change the way health conditions are managed. All want to make a great or important change in the way a specific disease is managed or treated. Without creating a sense of something needing to change, there is no need for new treatments, technology or services. So, to be clear, to be competitive and focused we should move beyond describing our strategies with such an all-encompassing term and start digging into the underlying issue – the challenge we are looking to address by driving this level of change.

Firstly, should we be restricting ourselves to ‘treatment’ paradigm change? Are we not actually striving for complete disease management change? A classic example would be the need to change the timing of treatment in a chronic disease where treatment is gradually added in as the patient gets worse, with the healthcare professional ‘holding back’ more effective or newer medicines to preserve options later in the disease progression. In this scenario, if the desire is to bring the more effective medicines earlier in the treatment, the strategy would need to consider: policy change; budget identification change; pathway change; behaviour change; patient identification change; potentially site change in terms of where the patient is seen, by whom and when; evidence change and so on. Describing this level of change as a ‘treatment’ paradigm change does a disservice to the scale of change required and raises false expectations of what is achievable and by when.

Secondly, a paradigm shift can be seen to imply that the current situation is incorrect somehow and should be stopped and started again, but this time in the correct way, ie the new paradigm. If we continue with our working example of bringing in more effective medicines earlier in the disease management, then could our strategies not build on what is there, and the wins already achieved, meeting healthcare systems and the people working within them where they are and together considering the full range of options to reach the mutually agreed goal?

Lastly, isn’t this type of change what most comprehensive healthcare systems are trying to do anyway? Aren’t they trying to improve the health of their users, be more pre-emptive, productive, efficient, holistic, innovative and so on? Most healthcare systems are trying to create a health paradigm shift, to preserve health and well-being and be pre-emptive to slow and limit chronic conditions so as to afford the pressures of an ageing population. Is it helpful for the pharma and biotech industry to have its own ‘shifts’ planned at a single treatment option level when many customer stakeholder groups are focused on societal health paradigm shifts?

A health paradigm shift needs to happen but, to be of use and do our part towards this as an industry, we should be specific in our strategies, stay away from broad-sweeping paradigm shifts and instead look at our role in working collectively towards the increasingly important societal health paradigm shift.

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