In this Q&A, EPR talks with health access specialist Dr Michal Davidescu about patient centricity, it’s impact on drug development considerations and why it’s essential to help treat our diverse and evolving global population.
Can you tell us a bit about yourself and your role at Pfizer?
I’m a pharmacist with an MBA and PhD. My PhD thesis is about considerations in the production and purchasing of drugs.
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I joined Pfizer in January 2023 as a health access specialist, after working at Clalit Health Services in Israel for almost 20 years.
At Clalit, which is the second largest healthcare provider in the world, I worked in several management positions and gained a broad understanding of the needs and constraints of a healthcare system. At Pfizer I promote the company’s interests and deliver value-based messages within the government arena.
What is patient centricity and why is it an important consideration in drug development?
Patient centricity is the process of obtaining the patients’ voice and making them active participants; identifying their needs and utilising them to improve decision-making in the healthcare arena. Insights obtained from patients are used to better understand the impact of the disease on their daily life, and to carefully design all stages of drug product manufacture: from clinical studies to package design.
What are the three main factors to consider when looking to develop patient-centric drug products?
In my opinion, the three main factors to consider are:
Ability to convince patients to be active participants; to make their voice heard so that they share important information about their dealings with their disease and the constraints they encounter every day. Some patients are ashamed of their illness or are suspicious, therefore convincing them is not always easy.
Ability to reliably and objectively obtain the voices of patients. Today, there is a growing consensus that tools such as genomic tests or digital measures can reliably and objectively obtain this voice.
Ability to utilise the patient voice at every stage of the drug development process; for example, designing clinical trials endpoints or organoleptic properties.
There is a growing consensus that a ‘one size fits all’ approach is no longer suitable owing to wide population variability, and by using ‘old-fashioned’ practices, the healthcare system misses the opportunity to give proper care to patients. We should move from ‘one size fits all’ to ‘more sizes fits all’ in order to make patients active participants.
In what ways do patient-centric considerations influence drug formulation and drug delivery choices?
Various aspects of a disease such as mobility, coordination, dependence on a caregiver or even colour perception or literacy might affect a patient’s compliance. It is therefore crucial to make drug formulation choices that will adhere to patients’ needs as much as possible. For example, patients with limited coordination will prefer a package that is easy to open, and patients with difficulty swallowing will prefer granules rather than tablets, due to their small size.
Of course, patient-centric decisions bear costs, therefore we cannot switch from ‘one size fits all’ to ‘all sizes fits all’, but there is a growing consensus that the ‘one size fits all’ strategy also bears costs as it embodies alternative costs due to side effects, hospitalisation days and doctors visits.
Can you elaborate on the role of personalised medicine in drug formulation?
Personalised medicine supports the production of a patient-centric drug. By classifying patients into subgroups, personalised medicines (as opposed to non-personalised medicines), can allow pharma companies to identify needs and develop unique formulations. By using elements such as genetic tests, biomarkers research or pharmacogenomics, alongside retrieving data about daily life, perceptions and needs, personalised medicine helps us understand that there is no ‘one size fits all’ but rather a wider supply of formulations, which will provide an adequate solution to a society that is diverse in terms of therapeutic needs.
What drug delivery systems do you find promising from a patient-centric perspective?
Today we operate a holistic healthcare system and we understand that the surroundings of the patient plays a positive role in the decision-making process.
I believe that a delivery system that enables patients to be near familiar surroundings is preferable due to its positive effect on their adherence and willingness to actively participate.
How do you see patient needs changing in the future? Is the industry equipped to adapt?
Our healthcare system is advancing by great strides: thanks to genomics tests, rare diseases are discovered and the healthcare system is required to allocate resources and provide proper treatments. Alongside this, demographic changes are taking place that also require suitable allocation of resources: the world’s population is ageing and there are waves of migration from weaker countries to established ones. I believe that we are at the beginning of a very challenging decade but am confident in our success as a society. The corona pandemic taught us that our healthcare systems are adaptable and agile – the rate of their technology adoption has jumped by tens of percent and many barriers have been removed during that very short period of time. I have no doubt that the pharma industry is equipped to further adapt to evolving needs and will continue to move our society forward.
About the interviewee
Michal Davidescu, PhD is a Health Access Specialist at Pfizer Pharmaceuticals Ltd. She joined Pfizer in January 2023, after working at Clalit Health Services in Israel for almost 20 years.
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