Healthcare Agency Roundtable

Executive management from healthcare communications agencies and networks weigh in on industry topics ranging from the COVID-19 pandemic to diversity, equity and inclusion.

By Andrew Humphreys • [email protected]

1. How has year two of the Covid-19 pandemic impacted your business and the industry?

Celine Vita

 

Carolyn O’Neill

Celine Vita, President, and Carolyn O’Neill, Chief Creative Officer, Centron: As the rest of the industry, we have seen delays in clinical trial programs, regulatory path meetings, and approval timing. We have also seen a significant shifts in the promotional channel mix, field force model and anticipate that these dynamics will endure.
These dynamics have also increased industry/client appetite for piloting more “firsts.” Whether as simple as stepping into social, integrating an AI solution, or a more complex digital tool with backend PRO data management, our clients are embracing and navigating new commercial and regulatory territories.
At the agency, year two has seen a natural evolution and cementation of our ways of working and being. We are constantly aligning our desire to live into simplicity with the world around us and so naturally adjustments will remain a constant. We are fortunate and grateful for the new client relationships 2021 has brought and we look forward to all that’s ahead for 2022 and beyond.

John Tenaglia

John Tenaglia, Managing Partner, Moon Rabbit: From an industry perspective I think we are in our groove. Thankfully healthcare hasn’t missed much of a beat, they just refocused for a bit there on where spend was going, which channels they were going to make a bigger push in, and how to still deliver for their customers.
I think where we are still seeing an impact is on the working remote front. We are seeing some agencies come back into the office, some offer permanent work from somewhere else options, some demand one or the other so they can manage how much space to pay for, we are seeing a hybrid with a few days in the office and a few out, but there really is no industry standard at this point. Growing up in a very pre-COVID world (I have been around a while haha) I had the benefit of being in the agency every day, learning, absorbing, seeing how things came to life, being a part of the solution, and really getting an education all along the way. This was critical for my development and for me to really discover how much I loved in being in an agency and how to provide value internally and externally. I have no idea how anyone now who is earlier on in their career will get to grow. It will take an amazing amount of discipline from anyone not coming in to stay sharp, to keep learning the craft and their brands, it will take a real commitment to their career. These aren’t things you can throw on an agenda and cover off on in a once a week Zoom with your manager. These are lessons learned while being in it with your team. When you are in the agency, all of these things happen naturally. Now people are sitting at home and dialing into a meeting here or there to move a project along, they are seeing things in a virtual routing tool and then it’s pencils down until the next functional task hits them. I feel for the younger crews out there, they are going to face some serious challenges in their growth which will impact their ability to compete at high level and provide real value to their teams and clients.

Ari Schaefer

Ari Schaefer, Co-President, Klick Health: As the pandemic continues into year two, a lot of industry focus has been in striking a balance between a pursuit of a return to normalcy and embracing the new normal that we find ourselves in. One example is the duality of salesforce access. Seeing some physicians’ offices comfortably reopen their doors to salesforce interactions has meant a return for in-person exchanges that drive critical value for pharma brands. At the same time, the role of remote detailing continues to rise as more and more brands have demonstrated during the pandemic that brand conversations can and will happen effectively even if exclusively remote and online.
The evolution of the industry during the pandemic has also changed the way patients expect to interact with their physicians. The pre-pandemic promise of telemedicine never quite lived up to the expectations. In the first year of the pandemic however, we saw a shift out of necessity to greater uptake and eventual comfort with remote interactions. Now in year two, patients can take advantage of greater choice between tele- and in-person medicine. That choice has led several pharma brands to take advantage of on-demand remote brand experiences. Telemedicine and remote brand experience isn’t just one thing. Suitable brands are taking advantage of the patient experience benefits using different strategies for tele-diagnosis, tele-prescription, and tele-monitoring.

Greg Lewis

Greg Lewis, Managing Partner/President, Calcium: COVID-19 has redefined the essence of collaboration amid teammates, with client partners, and very importantly between HCPs and their patients. Technology has not disappointed in maintaining conversations, supporting brainstorms, and fostering medical appointments.
At Calcium, we are fortunate to have progressive client partners who faced the challenges of COVID-19 each step of the way. Step one was to ensure the brands maintained their relationships with HCPs and step two was all about supporting the patient.
Most organizations immediately leveraged virtual solutions to support interactions between sales forces and the medical community. Next, it was imperative to educate patients and caregivers about the availability of virtual medical appointments to ensure continuity of care and ultimately post-Rx, supporting the patient on brand.
Hopefully, the forced reliance on technology in March of 2020 has forever realigned the health experience and will ultimately drive better health outcomes for patients we serve.

Chris Hatton

Chris Hatton, SVP, Creative Director, Copy, Calcium: In general, the COVID-19 pandemic shook up the entire industry and continues to do so, simply because it proved that working from home is a functioning model. Whether all employees can thrive equally under that model, or all employers embrace it fully, it doesn’t matter anymore. In order to compete for new talent and retain existing talent, all agencies have to be open to the flexibility of at least a partial WFH setup. It’s enabled us as an agency to grow exponentially and tap into markets we wouldn’t have had access to in the past. It’s also enabled the employees to demand top market rates regardless of their real location. That phenomenon drives turnover and means we as managers have to be conscious of overpaying for people whose title or salary demands feel akin to the inflated housing prices in my neighborhood. Metaphorically, you have to know when to bow out on the bidding or when to jump in early before they even enter into an “open house” situation.

Bill McEllen

Bill McEllen, Partner, Fingerpaint: The COVID-19 pandemic has left an undeniable lasting impact on the industry by accelerating the adoption of advanced technology and tactics, as well as putting a spotlight on the overall importance of health. Tapping into machine learning and artificial intelligence for everything from drug discovery to omnichannel marketing is no longer a novelty – it is the norm. The industry has also become much more conscious of the fact that early collaboration between stakeholders is critical to adoption and success. As people’s overall health, whether mental or physical, is prioritized, we will see more importance and focus on ways to address these topics.

Mike Guarino

Mike Guarino, Chief Commercial Officer at IPG Health: While the last two years have been complex and challenging, they’ve also been the most successful for our network in terms of growth, our clients’ growth, the number of people we’ve hired and our ability to retain talent. We’ve had our two best years in the middle of the pandemic and that’s on a consistent track record of year over year growth. In July of this year, we also undertook a monumental and industry-changing endeavor – taking the two most successful, awarded, and respected groups of agencies in the world – FCB Health and McCann Health – and launching IPG Health. IPG Health really is the embodiment of the fundamental principles that have contributed to our monumental growth – a belief that interoperability and interconnectivity are force multipliers that enable to innovate, adapt, and lead change in our industry. IPG Health sits at the nexus of data, technology, media and creativity built on the most robust global scientific and medical offering in the world. When you look at the impact of and the continuing evolution of healthcare driven by the pandemic, it becomes apparent very quickly that IPG Health has been able to thrive. Our excellence in omnichannel marketing, creativity, remote and hybrid productions (we’ve done over 100 since COVID began) and product-based technology offerings all driven by a robust data and media offering form the foundation for continued growth post-pandemic.

JD Cassidy

JD Cassidy, President, Syneos Health Advertising: The COVID-19 pandemic continues to shape our business and industry in numerous ways. The past year has forced us to adjust to a “next normal” as we continue to primarily work from home while managing the rapid growth of our business, fueled by the rebound in work as vaccines begin to turn the tide on the pandemic.
Our industry and business will never be the same, which we see as a positive. The world is more focused on individual and public health than ever before, and we are hopeful that this positive attention will draw more talent and growth to not only our agency, but the industry as a whole. This past year has reminded us why many of us entered healthcare communications and the sense of purpose and fulfillment it provides. In the meantime, we continue to stick together, emphasizing our employees’ and clients’ total health and wellness while remaining confident in the way we show up for our customers and the communities we all serve.

Faruk Capan

Faruk Capan, CEO, Intouch Group: Despite the obstacles the pandemic has continued to present, Intouch has remained strong through year two. We launched 11 new Intouch websites to support our network, agencies, and service offerings: Intouch Group, Intouch Solutions, Intouch Proto, Intouch Seven, Intouch Oxygen, Intouch B2D, Intouch Media, Intouch Analytics, Intouch MedComm, Intouch Market Access, and Intouch International. Our client roster grew, and we’ve seen significant wins with marquee clients. We also hosted our second class of 55 virtual summer interns and hired more than 544 new employees in 2021. Our high-touch, transparent employee communications approach since we went virtual last year has helped maintain our strong culture, support employee morale, and – as a result – has ensured our business remains healthy.
In terms of our industry, COVID-19 has been a wake-up call for pharma to evaluate their organization’s digital maturity and ability to serve customers personalized experiences. In many ways, the pandemic has accelerated preexisting trends: an increase in the use of health tech and telemedicine; a decrease in sales rep access and the need for a new, hybrid approach to providing HCPs the key information they need to make prescribing decisions; a continued focus on customer experience as patients and caregivers have become more digitally savvy and stronger in their ability to advocate for their own healthcare needs; and the momentum of digital transformation across pharma organizations.

Robin Shapiro

Robin Shapiro, CEO, TBWA\WorldHealth: As we reflect on the vast amount of change we’ve undergone over the last two years, it’s hard to find any aspect of our business that hasn’t been in some way impacted by this pandemic – for better or worse. And while we could spend hours talking about the acceleration of omnichannel or agency structure and hybrid ways of working, the biggest impact to our industry, we believe, is a fundamental shift in value; what our employees value in their work and what our clients value in us as their agency partners. We’ve even gone so far as to label the last two years “The Great Reprioritization.”
Like everyone, we’ve been on an emotional roller coaster the last two years. Early in the pandemic we kept asking ourselves, “Can we really do this? Is it sustainable?” with a relatively swift and emphatic move to “We totally got this, who needs an office anymore?” But then human nature set back in late last year and we shifted back to “We really miss each other.” But we know that the future will lie somewhere in between, a new third way. Every employee has their own individual “value equation” defining what they’re looking for in their work experience.
The move to remote work brought on by COVID enabled employees to take a giant step back and reexamine what they truly value. There’s been a positive emphasis on quality of life. There are also evolving needs when it comes to career growth, learning and development, and the role that the office plays in that equation. As agency leaders we’ve begun to challenge ourselves to think differently about how we design the overall work experience to find more personalized solutions in order to create maximum engagement.
For our clients, the soul searching is even more profound. In addition to working through similar employee engagement issues, their fundamental business model has been flipped upside down and, in some instances, blown up altogether. The challenges that impact their brands continue to increase in complexity. Most can’t be solved through advertising. As a result, clients are looking for, and placing high value on, partners that can think multidimensionally and bring ideas and solutions to the table that extend beyond communications. As agency partners, we need to be even more business-minded than before, fully wrapping ourselves around our clients’ challenges. We are now becoming master orchestrators of creative solutions, integrating multiple agency partners together to create something completely new, maximally effective, and efficient.
While there is still a fair amount of uncertainty in our industry, we are certain that we’ve only begun to see the impact from The Great Reprioritization.

Jeff Berg

Jeff Berg, Ph.D., President, AbelsonTaylor: The short answer is that year two of the COVID-19 pandemic continued to create a net-positive impact on our business as well as the overall healthcare communications industry. That said, many subtle and not-so-subtle changes began to take a firmer hold, with much of the impact yet to be fully realized.
We learned that the trends in year one, already emerging before the pandemic, accelerated in year two. Work from home went from a desirable benefit to mandatory. Technology for mundane tasks went from being merely enabling to mission critical. The idea that we couldn’t collaborate remotely while being creative was laid to waste. Productivity increased, but so did stress and isolation. The concern that people would become slackers if not “watched” was crushed.
I will offer absolutely no predictions on what the “office” will look like down the road (and please don’t waste your time conducting another employee survey on this subject). Perhaps the Great Resignation of 2021 has affected advertising more than any other in-formation service industry. The labor pool became infested with sharks gobbling up talent by offering double promotions and 30 percent salary increases. Clearly not sustainable. I modestly predict the Great Reckoning of 2024. The impact of the COVID-19 pandemic will continue to be felt years from now and year two helped build the stamina and resilience that successful agencies like ours will need to thrive.

Nadine Leonard

Nadine Leonard, Co-President & Executive Planning Director, Heartbeat: Our industry needed to face some hard facts in year two – specifically that life wasn’t going to snap back to the way it once was. As the country grapples with vaccine plateaus and variant concerns, an individual’s decision on how to re-engage with the world has become a deeply intricate, personal one. And so, the collective challenge has been how to accommodate these individualistic preferences and still deliver mass progress.
In our agency life, this has meant committing to a fully hybrid workplace – “work wherever, forever” – by empowering our employees to select the approaches and locations that work best for their individual needs. Knowing that hybrid collaboration is now our “forever construct,” Heartbeat has created new ways of working to ensure that nothing disrupts our ability to develop the sharpest marketing strategies and brand campaigns. But much of the rest of the life sciences industry seems to be struggling to commit to entirely new approaches. Their solutions often feel like stop-gaps, which seem to send a message that the way we’re operating today is still a temporary construct. We believe the real winners will be the ones who are embracing radically new ideas now – who are pushing forward with progressive thinking around telehealth, virtual HCP selling solutions, and ways to reach physicians beyond congresses and conferences. As we round the corner into year three, we’re excited to partner with many of these brands to embrace the realities around us and stay nimble as they continue to evolve.

Fred Kinch

Fred Kinch, Founder, Brick City Greenhouse: For our agency, because we had a remote model prior to COVID, year two of Covid for the agency was still pretty much business as usual for us. Like year one, there are a few more dogs barking and children on video calls, but we already had all the systems in place for a seamless transition into lockdown. In the second year, we’ve seen greater interest from prospective staff members. Now that people have had a taste of a remote working model, they aren’t anxious to go back to an office-based culture and are reaching out to see what kind of positions we have open. We’re growing and we’re well positioned to find talent to meet this demand.
For our clients, while COVID initially thrust everyone into a world of nonpersonal promotion (NPP), year two ushered in NPP fatigue. Customers were reluctant to attend yet another Zoom call or Veeva Engage presentation, and this forced clients and us to think more creatively about how to get in front of customers. We are constantly questioning what the right cadence looks like, how traditional channel assumptions might have changed, and how to bring greater value to each engagement, despite the decreased frequency of face-to-face and NPP interactions.

David Lubofsky & David Brungard

David Lubofsky, Partner, and David Brungard, Partner, y’all: It has afforded smaller, nimble businesses like ours the opportunity to grow and adjust quickly with the changing world. We fully embraced remote work, which has allowed us to look outside of the local talent pool and bring in expertise from all over the world. It has allowed us to focus less on the way we do things and more on the things we do. We use our own experiences and empathy to build experiences that are helpful and relatable to our customers. In contrast, we’ve seen large institutions struggle to adjust, trying to reconcile in-office and remote work instead of forging a new path forward. We’ve seen other companies force people to go back into offices to justify the expense or tax break. And even pushing against digital collaboration tools because they don’t fit what the team is used to or has liked in the past. They’re dealing with a shrinking workforce while people wander off to companies with flexible working options. Removing physical walls has shone a light on the problems that were already there, forcing this industry to adjust – and in our case, we’ve tried everything to adjust for the better.

Gary Scheiner

Gary Scheiner, EVP, Executive Creative Director, CDMP: Year two of COVID most certainly has a different flavor than year one. In that first year, everyone was trying to make heads or tails out of the situation. We experimented. We trialed and errored. We tolerated missteps. And just as critical, so did our clients. It was a little sloppy at times, but we all managed our way through it together. In all honesty, it was invigorating to have to think on your feet like that and adapt on the fly.
But as we got into year two, and everyone found their groove, some of this new world order became commonplace. Parents figured out routines that worked best for their families. Technology got better (for the most part). And the talent pool opened up because we weren’t so myopically looking in our own backyard. Those are all good things.
On the flip side, it seems like we’re working efficiently, but longer, which is creating a different kind of stress. And it’s proven a LOT harder to build meaningful relationships with new colleagues and clients when you can’t sit across the table from them, break bread, and get to know one another in a deep and real way. We are in a people business–a relationship business. And the idea that this will become a job instead of a career for team members and that agencies will become vendors instead of partners for clients is something that terrifies to the core. The Great Resignation is one proof point that is playing out that hypothesis in real time.
So, in the end, it’s really year three that will matter most. It’s going to be exciting, to say the least.

Joel Jacob

 

David Stemler

David Stemler, Executive Creative Director, CDM; Joel Jacob, SVP, Director of Medical & Scientific Affairs, CDM NY; Kristen Gengaro, President, CDM NY; Sharon Callahan, CEO, CDM: Though the pandemic has created significant shifts in how our clients engage with their customers, and in turn how our teams assemble to support those clients, we believe the single greatest impact has been a humanistic one.
While most companies aspire to be “talent-forward, only those who really led with heart were able to show up authentically on this topic. And those who didn’t saw larger departures of employees searching for a more compassionate workplace.
This year, we learned important lessons about “seeing the whole employee” and looking beyond the workplace; about leading with “brutal honesty and credible hope” when our people were becoming more fatigued; and about bringing grace and compassion to the foreground in a way that permeates all that we do.
So, as we head into 2022, I think agency leaders need to reflect on a few questions: Do my employees feel seen and cared for? Do my senior leaders lead with compassion? And have we, together, created space for a more heart-forward culture?

Isabella Sergio

Isabella L. Sergio, EVP, Managing Director, PRECISIONvalue: It goes without saying that COVID-19 has hit everyone in the industry hard including patients, providers, and caregivers and industry. While the country continues to open, live engagement has not returned to where it once was – provider office visits are still down thus delaying diagnosis and patient treatment, communication between providers and patients trend towards telemedicine causing concerns for overuse and future reimbursement challenges, and live engagement between providers and manufacturers continues to be limited. All while therapeutic advancements continue to increase with a greater need for education. We see parallels among manufacturer engagements with health plans as well.
That said, the pandemic has allowed us to pivot traditional promotion to identify new strategies, create enhanced personalized messaging, leverage technologies to be more digital, and reach our stakeholders through an omnichannel approach, which will enable us to become more of a partner to our clients given that they are learning about what their customers need and want as well.
What has not changed is that our shared goal remains the same, patient access to medications continues to be at the forefront of our priorities. Now more than ever during year two of the pandemic, it is critical to ensure that all patients
are screened, diagnosed, and receive the appropriate treatment.
Brian J. Ward, MBA, Partner, Director of Operations, Peregrine Market Access: At Peregrine Market Access, we’re fortunate that year two of the pandemic has not slowed us down. In fact, the way that the agency adapted during year 1 has set us up for success and made us even more versatile. For example, we very quickly rolled out enhanced virtual meeting capabilities for advisory boards and other typically in-person events, as well as remote video capture. Although there’s no substitute for in-person relationship building, these virtual capabilities have enabled us to effectively complete projects for our clients without sacrificing quality.
We have started to slowly get back to in-person programs, but these new capabilities and the versatility of our team enabled us to not skip a beat and grow our business. In fact, Peregrine Market Access was recognized in 2021 as one of the fastest-growing private companies in America, and we expect that growth to continue into 2022 and beyond.
In terms of the biopharmaceutical marketing industry, the pandemic has increased the use of digital and social media marketing and communications tactics to target and reach audiences where they are – which is, by and large, still not in-person. Digital marketing improves analytics for measuring the effectiveness of tactics and for knowing where the best returns are, especially for clients who have reduced their marketing spend during the pandemic.

Kim Johnson

Kim Johnson, Global CEO, Ogilvy Health: We have fundamentally changed the ways we work. Collaboration is at the heart of our business, and that includes collaboration between our expert agency teams and with our clients. McKinsey issued a recent article entitled “Great attrition or great attraction? The choice is yours.” The piece highlights the importance of workplace interaction vs. transaction. Trends suggest there is a greater demand for more flexibility in how we spend our time and an increased desire for meaningful, purpose-driven work. The factors that are important to employees are shifting and therefore our workplace strategies must follow suit. Our efforts are also focused on opening new paths to attract diverse talent to our industry.

Harrison and Star: The second year of the pandemic amplified trends that were already deeply under way; everything on-demand, customer-centric value and driving higher CLV (customer lifetime value) superseding simply driving new bodies into the funnel.
As strategic partners for our clients, we had several virtual co-creation sessions and continued auditing existing workstreams and creating new ones that were aligned to this new landscape. The other dimension to this that can’t be overlooked is the net effect on the end user, patients. What effect would quarantining play in their ability to receive care, to stay adherent, to refilling their medications, to having routine follow ups and labs conducted? And how we could help our clients and physicians overcome these barriers?
Most brands created COVID-specific workstreams that either explicitly or implicitly acknowledged this new landscape, while providing guidance and reassurance to their customers. Physicians also took a more cautious approach when it came to switching therapies, which was completely understandable and appropriate. Since we were the agency of record for the first EUA and first FDA approved therapy for the treatment of COVID-19 to market we had more information about what was occurring on the front lines than our competitor agencies.

CultHealth Roundtable Team

In general, CultHealth felt that if year 1 was a quest for adaptation to a new way of working, year 2 has been one of acceptance… this IS our new way of working, and what does that mean for us and our industry?
Jeff Rothstein – Partner/Chief Executive Officer, CultHealth: The economics are starting to hit more directly. At the beginning there was a lot of spending on immediate videos to reassure people, transforming print pieces to digital, sales to non-personal… now we’re feeling the effects of job loss, insurance loss, and challenges for people paying for their medicines. All of that impacts pharma, which impacts us. And most important, impacts overall population health.
Alysa Vasapolli – Director, Talent Acquisition & Employee Development, CultHealth: It’s also mental health. People have been affected so many ways and they’re really evaluating their work-life balance. Agencies, clients… not just our industry… everyone is having a harder time hiring and keeping staff.
Glenn Stevens – SVP, Group Creative Director/Art – HCP Marketing, CultHealth: COVID was a catalyst for progressive ideas on the office of the future, but beyond that we are realizing the true effect of new employees that have zero context of a traditional office. It’s important to understand the true perspective and expectations of someone entering agency-life today.
Jim Metropoulos, MD – Partner, CultHealth: Surveys show that more and more people are thinking one salary can be enough for a household, so people are dropping out of the workforce for quality-of-life reasons and to focus on other priorities when a year ago they didn’t believe that was possible for them. Our industry depends on a flex force, so this has huge implications for how agencies will service clients.
Robin Steinberg – SVP, Strategic Planner, CultHealth: And the people who are working work longer hours remotely, and it’s leading to mass burnout.
Todd Hoza – SVP, Digital Director, CultHealth: There’s a rhythm to in-office work life… your commute starts and stops your day. We need to train people how to build that into remote work.
John Nelson – Head of Planning, CultHealth: One of the big challenges we’ll face is that we’re not either/or anymore… it’s not “we’re all in the office” or “we’re all remote.” This hybrid work, some people in the office, others dialed into Microsoft Teams calls, is a whole new challenge that is much harder to solve than telling every-one to use video chat features.
Jessica Ward – SVP, Group Creative Director/Copy – HCP Marketing, CultHealth: On the plus side, we’ve been able to hire people all over the country which never would have happened before. We’re open to the largest talent pool ever, and when people live where they want and have careers they want, there will be a new type of rhythm and satisfaction.
A more pessimistic theme emerged in this discussion among Cult­Health management about the role of science and healthcare education…
Jim Metropoulos: Segmentation matters, even when you consider how people look at health providers. At the beginning of the pandemic, doctors, nurses, technicians were heroes, people cheered for them every night. Now in some places they’re harassed like villains. Public health officials are getting death threats.
Todd Hoza: People seem to be getting more skeptical about science… doesn’t make our jobs any easier.
Nancy Liu – SVP, Account Director, CultHealth: I think it’s more subtle. I know a lot of people who understand and believe in science, but they’re concerned about getting pediatric vaccines for their own children.
Jeff Rothstein: That’s a phenomenon Jim and I have been studying for years now… we call the “Belief Gap” when you understand and know that one thing is true, but you still believe something else contradictory. We’ve been preaching for a long time that most people promoting pharma brands are trying to solve for “Education Gaps” but the real way to sell is when you close the “Belief Gaps.”
Jim Metropoulos: Here’s a real-life example… just last month people died, and others got sick from an aromatherapy product sold at Walmart. People freak out about what they perceive as risks from a vaccine that has been studied extensively but they’ll breathe in fumes they know nothing about. We need to figure out how to better communicate about risk.
John Nelson: Exactly. The process is broken. Our work needs to be about beliefs. We can get all the facts in the world, but COVID is proving it more than ever… education without any attempt to change beliefs is a non-starter. And that goes for HCPs too, not just patients.

Nadia Cervoni

 

Eileen Yaralian

Eileen Yaralian, EVP, Director of Strategic Services, Managing Partner; Nadia Cervoni, EVP, Director of Medical and Scientific; Michael Schreiber, EVP, Executive Creative Director; Eddy Rodriguez: SVP, Creative Director, Art, DDB Health: In year two of the COVID-19 pandemic, our teams have settled into ways of working that allow for more flexibility in their lives. Never has a focus on mental health and wellness of our teams been more critical. We’ve begun to find a productive and rewarding balance between virtual and live work, among our teams and with our clients. Just as we’ve moved toward a more fluid model, HCPs and patients as well expect more fluidity in communications. They expect to be able to absorb content on demand and on their own time. Consequently, our business has shifted tremendously toward digital channels, where micro-content and omnichannel distribution have been key to delivering relevant, continuous, and connected customer experiences. We’ve doubled down on investing in our customer experience and innovation group to meet this skyrocketing demand.
As a result of COVID-19 and the contemporaneous uncloaking of systemic racism and inequity, the industry as a whole has begun to focus on healthcare challenges facing underserved populations. Awareness of the issues is an important first step, but we have a lot of work to do in this area as we strive for healthy equity for all.

Justin Freid

Justin Freid, Chief Growth & Innovation Officer, CMI Media Group: COVID was a catalyst for change. It forced us to adapt immediately and did not give anyone time to debate. Year two of the pandemic was about thriving within our current state of normality. CMI Media Group continued to have record-breaking growth, partially due to how ready we were to support remote work but also because it pushed us to innovate for our clients. Many actions we took in year one, such as the building of PROACT Rep and continued evolution of our Empower platform, were widely adopted and extremely effective for our clients. We also listened to our employees and understood how the pandemic affected their lives, making modifications that center around their needs.

Jose Ferreira

Jose Ferreira, SVP, Product & Innovation, CMI Media Group: Necessity is the mother of invention, which during COVID translated into rapid acceleration of nascent technology and marketing philosophies. Telehealth is a great example of how an existing technology scaled exponentially as required by demand. It has since stabilized and will start to evolve into a key part of the healthcare delivery mix by addressing payor and technological equity hurdles. Omnichannel changed from a long-term north star for marketing practices to something that needed to be scaled immediately. Organizations are now laying the infrastructure that will enable real-time pivoting of customer engagement practices if one or more channels are largely unusable for a period of time, like what happened with sales reps. It will enable marketing teams to be agile across all customer touchpoints and essentially pandemic proof.

Ryan Burchinow

Ryan Burchinow, VP, Paid Social, CMI Media Group: I see the remote environment and the longevity of this pandemic causing clients to reassess what the “new normal” and, more importantly, “new preferences” will be moving forward. Due to the extended nature of this pandemic, HCP and consumer behaviors and preference have shifted. While we were originally upping NPP promotion due to necessity we’re also seeing changes in preferences and adoption of platforms. On the HCP side we see indicators that more and more HCPs are starting to prefer less face-to-face time with reps and would be more reliant on “self serve” options in order to get more info and connect with a person digitally for specific questions. On the consumer side we’ve seen mass adoption of platforms by older demographics which has made us rethink and reoffer “reach” offerings into main stream proposals.

2. What will the sudden shifts in operations and regulations during the pandemic mean for the industry in the long term?

Dr. Joe Sklar

Dr. Joe Sklar, Ph.D., Chief Medical Officer, Concentric Health Experience: At the onset of the pandemic, many were scrambling to adjust to the new way of life that we were collectively thrust into. The expectation was that the changes that were put in place would be temporary, and that life would return to the habits and routines that were ingrained prior to the outbreak. The reality is that “year two” has led to an increased understanding of the longer-term effects the pandemic will have on our lives, including the changes that shape our industry. We are collectively in this together for the long haul!
Precipitated from necessity, the traditional model for healthcare negotiation between patient and physician has evolved indefinitely. A hybrid model of remote and in-person interactions will continue to dominate healthcare for the foreseeable future. The use of telehealth permitted safe interactions between patients and physicians during the height of the pandemic, but a nice tangential effect was the demonstration that this platform can also address gaps in care. Healthcare interactions have become more seamless. As vaccines and acute treatments become more widespread, the patient is not forced to return to in-person consultations when a virtual one can meet their needs. Patients now have greater flexibility in how they choose to interact with the healthcare system and receive care.
With respect to promotional efforts, this new hybrid way of life demands that we carefully consider channels, content, and preferences that feel bespoke to the end user. This was always important but now should be considered the cost of entry. This isn’t a bad thing, as this facilitates interactions with our customers in their natural environment. Our end users will have experiences with brands that feel natural rather than disruptive or intrusive. Brands that use this approach will prosper, while those that don’t will feel dated and relegated to an antiquated approach that has had some success during our pre-pandemic lives.

James Tinker

James Tinker, Managing Partner, Moon Rabbit: There are a lot of areas here, but for me it’s going to be imperative for agencies to ensure that they are proactively thinking about the growth and development of their teams, in whatever level of hybrid or fully virtual environment in which they are working. Especially for those starting their career, how can we make sure they are exposed to environments where they will learn quickly. Often, with in-office roles, this was seamless and some of the best learnings were less structured. It was exposure to conversations going on around you, discussions at the water cooler (however cliché that may sound, I’ll stand by it), and seeing how every element works together and comes together. If agencies don’t have that development front of mind, they will lose – especially in today’s competitive talent marketplace.

Dan Carucci

Dan Carucci, MD, PhD, Global Chief Medical Officer at McCann Health, an IPG Health company: These past 18 months have shined a new light on what can be achieved by bringing together medical innovation, technology, information sharing, along with forging and strengthening new partnerships to end a global pandemic. But while there is much to celebrate it has also exposed the harsh inequities that exist in our healthcare system. All of this, the good and the bad, are playing out in living rooms, dining rooms, on playgrounds, and through social media for everyone to see and comment.
The rapid development of safe and effective vaccines, and therapeutics to meet the global public health need could not have been achieved without unprecedented levels of cooperation, enormous human and financial resources, and commitments from governments, pharmaceutical companies, and regulatory bodies. The urgency of the pandemic and its potential enormous impact on the health of the world’s population and global economies demonstrated what could be done to contain a highly infectious and lethal virus.
What then are the potential long-lasting changes in the pharmaceutical and regulatory agencies that may persist in the post-pandemic era?
It will take some time to assess the long-term impact of COVID-19 on drug and vaccine development processes more broadly, however, several important themes have arisen:
1. The importance of partnership and trust building, particularly between the pharmaceutical industry and regulatory agencies. While it is unlikely that the human resources will be available for continued and ongoing streamlining of administrative review, convening meetings, and other pre-submission activities, regulatory agencies should review where efficiencies can be made to accelerate the approval process.
2. Regulatory agencies from different countries or regions should examine how information can possibly be shared to accelerate approval across regions.
3. The pandemic resulted in the rapid (some would argue too rapid) release of information particularly from clinical trials to the general public. Often companies would announce the results of interim clinical trials data prior to important peer review. Pre-print services meant that researchers could publish scientific papers prior to peer-review but with caveat that changes to the results or analysis could be made prior to full peer review in advance of publication in an academic scientific journal. The speed with which clinical data could be released to the general public meant that media organizations, traditional and social, could potentially amplify or sensationalize a research finding without providing sufficient context to fully explain the significance of the data.
4. As the pandemic unfolded in news reports, as pharmaceutical companies released clinical trials data as they were available, and as regulatory agencies provided rolling or interim approvals for drugs and vaccine products, the general public had a front row seat into what had previously been a fairly opaque process. They were suddenly conversing with friends and family using newly found terms such as “severe adverse events,” “clinical holds” and “efficacy.” They became aware of the fact that while extremely rare, vaccine side effects, sometimes serious, can occur.
The future post-pandemic world will hopefully see strengthened partnerships between the pharmaceutical and regulatory agencies; strengthened partnership and communications between regulatory agencies of different regions and countries; the inevitable continued use of pre-prints in advance of peer-reviewed publication but with a more robust system to highlight revisions and retractions should they be necessary based on further peer-review; a patient population who although potentially more skeptical, particularly of the safety profile of new drugs and vaccines, are more conversant with their development and approval.

Paul Pfleiderer

Paul J. Pfleiderer, PhD, Global Chief Strategy Officer, TBWA\WorldHealth: Historically, there have been open-and-often declarations that healthcare is several years behind the marketing/advertising practices found in the consumer goods world. The “why” behind this can likely be debated endlessly. That said, over the last 12 months, we’ve observed a profound desire and effort to play catch-up – most notably in the push towards omnichannel. This shift is, in our opinion, here to stay, with long-term and lasting implications in how we and our clients should be thinking and operating.
From a brand perspective, we need to shift our thinking away from the importance of creating advertising platforms toward one of orchestrated creative experiences: connecting our ideas into one cohesive and more personal experience, driving awareness, salience, and reinforcing distinctiveness.
With this shift toward orchestrated creative experiences comes a need to shift our ways of operating to become more integrated and less siloed. Within many of our clients’ organizations, individuals and teams responsible for omnichannel efforts are separate from brand teams or are separate disciplines within a brand team. While this is natural, it’s new and requires new subject-matter experts, and it can result in a fracturing of brand ownership and an unforeseen tension between effectiveness versus execution. As omnichannel is so new, much of the attention and effort are placed in this arena, leaving many of us to forget the need for breakthrough, effective creative. As agencies, it is incumbent on us to ensure that there is no wrestle for brand ownership, and that equal weight be placed on both effectiveness and execution. After all, and as David Abbott once said, “Sh*t delivered at the speed of light is still sh*t.”

Nicole Basa

Nicole Basa, Director, Media, CMI Media Group: Shifts in operations and regulations to more flexible, remote working, with focus on health and safety has highlighted an overall industry shift in change of perception; viewing fellow employees and clients as people. It has highlighted a need to have a professional level of empathy for one another and respect of personal and professional boundaries as well as work/life balance. It has resulted in quality vs quantity of work and a focus on efficiency/productivity, which has allowed for happier more engaged client and agency partnerships to flourish.

Julie Hurvitz Aliaga

Julie Hurvitz Aliaga, SVP, Social Media, CMI Media Group: We will continue to see this shift evolve in different ways: For the last two years, we have traded commutes to the city for commutes to our home offices – our Apple Watch “steps” certainly saw this shift! In all seriousness, there will be changes long-term that stay – such as more flexibility and more remote opportunities. Much like our own commutes, we are finding different work/life balance when taking a commute out of the equation, and saving money in the process. We will need to re-invent how and when we need in person interactions, and what they look like. There is still no substitute for that “human touch,” but in the same vein, there is also no substitute for more efficiencies and greater balance when it comes to one’s home life and passions outside of work. We are not yet out of the woods, but we are much closer, and time will certainly tell what stays, what goes, and what gets reimagined.

Alexandra Gilson

Alexandra Gilson, VP, Paid Social, CMI Media Group: We are in unprecedented times and as COVID continues to evolve, so do patients and HCPs’ questions. It is important to keep our fingers on the pulse of those conversations, which is why social listening is now more important than ever. We need to be proactive in addressing needs when it comes to patient health during the pandemic.

Deb Goldberg

Deb Goldberg, EVP, Director of Client Services, CDMP: One of the most exciting aspects of the pandemic was the forced advancement of technology in medicine, and especially in caring for patients. Telemedicine was seldom used previously, with some strict regulations for its use. During COVID-19, necessity drove the initial uptick of telemedicine and the benefits were realized immediately and here to stay.
Expanding access to care is one of the main benefits of telemedicine. Location does not need to be a determining factor for patients when seeking care. Telemedicine may also encourage more proactive healthcare for those who are reluctant or embarrassed to see a healthcare professional. It also allows for caregivers who may be in a different location to be a part of the visit with the doctor.
This new format of medicine warrants a new format of educational resources. Physical handouts are no longer appropriate, whereas technology to highlight important information in real time may become the norm. Continuing to reinvent and optimize our communication methods for this new modality is part of our future.

Fred Kinch: As authorities loosened telemedicine restrictions under emergency state orders, many medical specialties realized that this once fringe way of interacting with patients was actually preferable to pre-COVID, face-to-face appointments. Mental health, neurology, even initial consultations across a broad spectrum of fields discovered the benefits. If a procedure or direct, hands-on examination isn’t required, that visit is now a candidate for a telemedicine appointment. In fact, anecdotally, some providers we know are permanently shutting down their brick-and-mortar locations. What remains to be seen is how this affects prescribing habits long term. Initially, we saw a greater uptick in prescriptions that were more easily managed remotely, and therapies that required closer monitoring or in-office administration were delayed or relegated to later lines. For pharma marketers, this makes for a rapidly shifting competitive landscape with product features that were once considered secondary or tertiary suddenly become primary reasons to believe in the brand’s value proposition. Do you change the brand’s narrative to address this physician epiphany or stay the course hoping this is just a COVID fad? Like remote working, the question is still unresolved.

David Lubofsky and David Brungard: Sorry big networks, but larger companies will continue to shrink into smaller, more agile teams that can get work done more efficiently with less overhead. Sorry round-the-clock agencies, the 16-hour work day you trick employees into working by offering dinner, liquor, and camaraderie is being replaced with 10-hour work days that often are split into pieces and usually involve spending time with their children. We’re in a different world now where people have shifted their focus to where it should have been all along: with their families, loved ones, and spending time on themselves. We cannot expect to keep doing things the same way, especially now that we know exactly what was being sacrificed.
As leaders, we have to find ways to adjust to the needs, wants, and the new flow of life for our people. More and more, ping pong tables and booze won’t move the needle for potential employees; instead, the needle will be moved by offering hybrid work environments and unique-to-the-employee work schedules. Don’t be left in the dust.

Isabella L. Sergio: The COVID-19 pandemic has had a significant impact on health care utilization and there will be a new normal for many stakeholders.
There was an unprecedented growth in telehealth and it’s here to stay, though to a lesser degree than earlier in the pandemic. Digital and self-administered health care is increasing with:
· Patients using online channels to communicate with physicians, insurers, and pharmacists
· Physicians pushing and pulling EMR data across systems to support real-time decision making
· Payers contracting and rebating online and de-identified data linking Rx with other data via cloud
· Hospitals leveraging advanced analytics to identify patients, improve scheduling, and inform treatment sequencing
The pandemic has also brought more awareness of the impact of disproportionate access and affordability for underserved populations. This remains a top priority within our industry and we believe that we will see more innovation from payers and manufacturers on how to support these patients in the long-term.

Brian J. Ward: The pandemic was a wake-up call for supply chains, as it highlighted the United States’ overreliance on materials from other countries to manufacture and deliver treatments and healthcare products. While there are opportunities for American businesses to fill the void and provide the supplies needed right here in this country, there will always need to be a measured balance in order to maintain global stability. Additionally, the sudden shifts in operations and regulations require a more concerted effort to bring automated technology and predictive capabilities (artificial intelligence) to bear on the supply chain challenges to effectively track materials and get ahead of shortages. Plus, manufacturers should have back-up plans to contend with supply chain shortages. We predict that one of the lasting impacts of the pandemic will be an effort and desire to eliminate office spaces and move companies to a more virtual setting and stop spending on brick-and-mortar spaces. We feel this is shortsighted. Collaboration is the backbone of American ingenuity and innovation. The industry was resilient, put its head down, and made do; however, if this is the new normal, companies still coming together in-person to work will have an edge.

Kim Johnson: A recent canvassing of experts in tech, communications, and social change by Pew Research Center recently found that post-pandemic shifts are poised to create a tele-everything world. Changes for the health industry long-term include the emergence of an “Internet of Medical Things.” The predictions include increases in tech use, virtual health and precision medicine. Noted is an “increased use of sensors and devices that allow for new kinds of patient health monitoring; advances in synthetic biology and computational virology that improve drug testing and targeted disease therapies; diagnostic screenings that cover a person’s diet, genes, and microbiome and a new class of tele-care workers.”

Harrison and Star: The last 18 months essentially created a “natural experiment” for the industry that asked the question, what happens when sales rep access dramatically decreases? Smart companies are analyzing what did and didn’t work during the period when reps couldn’t visit physicians live. One thing that many are learning is that nonpersonal promotion did not fill the gap of live customer interaction. So even as companies are reemphasizing personal selling, they are working to make nonpersonal efforts (e.g., virtual visits, immersive experiences, targeted communications) more engaging and of higher value for customers. Ultimately, this is the only way to meet evolving communication goals.
Additionally, the industry is learning how to move faster. The pandemic forced shifts in how we conduct studies, how we communicate, and how we work and collaborate. It is easier than ever to tap into the right expert or find a new solution to a problem. We expect that many companies will apply these learnings to accelerate drug development timelines and to make their commercialization and marketing strategies more nimble and agile.
With regard to regulation, there are two new (and competing) dynamics. On the one hand, public health experts have been given more authority than they have ever had before. As the pandemic demands less of their attention, expect them to propose new rules and regulations meant to address other systemic challenges. Running counter to that, the world just saw that easing some regulatory burdens cut vaccine development time by 75 percent and has led to other solutions being implemented on faster-than-normal timelines. Some experts and lawmakers may start to push against what they see as outdated and costly barriers to approving and accessing other treatments.

Celine Vita and Carolyn O’Neill: The sudden regulatory changes made under crisis in 2020 have had rapid and long-term impacts on healthcare and our industry. A transformative example is the rapid adoption of telemedicine, made possible by emergency orders eliminating barriers related to physician state licensing and reimbursement. Telemedicine is now integrated into every level of the healthcare system, from routine care visits to clinical trial protocols. These regulatory shifts have also been life-changing for people with rare diseases who can now access centers of excellence across state lines without travel, logistical, or financial burdens. As an industry, we need to understand the new context of care and have the opportunity to bring continued innovation in remote engagement and monitoring. A second example are State-specific regulatory changes relaxing or removing requirements for NPs and oversight by a physician. Introduced to address strain on the healthcare system, the duration of these changes will be State-specific but emphasize the increasing influence of NPs/PAs in care and prescribing decisions. As a time when physician access is increasingly limited, we anticipate that industry will continue to increase focus on these important stakeholders.

3. What are your thoughts on the Build Back Better Agenda’s plans to lower Rx drug costs and reduce health insurance premiums, and what industry themes/elements would you like to see included in the agenda?

Jay Carter

Jay Carter, EVP, Chief Strategy Officer, AbelsonTaylor: As I write this note, the Build Back Better bill was passed by the House. If I wanted to waste words, I would get into all the legislative nitty gritty about it passing the Senate, but Schoolhouse Rock did a much better job of that than I could.
I’ll focus first as a taxpayer. I like the idea of single negotiation of prices and rebates by Medicare; the federal government writes the check, yet multiple negotiations with plans can lead to a dilution of buying power. In this instance, single payer makes sense to me.
As a working member of the industry, that action could obviously affect revenue. The good news is, pharma is used to negotiating with big payers. For some companies, this will be the biggest fish of all, but I think that pharma will survive in that environment.
The better news is this: At the end of the day, the industry thrives by innovating in areas where drug therapy doesn’t help YET. This forces America’s pharmaceutical industry to continue to focus up-on better patient outcomes, where everyone wins.

Doug Wynn

Doug Wynn, RPh, EVP, Chief Strategy Officer, NAVISYNC LLC: I think it’s fair to say we all want lower drug costs and reduced premiums. Current law only allows contracted health plan sponsors, not Medicare, to negotiate Part D pricing with drug manufacturers. Less negotiation means less competition. Less competition means health plans have the power to maximize profits under the guise of access and affordability messaging, and improved outcomes. Health plan profit maximization means that our elderly often have to choose to either put food on the table or pay their high medical premiums and prescription out-of-pocket costs.
To help put things in context, health plan sponsors like OptumRx (the most profitable segment within Optum, a UnitedHealthcare affiliate) control how drugs are paid for, and which drugs are allowed coverage to maximize profit. These strategies helped Optum create a profit of approximately $136.3 billion in 2020.
With Build Back Better, imagine how Medicare’s new negotiation power can shift a fraction of that $136.3 billion back into our senior citizens’ pockets, as well as into necessary R&D. While I’m a fan of the agenda’s $35 out-of-pocket maximum for insulin products and no cost-sharing for certain vaccines, I don’t feel the agenda does enough to reduce specialty drug costs and to protect seniors from exorbitant specialty drug out-of-pocket requirements. I also worry how health plans will strategically counter the agenda’s inflation rebates downstream, leaving seniors struggling to pay for necessary, innovative launch products.
Our political divide left too much on the cutting room floor, with our seniors paying the price. Build Back Better is a good start, but I’m already looking forward to a less political version 2.0.

Mike Motto

Mike Motto, SVP, Market Access, Intouch Market Access: Three major takeaways, from where we stand today, on the Build Back Better Agenda: First, biopharma discount exposure stands to be much less than was originally expected. Second, utilization of some drugs can be expected to increase as a result of lowering financial barriers for patients. And third, it remains necessary for biopharma to monitor the changing policy landscape.
So far, the Congressional Budget Office estimates that the legislation will have a relatively minimal impact on the biopharma industry if it makes its way into law. The CBO analysis predicted about $160B over 10 years, about half resulting from Medicare negotiations for about 10 costly medications, and about half from limiting price hikes to the rate of inflation. These numbers are very different from the $450 billion that was projected from the bill that was proposed in 2019.
Among its provisions, the legislation would limit out-of-pocket payments for seniors in the Medicare Part D program to $2,000 per year, and limit the price of insulin to $35 per month. The Build Back Better Agenda should offer help to many of the Americans who most badly need better access to healthcare.

Andrew Cournoyer

Andrew Cournoyer, RPH, MBA, Senior Vice President, Director, Access Experience Team, PRECISIONvalue: I have mixed opinions about the Biden Administration’s Build Back Better Framework. In some cases, I believe it institutes meaningful policy to address issues of drug price affordability and in other cases it misses the mark. On the positive side, the framework’s proposal to cap Part D beneficiary out-of-pocket spend at $2,000 is a significant move, especially as seniors are spending higher proportions of their income on healthcare expenses. Conversely, one area the proposal misses the mark is in regard to negotiating prices for high-cost prescription drugs. The framework specifies that drugs will become eligible for price negotiation 9 or 12 years after they have been on the market. Typically, a drug will only have 5-7 years of patent life remaining once it is approved and marketed, after that period lower cost generic and biosimilar drugs can enter the market, significantly limiting the uptake and use of high-cost branded agents. The impact of CMS price negotiation is severely blunted by these timing limitations.
I would have liked to see the framework address challenges in access to care resulting from social determinants of health. As the US transitions out of COVID-19 restrictions, solutions that were used to maintain access to care should become front and center, including telemedicine and digital health solutions.

John Guarino

John Guarino, Founder and President, Peregrine Market Access: Lower cost healthcare is an important agenda item for the government to take on. But our entire system needs to re-evaluate how we assess the value of care. Vilifying pharmaceutical and biotechnology companies is commonplace these days. But prescription drugs are only 12 percent of the total healthcare spend. And over the last three years net drug spend is actually down due to patent expiration for significant therapies. I would love to see the narrative shift to value.
Value is a combination of clinical benefit and cost impact. The Affordable Care Act had a provision for comparative effectiveness to evaluate the impact of therapies, but it was woefully underfunded and never became a part of our process. There are a lot of people doing a lot of amazing health economic and outcomes research in the industry. I would love to see us use that data to make more informed decisions about quality care, instead of a blanket goal of making things less expensive. If we drive value, costs will come down.

Jose Ferreira: It was only a matter of time before government enacted laws to negotiate Medicare and Medicaid drug prices and worked to reduce health insurance premiums. Both are wildly popular with rank-and-file voters on both sides of the aisle. I think the industry is taking an unnecessarily circumspect view of these new policy initiatives. Yes, it will reduce margins and rein in prices in some areas of the healthcare industry, but it will also create new opportunities. It may mean more medicines can be covered by Medicare and Medicaid, more people will have access to health insurance and affordable care – both are expansions of the current market. Finally, this presents an opportunity for greater equity and inclusion of the general population within the health delivery ecosystem. Change is hard, most people push against, but others see and harness opportunity just when industries are changing. That is how capitalism ultimately works best. The ACA faced similar hurdles and after ten plus years we can objectively surmise that it’s been good for the average person and the healthcare industry. I think we’ll see a similar result with the healthcare components of “Build Back Better.”

Harrison and Star: This is definitely not easy to pinpoint a specific perspective just yet since the bill itself is still changing, but overall for most pharmaceutical companies this bill could be neutral to good. For big pharmaceutical companies, this could have a potential negative impact. The bill would extend greater subsidies for people buying insurance through the Affordable Care Act, which in theory should mean more patients get and maintain insurance and therefore have enhanced access to care and drugs. This could mean that the potential pool of patients that afford branded drugs should grow slightly. However, pricing would get more complicated and it would be harder for established molecules to fund new R&D and launches within organizations. Some themes that would be interesting to see would be how the provisions will work out with lowering the price of prescription drugs and how this will impact competitor drugs in the future. Also, if brands can’t increase their prices faster than the rate of inflation the impact of the cost of drugs at launch could be high. Lastly, what will the impact of generics and biosimilar market be based on some of the amended clauses.

Eddy Rodriguez

 

Michael Schreiber

Eileen Yaralian, Nadia Cervoni, Michael Schreiber, and Eddy Rodriguez: A key focus of the Biden Administration’s Build Back Better plan is to expand affordable healthcare through reducing the cost of prescription drugs while also reducing healthcare premiums for those who buy insurance through the Affordable Care Act Marketplace.
The plan’s approach to making prescription drugs more affordable is complex. It proposes the implementation of key multifaceted initiatives including the enablement of Medicare to negotiate drug prices, capping the out-of-pocket amount that seniors spend on prescription drugs, preventing drug prices from soaring well-above inflation, and increasing competition by reducing the time needed to obtain generic drug equivalents.
It’s no secret that Americans pay disproportionately more for prescription drugs than any other nation. Multiple studies have examined and confirmed this, and more recently, a RAND Corporation study reported prices in the United States averaging 2.56 times those seen in 32 other nations. When only brand-name drugs are considered, the difference goes up to 3.44 times those in comparison nations. These data alone illustrate an obvious unmet need.
With the widespread success of drug-cost negotiating globally, it makes sense to implement this policy here in the United States. The Build Back Better plan describes how the policy will establish a clearly defined negotiation process that is fair for manufacturers while providing the biggest savings on drugs that have been on the market a long time.
One global trend worthy of consideration is the practice of using comparative and cost-effectiveness research for determining price ceilings. Other countries generally assess not just whether a new drug is effective, but whether it is more effective than existing therapies and, in some cases, whether it is cost-effective. Of course, key differences between our healthcare system and those that offer universal healthcare would make this practice challenging to implement. However, requiring evidence of better health outcomes for coverage might be possible in the United States through collaborative agreement between private insurance on an efficacy threshold. If attainable, this approach would serve to add a layer of scrutiny and accountability for all involved in drug development while placing increased emphasis on the best patient outcomes.
As for the other key elements of the plan, keeping drug prices affordable for seniors and those who rely on drugs to maintain their quality of life, feels like a big no-brainer. In listening to President Biden’s remarks late this summer, however, the one thing that remains unclear is the onus placed on government versus the pharmaceutical industry.
President Biden stressed the role of government in putting this plan into place but also criticized pharmaceutical companies for not using enough of their profits for innovative research. In fact, he goes one step further by proposing that the government spend $6.5 billion to set up an agency within the NIH that is focused on speeding up cutting-edge research for devastating diseases such as Alzheimer’s, diabetes, and cancer. Many of us often don’t associate ‘government’ with ‘speed’ and, in fact, when we think of cutting-edge advances and lifesaving research, the first thing that comes to mind is the pharmaceutical industry. Thank you for the COVID vaccines!
All this to say, in addition to asking pharma to do their part, perhaps we should also look at whether government cost-savings could be best utilized by contributing even greater funds to offset patient out-of-pocket expenses. And let’s just leave the R&D to pharma so that we can further realize the vision of improved and affordable healthcare in this country sooner than later.
References:
https://www.rand.org/news/press/2021/01/28.html
https://www.commonwealthfund.org/publications/issue-briefs/2017/oct/paying-prescription-drugs-around-world-why-us-outlier
https://www.whitehouse.gov/briefing-room/speeches-remarks/2021/08/12/remarks-by-president-biden-on-how-his-build-back-better-agenda-will-lower-prescription-drug-prices/

4. What are the key issues trending among U.S. healthcare stakeholders?

Roshawn Blunt

Roshawn Blunt, Managing Director, 1798, a Fingerpaint company: Horizontal and vertical consolidation in the payer and healthcare delivery sectors accelerated during the COVID-19 pandemic, both in response to the current medical care climate and in an effort to impact how primary care will be delivered effectively and efficiently in the future. Virtual care and telehealth continue to evolve, and also retail pharmacies are quickly pivoting and branching out into the healthcare provider space.
Telemedicine providers seek to increase their offerings while lowering their costs. Private payers have identified this as an opportunity to expand and develop comprehensive care solutions by acquiring or partnering with telehealth vendors to achieve these goals. Virtual care companies such as Teladoc have built out end-to-end offerings to differentiate themselves in an increasingly competitive market. Last year, Teladoc purchased digital health management company Livongo, which brought Livongo’s programs for remotely managing ongoing or chronic conditions such as diabetes under Teladoc’s umbrella. Teladoc also purchased InTouch Health, which works with hospitals and has provider-to-provider telehealth capabilities for both inpatient and home healthcare needs.
Importantly, Teladoc utilized insights from those acquisitions to develop Primary360, a tool for payers and employers that allows members to choose a primary care provider and work with a care team to create personalized healthcare plans and schedule phone or video telehealth appointments. CVS Health’s Aetna unit offered virtual primary care to self-funded employers nationwide using Teladoc. The Aetna-based virtual primary care service allowed members to receive healthcare services remotely and in person.
As Teladoc was developing virtual care offerings to closely partner with payers, Cigna was electing to acquire telehealth providers. For example, MDLive was acquired by Cigna’s health services subsidiary Evernorth. One of Cigna’s rivals, UnitedHealth Group, purchased virtual behavioral care company AbleTo and also post-acute care management platform, naviHealth.
Similarly, across the industry, insurers are expanding their reach into in-person care delivery. Humana, for instance, has been purchasing physician networks in order to expand its reach into primary care. UnitedHealth Group’s OptumHealth unit now owns medical practices that account for approximately 5 percent of all U.S. physicians, although this fact is not widely known. And CVS Health added hundreds of HealthHUB clinics at retail stores during the pandemic; the company recently announced it is closing over 900 retail locations but will convert some of its remaining storefronts into dedicated primary care services.
As payers now have direct ownership of provider facilities and healthcare delivery platforms, their direct impact on patient care may expand even further in the future.

Hilary Gentile

Hilary Gentile, Global Chief Strategy Officer at McCann Health, an IPG Health company: One of the silver linings of the COVID calamity is for us to acknowledge that for our sector, change is paramount. There is a call to action that our health experience needs to change, health experts want to anticipate and navigate patient demand, health systems wish to create value exchange for their constituents and field teams wish to engage with health experts in new and meaningful ways. A red thread which effects every person in the health ecosystem is the Where of Care.
The WHERE OF CARE can be ANYWHERE: No longer is care limited to the physical office, it’s out of our homes, in pharmacies, pop-up clinics, on Zoom, or wherever a human needs it. We all continue to be uber-connected, and hyper aware of our health status. The agility to engage, when and where it makes sense for our families and our business (health experts) is a mandate.
NOW WHAT? To adapt to this dynamic we need to become, omni-competent.
1. REAL TIME UNDERSTANDING:  Employ real-time learning canvas to digest and codify the care paths of our health consumers and the scenarios of our health experts.
2. CONTENT THAT CARES:  We need to create liquid content, that helps each person navigate their care, each health expert make decisions with conviction and understanding.
3. BETTERMENT THAT IS CONTIGUOUS: To thwart a fragmented experience we need to create a consistent and beneficial engagement experience regardless of where the health stakeholder connects with our content, company or brand.
4. COMMUNITY-CENTRICITY:  Double-down on community. Our communities both physical (pharmacies) and virtual (what we ascribe to) have become our havens. Looking at geography, proximity, new key influencers, new tribes which have formed will be critical to understanding the new trust networks which have emerged.

Milo Elmir

Milo Elmir, Managing Consultant, Fishawack Health: Let’s look ahead a few months. Picture this: It’s the early morning hours of January 1, 2022. The ball has dropped, cleaning crews are sweeping confetti off downtown city streets across the country, and the last of the crowds have stumbled home. All of us are nursing a collective hangover from the past 20+ months that changed life as we knew it and caused seismic shakeups across the American economy, impacting how we work, how we learn, how we communicate, and of course how we deliver and experience healthcare.
Will things just go back to “normal?” Looking further into the future, it’s almost certain the answer is no. Certain processes have already been put into place, others greatly accelerated, and there is no turning back from some of the changes that have come about during this pandemic period. And that’s not necessarily a bad thing; let’s look at why.

An ecosystem in transition
You’ve surely heard healthcare bemoaned as a slow-moving industry, slow to innovate, and even slower to adopt new technology. That has certainly been true, and for valid reasons. But it’s this very point that made the industry ripe for disruption.
In comparison with other verticals, healthcare is rapidly increasing in complexity. There are more therapies to choose from and different kinds of treatments such as cell and gene therapies that require entirely different engagement models. Additionally, there is complexity in delivery settings, with sites of care changing and services increasingly delivered in communities or via pharmacies. New nontraditional entrants to the market—think Apple, Amazon, or even Best buy for that matter—have forever altered the competitive set. Healthcare providers are overwhelmed, stretched thin, and frequently burned out as they navigate these changes. And patients, while increasingly empowered, still struggle to meaningfully engage in decision-making. Add to this growing complexity a tightening regulatory environment, and what results is a stubborn stasis caused by constraining the very dynamics of agile innovation necessary to meet the many challenges.
For these reasons and more, changes and advancements in the US healthcare industry moved slowly until COVID-19 forced an accelerated disruption of many aspects of healthcare in the United States and around the world.
COVID-19 has largely sped up the digital transformation of healthcare, boosted innovation, and put the human-centric experience of healthcare front and center. Perhaps counter-intuitively, during the pandemic, more choices and options opened up to patients and providers in the United States. These changes are here to stay.
We see it across stakeholders—no one will be left unchanged in the post-pandemic world. This includes patients, healthcare providers, and payers.

Patients
Patients are more informed and more involved in their health and wellness than ever before, and this has changed how they want to receive and consume care. Today, they have more choices and more information available at their fingertips; this was unthinkable even a decade ago. Patients can now access care on-demand through virtual visits and telemedicine. In fact, telehealth utilization is 38 times higher at the end of 2021 than it was prepandemic.1 They can order their own lab work through at-home testing kits or directly through nationwide laboratory chains and monitor their vital signs and important health stats through wearables that track heart rate, blood oxygen level, sleep quality, even fertility, and sun exposure.
The result of this is more patients doing their own research, engaging in collaborative decisions with their doctors, using digital tools and apps to understand their disease, and keeping up with their treatment. They are also demanding information and access to cutting-edge treatments (eg, early access to trial medications), rating doctors, practices, and medicines online, and advising each other about treatments. Today, more than 80% of Americans are researching health topics online.2
We see the hunger patients have for information on their own health and wellness to only continue to grow as the healthcare offering expands through novel technology.

Healthcare professionals
The telehealth takeover isn’t limited to healthcare professional-to-patient interactions. The pandemic has fundamentally changed the way healthcare professionals engage with pharmaceutical sales reps. The demands on healthcare professionals are high, and to be successful in a COVID-19 world, the value delivered to healthcare professionals through each interaction needs to be clear, concise, and delivered in the channel and manner the healthcare professional wants to receive it.
Remote and virtual communications have seen a rise of 424% from baseline, with many healthcare professionals still restricting access to themselves and their practices. Going forward, 44% of healthcare professionals want to maintain the status quo for the foreseeable future,3 and 28% want reduced rep access to remain permanent. Biopharmaceutical companies will have to find novel ways to engage with their customers and ensure the engagements they do have with healthcare professionals (whether in person or virtual) are meaningful, informative, and personalized to the needs of the individual.

Payers
With the estimated direct cost of COVID-19 care topping $103 billion, insurers are placing new demands on how patients are treated to optimize value.4,5,6 With this shift, we are seeing greater involvement from payers to move towards value-based care pathway designs, signalling a transition to human-centricity in healthcare. Payers are rewarding healthcare providers for quality of care over quantity of services provided, tracking metrics like lower hospital readmissions, more robust preventative care offerings, integration of technology, and patient engagement or satisfaction with their care.
We are also seeing a move toward more tailored offerings in the payer space. Large companies like Amazon and General Motors are offering direct-to-provider plans customized for their employee base. These plans cut out third-party administrators, preferring to negotiate favorable plans directly with health systems.

The continuous engagement revolution
Today, patients, healthcare professionals, and payers have one thing in common. Spurred on by the COVID-19 pandemic, they have all increased their adoption of technology and digital channels. It is easy to think that the solution lies in another piece of technology. However, if you dig deeper into their requirements, these stakeholders are ultimately seeking a human-centered solution.
Patients, payers, and healthcare professionals are all striving for more personalized and connected customer experiences on their terms. They expect value-adding, tailored content delivered at the right time, through the right channel, across their entire journey.
Life science companies must become laser-focused on patient- and customer-centricity to meet stakeholder needs and improve outcomes in increasingly complex environments. The most successful will leverage behavioral science to develop omnichannel strategies that increasingly integrate a broader set of digital channels to deliver tailored, cohesive experiences for key stakeholders.
Leaders of this continuous engagement revolution will thoughtfully and efficiently pivot from a product-centric view to a human-centric perspective, based on the stakeholder’s environment, external challenges, and needs, including the social determinants of health and health equity. Those that can align their people, processes, and technology to deliver on human-centricity will win the future because, in the end, healthcare is and remains a people business.

Building a vision of the future
The pandemic sped up change and has afforded our industry the chance to redefine what healthcare will look like going forward. There continues to be room for expansive growth and innovation. Life science companies can help shape the care pathways of the future by developing innovative solutions that enhance the rapidly changing dynamics affecting pharma, patients, healthcare professionals, and payers.
To do that successfully, stakeholders will need to look both inward and drive top-down organizational change that breaks silos and helps deliver on the promise of digital and transformation. By looking outward, to recruit and retain top-tier digital/tech talent with the right specialist and generalist skillsets in digital and analytics, biopharmaceutical companies can bring their visions of healthcare future state to life.

1https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality
2https://www.webershandwick.com/wp-content/uploads/2018/11/Healthcare-Info-Search-Report.pdf
3COVID-19 Potential Cost Impacts, Covered California
4COVID-19 and Health Insurance Losses, FamiliesUSA
5COVID-19 Potential Cost Impacts, Covered California
6COVID-19 Mega-payers and Pharma, ZS

Mike Dennelly

Mike Dennelly, Executive Director of Strategy, TBWA\WorldHealth: Over the last 12 to 24 months, we’ve observed a number of key issues impacting healthcare stakeholders in the US. Three of these continue to rattle around in the back of our minds, as we develop work for our clients.
Generation Burnout: Day in and day out, HCPs struggle under the weight of “more” – more patients, more paperwork, more hassles, and more information. It’s no wonder that, according to a recent study by Medscape, approximately 42 percent of HCPs reported experiencing burnout. As healthcare marketers, we have an opportunity to create simple, elegant experiences that don’t add to the burden.
The Technology Trap: Technology that had promised to transform the practice of medicine has done quite the opposite. Many practicing physicians spend their days glued to an EHR terminal doing mindless data entry tasks that distract from what matters most – spending time with their patients. “This is not why I got into the practice of medicine” is a common refrain. As healthcare marketers we can help by putting more humanity into the interactions we create and deliver.
(Mis)Informed Patients and Fake News: The advent of Google has made everyone an expert, and doctors are at the forefront of dealing with the “I’ll do my own research” phenomenon. Armed with a strange brew of facts, internet stories, and, in some cases, flat-out fake news, patients have created a new role for HCPs – fact-checker and truth-teller. Our opportunity here is simple: stand strong behind the facts and evidence we create every day, and be champions for the healthcare professionals, their patients, and the community who speak truth to power.

Lisa Varshney

Lisa Varshney, EVP, Strategic Capabilities, Heartbeat: The pandemic has produced deep clefts in the U.S. healthcare system that ultimately run the risk of creating new public health crises. The first issue is the growing physician shortage, particularly in the primary care space. This existed prior to the pandemic and has only become more dire, as a large percentage of the HCP workforce is nearing traditional retirement age and others are proactively choosing to leave based on current stresses and risks. This leaves a major care gap just as our largest generation, Baby Boomers, are reaching the age where frequent healthcare is more critical.
It doesn’t help that the employers of many of these physicians – hospitals and health systems – are facing remarkable net income losses and financial instability. This is largely due to a decline in outpatient visits due to COVID-19 concerns and a surge of inpatient visits, for both Covid-19 and other acute issues. These inpatient visits cost more to treat and have a ripple effect through the top and bottom lines of a health system or hospital. Rural hospitals are often the hardest hit, despite federal aid, and “healthcare deserts” have become a real threat across much of the United States.
Thankfully, a solution that is poised to help alleviate these issues – telehealth + remote patient monitoring – is continuing to find its footing in both patient uptake and HCP infrastructure. It’s expected that a quarter of all routine care will occur outside of a hospital by 2025, which will alleviate some cost issues and create more streamlined workflows for stressed-out physicians. The looming question is how reimbursement will be handled when it comes to telehealth – what policies can be put in place to build on this progress, without unnecessarily bogging docs down with burdens of proof?

Laura Bartmess Goeglein

Laura Bartmess Goeglein, SVP, Account Director,AbelsonTaylor: The changes from the last 18 months have rippled across so many areas, bringing continual stress but also a ripeness for opportunity. Everyone wants to understand what the “new normal” is, despite circumstances still being far from “normal.” Some key challenges are centered on communication, and how we have been forced to evolve in the way we connect and build relationships.
One challenging area is where we work. People are heading back to the office at varying levels, from one day to five days a week, and a new issue is the hybrid work model. There is always someone not in person, making every live meeting also a web meeting. Having a conference room of people in person and a few on screen is a difficult new meeting structure that we now need to figure out. Do we go back to plain old teleconferences, or do we always have a video screen going? The Chicago Tribune recently ran an article pointing out that hybrid meetings take a lot more forethought and we haven’t really figured it out. I was also interested to read that Zillow has a “one Zoom, all Zoom” policy, where even when in the office, you must log in from a separate computer if anyone is remote.
Along the same lines, healthcare professionals have embraced engaging with sale reps in a remote setting and may at times continue to prefer this way of interacting for its efficiency. The rep-HCP relationship is often at its best when there is trust, chemistry, and an ongoing partnership in patient care and solving office challenges. How can sales reps continue to deepen such a critical relationship via digital channels?
And then there are conferences. All signs point to hybrid meetings moving forward, allowing flexibility for remote attendance. Virtual booths are table stakes now, but often seem to act as a microsite in terms of content and experience. How will the hybrid experience continue to evolve around conferences? How will important networking opportunities thrive outside of live group meetings?
As we continue to re-engage in a live setting, it’s clear that a parallel experience will need to occur in a digital setting for most interactions. Finding ways to make this inclusive, engaging, and frustration-free will help us determine what future state of business communications is our “new normal.”

Kristen McGirk

Kristen McGirk, SVP, Account Director, AbelsonTaylor: The need for more efficient patient care is a core topic among many healthcare stakeholders right now. Whether you are a physician, nurse, hospital system or pharmaceutical manufacturer, we all need to identify better ways to treat and manage patients that do not involve in-person care.
We’ve all seen the upward trend in telehealth, which was trending upward prior to the pandemic but has risen greatly since. This was a good solution during COVID by reducing the contact that patients needed to have with their healthcare providers. But it also expanded access to healthcare to those who are vulnerable, don’t have transportation, or don’t have healthcare in their geographic areas. How can we do more?
We still need to figure out better ways to manage and track the symptoms of these patients remotely. The use of monitors, our smart phones and other devices that can track our conditions and provide that information to healthcare providers is on an upward trend and there are some great advances in mental health with the use of virtual reality and augmented reality.
By focusing on how to efficiently manage patient care, reducing costs to both patients and hospitals, we should be able to have more effective patient care and expand our access to all who need it.

Garth McCallum-Keeler

Garth McCallum-Keeler, Managing Partner, Chief Growth Officer, Calcium: Arising from a COVID-impacted work, the teledetail has emerged as a foundational tool for interactions between brands and professionals. When executed well, we have seen interactions that are longer than previously held in-person events, and an increased ability to reach ‘no see’ HCPs, all while developing new and more flexible ways to present data. Three factors drive teledetail success:
· Modularity & Dissemination – The IVA must be redesigned as more of a dashboard to allow for quick access to information relevant to the conversation. Likewise, more “snackable” content readily available to be sent via email.
· Training – Sales representatives must be trained on how to effectively engage via video and how to leverage their IVA. With a longer detail time, the conversation has an opportunity to cover more ground and address more questions.
· Data Integration – Most important is that all virtual, personal, and non-personal engagements must be fully integrated to allow the representative to have a line of sight on the sales cycle; and to allow for optimization of interactions.

Andrew Bast

Andrew Bast, CSO, Concentric Health Experience: The delivery of care has been upended thoroughly in the past two years, obviously. Everything from the search for access to healthcare professionals to post-surgical evaluations has been fundamentally reset, and in ways both positive and negative. Initially, everyone rallied to withhold themselves from the healthcare system to create room for those hospitalized with COVID. Many elective surgeries were canceled, postponed, and dropped altogether, and along with them, was a significant hit to the revenue stream for many players in the industry – from hospital systems to device manufacturers, and even to surgical teams themselves.
Many industry stakeholders are seeking innovative ways to increase revenue and profitability. Instead of depending on traditional referral networks or reputation, these stakeholders need to both entice customers back into the system and compete for their business, including creating novel new partnerships with different stakeholders. We approach every business challenge with first identifying who precisely is the audience – the source of business – that we need to find and build and about whom we can learn everything. Finding and building a customer audience is fast becoming job #1 as the industry emerges from a pandemic and returns to financial health. Expect to see a demand for more data, more analysis, and more engagement to move consumers away from wait-and-see and into action.

Andrew Cournoyer: There are several key issues trending among US healthcare stakeholders. Here are 3 key issues to consider:
Paying for digital health – There are a growing number of digital health technologies to support patient care management. Examples include wearable devices, phone applications, and artificial intelligence. Many of these solutions, however, lack long-term and real-world data to substantiate the benefits they are envisioned to provide. In the absence of data, payer ability to appropriately evaluate these products is limited and as such, coverage is inconsistent. Moreover, infrastructure for capturing their prescribed use is lacking – meaning there are no medical codes nor NDC numbers to capture claim activity. Reimbursement methodologies are not established. These limitations are inhibitory to a digital health landscape that is developing at a rapid pace. Without an established evaluation and reimbursement infrastructure, healthcare providers and patients may not be able to effectively use these solutions, which can come at a high cost.
Social Determinants of Health (SDOH) – The influence of SDOH on public health disparities and the downstream impact on healthcare costs has become a core focus among healthcare stakeholders. This awareness was further magnified and brought to light by COVID-19 and a possible a silver lining is that programs to address SDOH are beginning to emerge with higher frequency. A recent study by Avalere compared 2021 Medicare Advantage benefit offerings to those offered for the 2022 benefit year. This study identified an increase in plans that offered supplemental benefits for meals, transportation, and nutrition. Moreover, these findings found an increase in access to Medicare Advantage plan offerings that provided these supplemental benefits with a zero-dollar premium. Payer investment into benefit programs to address SDOH lends evidence that mitigating their impacts proves beneficial to associated stakeholders.
Vertical integration is getting taller – In 2018 we witnessed the merger of two giant pharmacy benefit managers (PBMs) with two large national health plans; namely CVS / Aetna, and Cigna / Express Scripts. Additional health plan – PBM integrations followed suit, but each has expanded to include specialty pharmacies and now provider services. Vertical integration has also spread into health systems and integrated delivery networks, creating broader medical home settings. Leverage is key and vertical integration allows these organizations higher degrees of control and ability to negotiate access and costs. And although these designs allow for greater degrees of integration and interoperability, they present complex navigation challenges for patients, providers, and manufacturers to identify appropriate points of contact within the organization. And to that end, the importance of HUB services has become central for simplifying and streamlining the patient and provider experience.

John Guarino: Access, and new breakthrough treatments are the issues trending most among U.S. healthcare stakeholders. Patients, advocacy groups, healthcare providers, formulary decision makers, manufacturers, employers, and lawmakers, among other stakeholders, have their eyes on the ever-rising costs of healthcare and the transformative cell and gene therapies that are coming to the market and filling the pipeline. The issue, however, is not the price of treatments per se, but the misalignment of perspectives regarding value. We need to: 1) redefine the value of healthcare in America so that it includes not only cost, but also clinical benefit and outcomes, and savings to the overall healthcare system, and 2) ensure that the diverse voices and perspectives of stakeholders are aligned around the definition of value. There’s plenty of money in healthcare. The problem is we have disconnected incentives. There are quite simple things that we can do through analytics, through understanding value, through aligning stakeholders and helping them find common ground that advocates for the patients. There is a solution here, but we must have the desire, integrity, and know-how to dig in and find it.
Here’s an example: At Peregrine Market Access, we instituted no-cost healthcare for our employees AND their families in June 2021 because we learned that the high-deductible plan we had was a deterrent for some of our employees getting care they needed. So, being a research- and data-driven company, we decided to crunch the numbers. We partnered with Marshall & Sterling Insurance and studied three main costs – the premium, the deductible, and out-of-pocket expenses. The analytics pointed us to an HMO offering in which Peregrine Market Access pays 100 percent of the premium, deductible, co-pays, and out-of-pocket expenses for in-network healthcare, which includes an extensive national network of providers covering 93 percent of providers and 95 percent of hospitals. How it works is that our employees have a card that they swipe for co-pays and other out-of-pocket expenses, and we have a vendor who manages and tracks how employees are moving toward their maximum out-of-pocket expenses for the year. Turns out, our no-cost healthcare benefit is not only the right thing to do for our employees, but it costs the agency less than our previous high-deductible plan because we were smart about how we structured the plan and found the right payer. It’s a lesson for our industry that there are answers to the high costs and access issues in healthcare if we take the time to innovate and collaborate to find solutions.

Harrison and Star: As already noted, the pandemic amplified trends that were already deeply underway. It brought to the forefront the need to re-examine the role of the sales force and how they engage with their customers. Our clients were already looking at other ways for their reps to engage with HCPs in order to enhance their overall brand experiences, and the arrival of the COVID-19 pandemic accelerated this trend.
The COVID-19 pandemic also accelerated the development of customer-centric, personalized experiences across digital marketing channels. While the pharmaceutical sector has traditionally lagged other sectors in its digital marketing investment, spending on digital initiatives and infrastructure is starting to catch up with other industries. Digital advertising spend increased by 14.2 percent in 2020 and is on track to an 18 percent increase in 2021.

CultHealth team members say “the pandemic has caused a pivot point in our healthcare system, and we believe the way we move forward is up to all of us. There are silver linings coming out of this pandemic with the ability to trend forward. Do we nurture them, or do we let the system fall back to the way it was?”
Jeff Rothstein: Our clients and we here at CultHealth are busier than ever, working hard to meet tightened deadlines. While that may not be new in our industry, perhaps there is a renewed sense of mission.
After all, Pfizer, Moderna and other pharmaceutical companies have showed us all what saving the world from a deadly disease can look like.
It wasn’t long ago that the pharmaceutical industry didn’t have the best reputation. Today, I think people have a new appreciation for the innovation that pharmaceutical companies can offer, and the good they can bring to the world. They have earned respect and perhaps even likability.
How cool that we as healthcare marketers get a chance to continue to reinvent or reposition our own category. How can we as an agency help our clients to build on this good reputation? Let’s keep the momentum moving forward and imagine a future where this translates into better patient compliance, an active role by patients in screenings and other preventative care, a continued appreciation in R&D which is costly, requires investment, cooperation and an unwavering belief in the best possible outcome.
Jess Ward: This past spring we watched the news cycle as Amy Klobuchar informed us all that she had breast cancer. Like many other women across the country, she had put off her routine mammogram because of the COVID-19 pandemic. Now she is looking to pass legislation, the Preventive Care Awareness Act, aimed to “help people get appointments needed to detect cancer early by promoting healthcare screenings and routine examinations and physicals.”
And again, we ask ourselves, what is our role as an agency in helping the communities we serve take the best possible care of themselves? What ideas can we bring to our clients? How can we help our oncology clients build on this important momentum that saves lives?
Amy Klobuchar’s office reported, “Studies have found that more than one in three adults re-ported delaying or forgoing health care because of coronavirus-related concerns. Other statistics show that the odds that a woman received a breast cancer screening were 20 percent lower in 2020 compared to 2019, and during the early months of the pandemic, health screenings for children decreased in frequency by 40 percent.”
How many more Amy Klobuchars are out there who can advocate for preventive healthcare? And how can we find them?
John Nelson: A year ago we could just walk across the street to our local CVS and get a flu vaccine. Now, we must register online, in advance, because pharmacists have taken on much more responsibility. They are rising to the new front line providing their local communities with, not only the flu vaccine, but the COVID vaccine. They are there to answer neighbors’ questions in this new unknown that we are living through together.
While drugstores like CVS and Walgreens are big chains, the largest in the country, they are in many ways re-establishing their role as pillars of the community, central to our support system and well-being. The local pharmacist is someone we know we can rely on to help and inform us in these uncertain times.
As an agency, if we can do our part to help this local connection continue, it would be good for health, good for the community and good for industry.
Robin Steinberg: Here in NYC, the epicenter of the pandemic in the United States, it was very difficult to get a Covid test one year ago. There were long lines in the cold outside of urgent care centers. Now, COVID test sites/tents/trucks are practically on every other street corner. It is encouraging to see the healthcare system rising to meet the needs of those in need.
At the same time, the pandemic has highlighted the inequities in our healthcare system, racial disparities in accessing healthcare and the intersectionality of it all.
What is our role in making sure all those who want healthcare receive healthcare? It may start with a COVID test on a street corner, but where does it lead? How can we keep the momentum moving forward?
In summary, we see sparks of inspiration, trust, community, connection, renewed empathy among stakeholders in the healthcare system. The danger lies in not seeing the sparks that are all around us – literally on our street corners. They need energy behind them to continue. Together, let us rise to the occasion.

Celine Vita and Carolyn O’Neill: As with the world at large, US healthcare stakeholders continue to navigate the uncertainties directly and indirectly related to COVID-19. Beyond navigating infection surges and prevention measures, we are only beginning to see the long-term impacts that are so tightly associated with COVID it may not be accurate to call them “indirect.” Gaps in preventive screening and care are leading to delayed cancer diagnoses. Behavioral health issues, including isolation triggers, substance abuse, and suicide, are a global pandemic of their own. These and many more issues will continue to emerge in the months and years ahead.
As a result, digital solutions will play a key role not just in connecting HCPs and patients from afar, but improving health monitoring and outcomes. Social media will only increase as a lifeline for connectivity and medical information. Optimized telemedicine platforms, monitoring tools, and health record platforms are currently being developed by the tech giants. HCPs will need to continue adapting and adopting digital innovation and a data-first approach, and we will continue to see data analysis and AI coming to the forefront of healthcare.

5. How are your clients using real-world data (RWD) and real-world evidence (RWE) to maximize their clinical and commercial results?

Harrison and Star: At no time has the RWD/RWE taken the spotlight as much as during the COVID-19 pandemic era. It has seeped into society’s vernacular, enlisted the involvement of organizations that have not traditionally participated in clinical studies, and is rapidly becoming an essential part of commercial marketing itself. We are seeing clients transform the role of RWD/RWE in several ways, using it to:
1. Craft real world use cases tailored to a particular practice setting (e.g., local/regional data, specific patient populations not necessarily addressed by the pivotal trial). RWD/RWE collaborations can be an area where a brand can be more innovative in their strategic approach in engaging their customers (i.e., HCPs, Payors) to truly gauge their value proposition in settings that are tailored to a particular context in which the brands could be used.
2. Inform not only the design of the clinical trials, but also observational trials to parse out potential new treatment approaches that may not have been considered but otherwise revealed in the RWD. RWD/RWE is no longer just the province of post-marketing commitments to monitor safety and adverse events, but can generate ideas for development throughout a drug’s lifecycle
While the potential for RWD/RWE has expanded, pivotal trial data remains the gold standard. RWD/RWE lacks some of the oversight/control that pivotal trials must adhere to – though even this is changing with FDA most recently updating its regulatory guidance in the use of RWD and RWE in its Framework for RWE. It is precisely this nascent oversight/control that makes RWD/RWE appealing, but also makes it harder to interpret. We have seen different clients come to terms with how these data should be shared and used promotionally. Sometimes a quick hard hitting bullet with RWE may be difficult to achieve if you need substantial context to interpret it. So many times, RWE may be related to the realm of medical – to – medical communication especially when RWE demonstrates data in a way that is not supported by the pivotal trial.

George Musi

George Musi, Managing Director at SOLVE(D), an IPG Health company: While real-world data (RWD) and the real-world evidence (RWE) it delivers continue to grow in significance, RWD and RWE are not genuinely new concepts in the healthcare, pharmaceutical, life sciences, and medical technology industries. Although sometimes used interchangeably, RWD and RWE are not the same. Data is factual information, such as numbers and statistics from a variety of sources, while evidence is data that has been analyzed and found to be relevant. RWD therefore furnishes proof that supports a conclusion. Hence, RWD is the information that supports RWE which in turn is used to support future decisions.
RWD and RWE add perspective to typical randomized clinical trial (RCT) results – where study design controls variability in ways that are not representative of real-world care and outcomes – by offering a granular view of the patient journey and treatment experience in the real-world settings. RWE is needed because there’s a gap between the RCT research (what we see or learn in controlled experiments) and the true efficacy, effectiveness, and safety profile of the product in the real-world.
In the healthcare, pharmaceutical, life sciences, and medical technology (MedTech) industries, RWD can be derived from multiple sources, including retailers, payers, providers, patients, and caregivers. Essentially RWD can mean any data that is collected outside of conventional randomized controlled clinical trials and can relate to the health of the patient and/or the delivery of healthcare. These data sources include: claims/prescriptions (medical & pharmacy), electronic health records (EHR), insurance claims & billing data, patient-reported outcome, patient (disease and product) registries, wearable devices & sensors, health & fitness apps, patient forums, blogs, social media, search/web data, etc.
When all these different data sources are combined, we find incredible high-resolution (360-degree), granular view of the patient population, journey, and treatment experience in the real-world, which helps improve clinical decision-making, patient access and health outcomes. The extent to which the data can provide valuable RWE to support decision making, depends on the relevancy and reliability of data sources, as well as on the appropriate use of expertise in analyzing and reporting the findings. Effectively utilizing these (structured, unstructured, and semi-structured) data sources (i.e., turn data into valuable insights and actionable information) requires advanced computing processing power and advanced analytics, modeling, and simulation tools, including artificial intelligence (AI), machine-learning (ML) or deep-learning (DL), and natural language processing (NLP) methodologies.
The healthcare ecosystem is increasingly leveraging RWD and RWE in a variety of ways to facilitate their decision-making to maximize their clinical and commercial results. The top ways we’ve seen clients use RWD and RWE include:
• Demonstrating actual clinical efficacy, effectiveness, and safety of products
• Understanding long-term health outcomes, cost impact, and risk/benefit ratios
• Understanding how patient characteristics and behaviors affect health outcomes
• Better comprehending patients’ unmet needs
• Identifying undiagnosed, underdiagnosed, and misdiagnosed illness
• Patient prediction for earlier health issues identification and treatment
• Comparing multiple interventions to inform optimal therapy choices
• Accelerating time to market of products
• Better biomarker identification for early diagnosis
• Identification of optimal patient treatment pathways positioning

Gretchen Eberhart

Gretchen Eberhart, MD, EVP, Director of Strategic Services, CDMP: Traditional clinical trials have long been the gold standard for both the FDA and clinicians. But such trials are highly controlled and conducted in relatively small patient populations. To provide a fuller picture of how a product will perform in the hands of real clinicians with real patients, our clients are increasingly looking at RWD and RWE.
With the explosion of electronic health records, mobile devices, and wearables, RWD can now be collected from a variety of sources. From wearable 12-lead ECGs to clothing that can sense a seizure, our clients are increasingly looking for novel ways to gather RWD. These data can be analyzed using sophisticated, new AI-enhanced capabilities to generate a body of RWE.
We increasingly see clients using RWE in promotion when the results are consistent with product labeling. We also see RWE being used to support clinical trial design and expanded indications. In the “real world”, the randomized prospective trial has now become the jumping off point rather than the final word.

Michael Harr

Michael Harr, Creative Director, Copy, Brick City Greenhouse: Now that we’re living in the age of big data, we’re seeing RWD/RWE exploding from EHRs, laptops, and other devices all over the world. The FDA is already using RWD/RWE to generate post-marketing data that will impact regulatory decisions. Indeed, many of our clients are starting to think about how they can leverage such a wealth of clinical information. Many are using RWD/RWE to validate clinical trial data. Others are using EHRs to maximize promotional messaging. And some are tapping into pharmacy data to better understand patient adherence patterns. One thing is certain, this is only the beginning of how we start capturing large amounts of clinical data. With the incorporation of AI, we’ll begin to see how RWD/RWE will revolutionize clinical decision making. It’s likely all the apps, wearables, and biosensors our industry has created over the years are now at the bottom of a data goldmine – all we need are the high-powered analytics to prove it.

Lynette Hunter

Lynnette Hunter, EVP, Director of Client Services, AbelsonTaylor: For several years the healthcare industry has looked at ways to build and leverage real world evidence (RWE) to better support the efficacy and safety of medicines beyond the clinical trials used for governing agency approvals and product labeling. For rare disease brands, RWE was important as the very small patient populations that are recruited for clinical trials could be followed via patient registries, enabling manufacturers to understand the outcomes and value of these clinical therapies with very high associated costs to the healthcare system.
Jump ahead to 2021, and we are now seeing the use of RWE in many broader ways. Real world data (RWD) is being used to identify and support expansion of product labeling and indications for therapies used in much more common conditions like rheumatoid arthritis and ulcerative colitis. RWE is where advanced biologic therapies can differentiate and have benefits beyond the initial clinical trials, separating products with similar clinical profiles and finding additional efficacy and safety benefits in specific populations. With the use of retrospective EMR and claims data, we are now able to identify trends in the market and impact the protocols used to treat patients as well as find opportunities to target specific populations where we see positive outcomes based on their past response to earlier therapies.
And finally, one of the biggest impacts of the expanded use of RWE is helping to drive overall healthcare costs down, bringing recognition and understanding to the benefits of what are typically deemed more costly therapies vs hospitalization and long-term medical costs. Health economics studies are now the price of entry when launching a new product, and manufacturers are recognizing the value of using real-world outcomes to establish the value of their pharmaceutical therapies on an overburdened healthcare system. This is even more important as we battle a pandemic, which places unparalleled pressure on medical and hospital resources.
As we look to the future, the key will be planning for RWE and RWD using advanced analytical technology such as AI and machine learning to speed the collection and review of data, then helping manufacturers implement systems to publish outcomes and encouraging the governing agencies to accept this data as a reliable and trusted source to make treatment protocol decisions.

Sean D’Evelyn

 

Sean D’Evelyn, PhD, Health Economist, Peregrine Market Access: Every company, both inside and outside the healthcare space, uses data and evidence a little differently, but here are some of the ways that we frequently see our clients utilizing data to make more informed decisions about healthcare.
First and foremost, all of our clients rely on evidence from clinical trials to evaluate the effectiveness of medical and pharmaceutical treatments. No drug or therapy is covered that has not demonstrated that it can improve the well-being of those who utilize it.
More than that, though, drugs do not exist in a vacuum. It is important to look for the way that taking one drug may affect other areas of the healthcare system, including reducing emergency room visits and hospitalizations as well as the reduction or delay of other, often more expensive therapies. Good clinical data as well as real world evidence can be used to build models to help estimate what types of ripple effects a new drug will have on the system as a whole.
As for commercial results, we live in an age with more data available than ever before. As such, we can paint a much more detailed picture as to which payers are more likely to respond to specific messaging than we were even five years ago. Markets can be segmented very finely to look for where there is a perfect storm needed for clients to be successful in the market space – aligning the right patient population with good coverage and supportive hospitals and clinician groups.

Eileen Yaralian, Nadia Cervoni, Michael Schreiber, and Eddy Rodriguez: As agency of record for PIQRAY (alpelisib) and PIK3CA-Related Overgrowth Spectrum (PROS) (a spectrum of rare disorders caused by PIK3CA mutations characterized by atypical visible overgrowths and anomalies in blood vessels, the lymphatic system, and other tissues), DDB Health is very familiar with the impact of real-world studies.
There are few options available to manage PROS conditions, and they are mainly focused on addressing worsening symptoms. It is devastating for patients to be without treatments that address the underlying cause of PROS.
The EPIK-P1 real-world study was a global, site-based retrospective noninterventional medical chart review of pediatric and adult patients aged 2 years or older with PROS who received alpelisib via a compassionate use program. Real-world data from patients and physicians included in the analysis of EPIK-P1 validated the potential of alpelisib in PROS, and Novartis has taken an important step toward reimagining medicine for PROS. Novartis continues to discuss this real-world evidence with the FDA in an effort to bring this treatment to people in need as quickly as possible.
DDB Health works with many molecules for rare conditions that do not currently have an approved medical therapy. As the US Food and Drug Administration (FDA) grants many of these potential drugs as Breakthrough Therapy Designation, real-world evidence will be pivotal to helping patients affected by rare diseases.

Sharon Callahan

 

Kristen Gengaro

David Stemler, Joel Jacob, Kristen Gengaro, and Sharon Callahan: Will we ever reach a point where we have too much data available to us? Hard to imagine. But with clinical trial data, HCPs and patients are left wishing for the nuances beyond endpoints. As our clients continue to learn and pivot with this global pandemic, some things still haven’t changed. For example, patients and HCP practices don’t always fit cookie-cutter inclusion and exclusion criteria. And placebo-controlled trials are critical to clinical validity – however, comparator “paper-tiger” arms, often under the guise of “standard of care,” may also fall short in the face of continuous advancements in treatment modalities.
Enter RWE. Our clients no longer need solely depend on registries, as they can now more easily tap into EHR platforms and digital insurance records to congregate and distill data from significantly larger patient pools. RWE becomes especially handy for mid–life-cycle brands that lack additional or large clinical trials and need something new to talk about with their customers. For technology companies focused on machine learning and cognitive systems, RWE is a gold mine. In short, in a sea of in-class sameness, clinical parity, and a lack of head-to-head clinical trials among dominant competitor brands, RWE has crowned winners – often with durability, safety, or HEOR data.
Looking for the next big technical innovation in healthcare? Across specialty groups, RWE-fed AI predictive models are poised to take us to the next frontier in medicine. From genetic biomarkers to lab values, our clients eagerly look forward to complementing their brands with the next generation of prognostic tools (eg, patient prognostic simulators) powered by RWE. RWE is here to stay and poised to revolutionize our healthcare decision points forever.

David Lubofsky and David Brungard: We live in a world now that is often remote and always connected to the web or some kind of data. With a million signals thrown at you constantly, people frequently ignore your content. We understand information overload. The only way to know if things are working is to strategically track your content to give you tangible results you can act on. Whereas there was previously no way to measure how many people drove past a billboard or picked up a pamphlet, we’ve adapted to ensure we can measure the pieces we produce. For example, our print pieces have QR codes, AR triggers, or other ways they can be tracked – and we use that information to tell us if a campaign is working or not. Honestly, tracking is only half the battle because the data is only good if you’re willing to act on it. We sit down with our clients once a month and go over what’s working and what isn’t. Then we’ll adjust the piece or the media that is driving to it and test our results. We keep a critical eye on what we’re building and either discontinue or improve the material to get the results our clients want.

Isabella L. Sergio: RWD is being leveraged to ensure that the right patient is receiving the right therapy at the right time. We are seeing our clients’ utilizing data in the discovery phase to determine which patients are going to benefit from an innovative therapy. Adaptive trial designs and RWE can help accelerated/expedited approvals for therapeutic advances – contextualize results and produce better conclusions in diverse populations. We also see RWD being used for retrospective reviews of claims and outcomes to approve indications for use in limited or rare populations that would pose challenges for clinical trial recruitment.
We also know that there has been more emphasis on moving away from traditional fee-for-service care into more value-based agreements. While this has been discussed for years, we are slowly seeing a shift to more value-based arrangements amongst stakeholders and RWD may serve as a metric in these types of arrangements.

6. How is your organization promoting diversity, equity and inclusion (DE&I) in the workplace?

Michelle Edwards

Michelle Edwards – VP, Human Resources, Heartbeat: Heartbeat is committed to establishing itself as the model for DE&I in the advertising industry, and we believe we have the programs, practices, culture, and support in place to make that happen. Our industry-leading push for equality and diverse representation starts with our internal diversity initiatives, which have increased dramatically in recent years to both accelerate progress and better reflect our core values. We released a commitment letter in 2020 outlining a long-term plan for a more inclusive workplace. We regularly hold workshops and training sessions to continue educating our community on topics such as Inclusive Hiring, Inclusive Leadership, Unconscious Bias, Microaggressions, Race-Related Trauma, and Tools for Raising Anti-Racist Children. We’ve reevaluated our hiring and promotion practices to ensure equity, and formed a diversity-focused, employee-led action committee devoted to keeping up collective momentum on all of our DE&I programs. We believe Heartbeat is among the most diverse agencies in the entire industry, and many Heartbeaters say that they’ve never worked anywhere as committed to the cause.

Sheena Amin-Liebman

Sheena Amin-Liebman, Diversity and Inclusion Director, Fishawack Health:

At Fishawack Health, ensuring diversity, equity, and inclusion is an important part of our organizational strategy and people-led philosophy.
Our diversity and inclusion (D&I) vision is to elevate an inclusive, supportive, welcoming, and fair work environment that promotes diversity and inclusion and recognizes the value of each member of our community, so we can serve an increasingly diverse customer group and society through impactful work.
Our goal for D&I is twofold. First, we are developing a diverse and inclusive culture internally. Our approach includes a dedicated Diversity and Inclusion Steering Committee, regional ambassadors, a robust governance model, and 6 active, passionate employee networks that are each dedicated to a specific D&I issue: gender equality, enablement, race/ethnicity, family, mental health, and LGBTQ+ colleagues.
The second part of our vision is to help our biopharmaceutical and med-tech clients understand, reach, and engage marginalized patient groups. It is only by achieving the first part of our vision—building a diverse and inclusive culture internally—that we deliver on this goal. By equipping our team members with the knowledge and tools to recognize inequalities, they become empowered to uncover novel opportunities for our clients to build a healthier world for every patient.

Our D&I strategy
We have developed a strategy centered on 3 strategic pillars—Understand, Enable, and Attract—to ensure all our employees can succeed across the business and better serve underrepresented patient groups, driving change across the healthcare industry.

1) Understand
Our Employee Networks play a critical role in driving this pillar. They provide a safe and confidential space to discuss the issues affecting them while facilitating learning and education. They also improve our policies and procedures while also keeping in touch with external policy developments. Our Networks have developed a robust educational program, including our 21-day Inclusion Challenge, which aims to make inclusive culture a habit, educational sessions led by guest speakers from marginalized groups, and diversity dialogues in which our team members can share their own stories in a safe environment free of judgment.
2) Enable
We have also rolled out a series of training programs and tools to enable employees to become D&I advocates. One action the D&I team has taken is to create a Diversity Advisory Council—building a bespoke team of advisors around the client challenge to ensure every campaign or asset accurately and sensitively represents diverse patient populations.
3) Attract
An important part of creating a diverse and inclusive culture is developing a diverse workforce. As a result, we need to widen the talent force and ensure diverse representation in our teams.

We have launched global mentorship, university ambassador, and internship programs to attract talent and increase early exposure for young adults exploring their career choices.
Our Ambassador Program drives industry experience and recruitment opportunities for college and university candidates from a variety of backgrounds. Our team members visit campuses in the US and the UK to speak to underrepresented minority students about a career in healthcare communications.
Our Mentorship Program in the US and our Coaching Program in the UK allow our employees to strengthen their leadership skills while working with high school students from diverse backgrounds. In turn, the students gain support in building their professional skills and increasing inclusive and empathetic skills in our teams.

What the immediate future holds
Our next big goal is to ensure we can measure our D&I performance. In 2022, we’re planning on creating our first Diversity Index—a data-driven tool designed to track our progress and ensure continuous improvement of our strategy across our growing global organization. We’re also excited to continue our work in D&I and further the rollout of our initiatives, developing new and innovative ways of engaging our teams and clients.

Minnie Damle

Minnie Damle, SVP, People & Culture, Brick City Greenhouse: Brick City Greenhouse prides itself on creating an environment where inclusivity is at its core in all facets of how we support our employee-centric culture and how we service our business. We find ways in our remote model to ensure we are consistently creating an equitable experience in onboarding, talent opportunities to advance, and providing diverse experiences our employees can be a part of, whether it’s supporting our world class clients or internal agency opportunities. Given our fully remote and distributed model, which was well into its existence before the pandemic, we’ve been afforded the opportunity to hire the best talent across the United States to represent our business and provide meaningful enhancements to our company culture.

Amy Gómez

Amy Gómez, SVP, Diversity Strategy, Klick Health: At Klick, we have a Diversity, Equity, and Inclusion Council composed of Klicksters from a wide range of backgrounds, experience, professional levels and geographies. This year, the Council established a first-ever set of DE&I goals that we published – along with our diversity data – on our careers site, demonstrating Klick’s commitment to transparency. We support five active Employee Resource Groups (Klicksters of Color, Women, Queer, Parents, and Mental Health), and we have a Diverse Mentorship program that engages Klicksters of Color as mentors for our senior leaders. The mentors raise awareness about the experience that Klicksters of color have at work and the issues that impact them, while the leadership-member mentees build relationships of influence for their mentors. We also host an Anti-Racism Speaker series that has included best-selling authors/speakers, including Ijeoma Oluo and Nikole Hannah-Jones.
In 2022, we will continue to evolve our commitment to DE&I, with initiatives such as Inclusive Interviewing training in Q1, followed by training on other Inclusive Leadership topics later in the year.

Sonja Foster-Storch

Sonja Foster-Storch, President, Commercial Integration, DE&I and Client Excellence, Syneos Health Communications: GSW continues to be passionate about building and maintaining diverse teams. We want people who bring unique backgrounds, perspectives and points of view that spark new ideas and create ground-breaking work. This can only happen, however, with an open and collaborative culture that encourages questioning our work, pushing each other and learning how we can do better. And we’re not there yet!
In 2018, for example, GSW employees questioned why we did not have a group dedicated to learning about diversity and inclusivity practices, so a passionate team of women and men proactively created RISE, an employee-led initiative that stands for Realizing Inclusivity and Success through Equality. RISE’s shared goal is for everyone in the agency to have the same opportunities to grow and advance as the person sitting next to them, and it continues to serve as a catalyst for the sometimes uncomfortable conversations that our industry needs to have surrounding equality in the workplace and beyond. The best part of this is that RISE was initially started by these employees asking, “Do we have enough females in leadership?” and it organically became, “Do we have enough OPPORTUNITY in leadership – for everyone?”
Today, RISE has grown from just a few founding members focused on equality to dozens of active teams cultivating a sense of belonging for all GSW employees. The remote nature of our work these past 21 months(!) has sparked even more growth in RISE and its collective goal: allowing members across offices to connect organically with others they normally would not collaborate with day-to-day.
GSW maintains steadfast in our belief that a diverse agency is a creative agency. We continue to challenge our unconscious biases and learn from the broad range of perspectives we bring to our team. There will always be more work to do surrounding equality in the workplace, and we are excited to continue doing this work.

Lisa DuJat

Lisa DuJat, Chief Talent Officer at IPG Health: Our network has always been built on the idea that business imperatives such as growth, innovation and DE&I cannot live with any one individual, or even a small team – that in order to truly live our principles, we need to make them everyone’s responsibility and embed them into every step of our journey.
As we build IPG Health, we’re crafting a strategic framework that doesn’t centralize DE&I but builds the principles of DE&I in every part of our business and makes leaders accountable for actively reviewing and modifying their practices through an equity lens.
And in the spirit of “never finished” learning, we’ve made sizable investments in various DE&I initiatives we already have in place:
• We invested in “Inclusive Manager’s Toolkit,” a customized, intensive 10-week training program, in partnership with DeEtta Jones & Associates, which provides every manager with the resources needed to lead inclusive teams.
• We reintroduced our Disrupting Everyday Bias program as a regular offering, and launched Allyship, Microaggression and Disrupting Thought Patterns workshops.
• We created a new Employee Relations group to ensure an equitable and healthy working environment by providing inclusive and consistent support to employees. Employees can raise a concern or seek advice on navigating difficult situations and resolving conflict while feeling heard and respected.
• We continued ongoing partnerships with diverse recruiting institutions like 4A’s Multicultural Advertising Intern Program (MAIP), Jopwell, and Braven, to help us continue to identify diverse talent.
• Our employee-led Culture & Inclusion communities continued their ongoing commitment to creating interconnectivity while promoting diversity as a part of our network’s fabric. Our C&I communities offer peer-to-peer learning opportunities and activities throughout the year around critical diversity issues that matter to our employees.

Scott Neverett

Scott Neverett, SHRM-CP, Partner, Director of Human Resources and Mary Pietryga, Partner, Director of Strategic Marketing and Creative Services, Peregrine Market Access: Since women represent more than 60 percent of the workforce at Peregrine Market Access, the agency recently formed a women’s group, TogetHER (HER=High-achieving, Empowering, Resilient), to provide peer-to-peer support and mentoring, foster a culture of inclusion, and ensure that opportunities for professional advancement are fair and equitable for all employees.
In 2022, Peregrine will continue to advance TogetHER initiatives and will also focus on implementing additional DE&I strategies, including recruitment efforts aimed at increasing the racial, ethnic, and gender diversity of our workforce and leadership, knowing that diverse perspectives make us better and stronger in everything we do. To help with those recruitment efforts, Peregrine Market Access, which is headquartered in Saratoga Springs, New York, recently opened a new office in Santa Monica, California.

Susan Perlbachs

Susan Perlbachs, Chief Creative Officer, Intouch Group: Let me start by saying there are very few agencies who are “achieving diversity.” Lack of BIPOC representation in advertising is far from where it needs to be across the board. I wouldn’t want Intouch Group or any other agency to feel they can pat themselves on the back for “achieving diversity.”
That said, we are working to increase BIPOC representation at every level. We are actively recruiting diverse candidates into our industry via The Copy School and our soon-to-launch Editorial School. We are revamping our Creative process to ensure diversity from the start. And we conduct training where we examine concepts like “intent vs impact,” helping our staff hone skills including self-awareness, curiosity, and empathy.

Julia Missaggia

Julia Missaggia, EVP, People & Culture, CMI Media Group and Compas: CMI Media Group and Compas were built on inclusion, equity and diversity. It is in our DNA and core values. From the perspective of attracting diverse talent, we have taken measures to ensure our recruitment teams and hiring managers represent diverse groups have been trained and have the tools to foster inclusion. We also have employee development programs for current and future leaders to grow diverse talent into leadership roles within the organizations.
We developed Employee Resource Groups (ERGs) that allow for diverse and underrepresented groups to have a voice in how to improve on our commitments. Two examples are PLUS+ – Promoting LGBTQ+ Understanding and Solidarity and BRAAVE (Bringing Relevance to the African American Vision & Experience). We use our framework of education, advocacy and allyship to share with our staff more about these communities and how we can better serve them. These are employee driven initiatives that have executive level sponsorship and support. The difference the ERGs make positively impact our clients, our partners, our communities, and our people. Our founder and executive chairman Stan Woodland serves on the WPP worldwide Inclusion & Diversity Council, which helps us to make an impact across the world. We also have strong partnerships to support our DE&I goals. This includes investments and active participation with Diversity Industry Partners, including: MVPOC, WeAllRiseTogether, ANA, HBA, and more. As well, we prioritize working with diverse schools to support the next generation of talent.

Amanda Preto

Amanda Preto, VP, Marketing, CMI Media Group and Compas: The fact that DEI has become something we’re focusing on in a much deeper way as an industry proves our awareness has been raised and that we are moving in the right direction, but we cannot let down the vigilance we gained in 2020 and throughout 2021. There is absolutely a heightened responsibility – on the part of every individual, across every industry – to be more accountable.

Jackie DeAngelis, EVP, Managing Director, PRECISIONvalue: Last year, our Humanity in Action (HIA) initiative was born, and the Precision team came together to enact change in the three key areas of talent, culture, and community. With HIA in its second year, Precision’s commitment to DE&I has been further codified through training offerings, diversity recruiting activities, and ensuring that our benefits are inclusive.
Our diversity is honored at Precision. We celebrate Pride Month, National Hispanic Heritage Month, Black History Month, and International Women’s Day by profiling community members who have had an extraordinary impact on science, healthcare, and volunteerism. In addition, during Global Diversity Awareness Month, Precision employees shared some of their favorite and most treasured family recipes with each other. We also raised over $14,000 for breast cancer research during our Precision in Pink initiative in October.
While Precision has always had a family culture, the numerous activities throughout the year that bring awareness to the achievements of people from different backgrounds, and celebrating our own diversity, further enriches our workplace environment.

A team of CultHealth employees got together to discuss how the organization is living into the vision of diversity, equity, and inclusion (DE&I) in the workplace
Jeff Rothstein: It has been a year and a half since George Floyd’s murder, a pivotal moment that brought all Americans to the table to reflect and act on race relations across the United States. A few weeks after George’s murder, The New York Times released an article titled, ‘Corporate America Has Failed Black America’. The advertising industry responded in united fashion, condemning racism, and vowing to dismantle organizational and structural barriers that perpetuate inequities. As Corporate America embarked on a reinvigorated journey to ensure equal opportunity for all, through DE&I, we all had to answer the following question, “Where do we start?” What follows is a conversation between CultHealth employees, an organization that has nearly doubled in size over the past year and includes a diverse staff, across all levels who recognizes the importance of mindset and perspective as there’s much more to be done.
Team Dialogue:
Alysa Vasapolli: We (Cult) have typically been “culturally” diverse and improving, and “gender” diverse and improving, but we have not been able to say we adequately represent POC (an oddity considering the melting pot, which is NYC, yet not an oddity unfortunately for the ad industry as a system) and therefore we’ve had to figure out why that is.
Mylik Ganey – SVP, Account Director, CultHealth: George Floyd’s murder challenged us to take a closer look at each other and answer the question, “who are we?” We were challenged to understand each other’s views and what we could do to break glass ceilings in Corporate America. I have a recurring dream of seeing more people of color in positions of significant influence within advertising. Being an empowered POC in the room forces a discussion that leads to creative that is much more authentic and powerful.
John Nelson: It started with us recognizing mindsets and changing attitudes/perceptions/behaviors through dialogue, it was not just about hiring more people of color. That ultimately leads to failed at-tempts at driving real and lasting change.
Alysa Vasapolli: Understanding unconscious bias and our differences to therefore improve hiring practices. Big programs and committees will come, but first it’s small group conversation. Sometimes uncomfortable conversations. And many are yet to be had.
Jim Metropoulos: Disparities in health outcomes is a fundamental problem and for us, as a healthcare company, that is where it began. We know we can’t focus on this problem in everything we do, but now we recognize there have been opportunities for us to recommend putting more emphasis on it that we missed and can’t miss again. Two thirds of all COVID deaths are people of color. A general lack of diversity and disparity in health outcomes go hand and hand.
Mylik Ganey: Our perspective on diversity needs to always show up in the work. To get work reflective of the current culture, we must take a serious look around us and make sure we have the right people in the room. Much of what we do indirectly impacts the outcomes of POC.
Alysa Vasapolli: We had many conversations to define our mission statement, which essentially is that “we believe creative thinking can change lives”. To truly achieve this mission, we must first achieve another mission: WE need to represent ALL people’s creativity, particularly those whose health needs are typically underserved. This is the CultHealth mindset. It’s where we are living today and it’s starting to show up more and more in who is coming to our agency and the creative, we deliver.
John Nelson: Having and expressing the right mindset has been essential to our success. Who we are is what we do and what we say to each other, our clients and the markets in which we advertise.
Jim Metropoulos: CultHealth understood from the very beginning, that it’s about opportunity. People must have the opportunity to be healthy. The data says this opportunity simply does not exist for many people. Access to medications, services and good food, actionable knowledge, shared decision making; these are all about broadening the opportunity to be healthy. Every community needs to know treatment decisions are evidence-based, not resource-based.
Jeff Rothstein: We like to say we help build communities around brands but that’s not exactly right. The communities exist already. Brands can make those communities stronger, by the outcomes they produce, the emotions they generate and the services they provide. Brands have the power to drive the change we want to see in the world. It is great to be at an organization that challenges itself to always find the belief system a brand can support.

David Lubofsky and David Brungard: Achieving DE&I in the workplace takes relentless effort and truthfully isn’t an initiative that can be “achieved” – it has to be an ongoing effort that doesn’t become just box-checking.
As an agency, we do everything we can to interview and hire all walks of life; as business owners, we try to instill in our teams to be inclusive across the board, in work and in life. And as humans, we each try daily to learn more about others, where they came from, and what they are experiencing. We have a long way to go, as a company and as a planet, to come anywhere near “achieving” this. It is all about daily effort and progression towards an equal earth.

Kim Johnson: We know that equity is a journey, diversity makes us better and that we can’t do or be anything without belonging. At Ogilvy Health, we ensure that candidate pools are diverse and that equitable growth for our people is at the core of the lived experience amongst other metrics but most importantly it is all about culture and psychological safety. We launched psych safety certifications in 2021 and will focus on Health Equity in 2022.

Harrison and Star: For us it’s been about culture change and embedding our Diversity, Equity, and Inclusion strategy into every layer, every strategy, and every conversation. If it’s not a full organization effort, it will fall short. We have pushed this year and made deliberate choices for improving our culture, making sure it is inclusive and healthy, and amplifying our internal energy for change.

David Stemler, Joel Jacob, Kristen Gengaro, and Sharon Callahan: As the world has become more focused on diversity, our clients and our people expect to see that diversity reflected in everything we do. The challenge is to incorporate diversity in a way that is authentic, rather than forced. And it has to be an ongoing commitment. We’ve all seen companies “rainbow wash” their message during Pride Month or change their email signatures during Black History month. But we know communities can tell when you’re being opportunistic versus being truly committed. The key is authenticity. It requires focus and a deep, long-standing commitment. Plan to go the distance or don’t go at all.
At CDM we’ve started by looking in the mirror, and ensuring that our teams are rich with diversity, through hiring employees that represent different genders, ages, races, political beliefs, ethnicities, physical abilities, and sexual orientations. We’ve reached into local diverse communities by creating our own talent pipeline programs to ensure we’re inspiring young BIPOC to get involved in our industry. Beyond this, we’re working in everyday situations to create awareness around biases, to create space for courageous conversations, and to model inclusive behavior in meetings. In our experience, inclusion occurs more naturally when your company lives it.

Celine Vita and Carolyn O’Neill: We believe that DEI is a constant pursuit and should remain at the center of all discussions, it is a required mindset at the agency. As an open destination agency, we continue to work towards the multi-year roadmap we defined and hold ourselves accountable against specific milestones we set ourselves to achieve. We are committed to transparent and open conversations as well as actions to enable mobility and equity, ongoing awareness and education with formal training and/or agency events around specific topics. We have incorporated DEI dimensions in all aspects of who we are and what we do: how we evaluate our collective and individual performance, how we recruit and hire, how we create and evaluate meaningful work, how we engage partners. This year again, we will be conducting an agency-wide survey to hear from everyone as how we are doing so can continue to improve and identify blind spots we can solve against.

7. Which health technologies are currently disrupting or will disrupt the marketplace?

Christopher Dimmock

Christopher Dimmock, SVP, Integrated Strategy, AbelsonTaylor: Active health and wellness monitoring has come a long way from “I’ve fallen and I can’t get up.” Our personal devices have moved well beyond communication to personal data aggregators. We can track our screen time, sleep, calories, resting heart rate, O2 levels, glucose levels and body temperature at any time. We are surrounded by IoT devices that are just waiting to tell us more, and this is giving patients a tremendous sense of involvement and influence in their healthcare.
At last year’s Consumer Electronics Show, the biggest splash (pun intended) was the Toto smart toilet that can analyze your diet and make recommendations accordingly. One could easily imagine an IoT conversation between your smart toilet and smart refrigerator, with Alexa listening in, to help with weekly meal planning.
Technological advances and the social distancing of the pandemic have also accelerated access to distributive diagnostics done at home or local facilities. Cumulatively, this wealth of personal health and wellness data will only continue to grow and become more interdependent as it is aggregated. Patients who take advantage of this will have an even greater sense of self-agency in their health and well-being.
While this is disruptive, the real disruption will be in how healthcare providers react and interact with this mass of patient-generated data. Will they trust information from proprietary algorithms that, while well-researched, may not be peer reviewed or FDA approved?
Health tracking apps are now including functions that will enable users to print out or email their data directly to their healthcare providers. This seems to beg two important questions. One, who holds the HCP education burden for correlating in-office diagnostics with this large personal patient data set? And two, how will the HCP practice evolve to manage it?
We should also expect that this growing large dataset will provide a platform for further industry research and development. Will pharmaceutical companies be able to leverage this information in the design and implementation of clinical trials?
As Silicon Valley continues to identify unmet needs and market products that empower individuals, they will also need to recognize and manage how this information will help HCPs care for their patients and evolve their practices.

Erica Rivera

Erica Rivera, VP, Engagement Strategy, AbelsonTaylor: I recently read about a multiyear study led by researchers at the University of Washington that looked to deliver treatment to rural patients for complex diagnoses – particularly PTSD and bipolar disorder – in a setting where physical access to diagnosis and treatment was often hours away. The project, named The Study to Promote Innovation in Rural Integrated Telepsychiatry (SPIRIT), had more than 1,000 participants and overall delivered a 32 percent increase in improvement on a scale of mental health functioning. The solution was quite simple: use telehealth technology to connect psychiatrists and psychologists in urban areas with patients in rural areas. The outcome shows that applying existing technologies to unmet patient needs and challenges can be the pathway to measurable success. When the initiative started in 2016, Zoom wasn’t the household word or everyday experience it is now, but that didn’t create a barrier to adoption, participation, or outcome. In fact, healthcare infrastructure was the more distinct challenge to be addressed.
Working in digital innovation and thinking about ways to make impacts for our clients, I believe this study highlights how frequently the conversation around disruptive health technology focuses on what’s new or not yet developed when a more important series of questions might be, “What do we have now that can be applied differently?” and “Who needs access to care that others have access to readily?”
The disparities in health outcomes across the nation have never been more glaring than they are after almost two years of life in a global pandemic. Recent data* from the CDC (Risk for COVID-19 Infection, Hospitalization, and Death by Race/Ethnicity) showed consistently that black, Hispanic, American Indian, and Alaska Native people have experienced disproportionate rates of illness and death due to COVID-19.
Now is the time for health technology to focus more on the individuals and communities we can positively impact. This is the time to strive for equality. In the same way the SPIRIT study applied innovative thinking with existing technology to solve a specific need for a specific set of rural Americans, we can do the same to push the next great healthcare disruption: equality.
The leaders and organizations that harness our existing power and innovative digital thinking to actively level the playing field and measurably minimize these gaps will put the U.S. on a path to overall better outcomes that extend well beyond our  health. This is the most important healthcare disruption we need for 2022.

Evan Daly

Evan Daly, Creative Director, Art, Brick City Greenhouse: Disruptive technologies within the healthcare space alter perceptions of what’s possible. Due to the closely regulated nature of the healthcare industry, disruptive technologies don’t just appear out of thin air, nor do they impact the market overnight. Three technologies that are having lasting effects and continue to create opportunities for patients and physicians are genomics, endovascular neurosurgery, and mobile health (mHealth, or more broadly, telehealth).
Genomics, the ability to sequence a patient’s DNA, has created a whole new way to understand and treat cancer. Doctors have known for years about the impact of genes as they relate to cancer but didn’t have the advanced tools to identify the cancer-causing mutations. Genomics is finally arming doctors with the knowledge they need to design truly personalized treatments for their patients.
Neurovascular disorders impact the supply of blood to a patient’s brain or spinal cord. Treatment techniques are highly specialized and may include microsurgery, including skull base surgery. The new frontier of endovascular neurosurgery lowers complication and risk by allowing doctors to insert a catheter into the groin and guide it to the patient’s brain to perform different tasks. This minimally invasive procedure results in less pain and shorter hospital stays for patients.
The ever-evolving area of mHealth is the practice of patients using consumer technology to capture their own health data and remotely connect with healthcare providers. The use of apps like Apple Heart Study and AliveCor’s KardiaMobile are helping doctors make diagnoses quicker and more accurately. This great leap in access, and most importantly, the accuracy of patient heath data, is having an impact on a global scale.
These types of technologies build momentum over time as they are adopted by more and more doctors and patients. The future application of these advancements is creating true, lasting change in the healthcare industry for the benefit of all.

Rico Cipriaso

Rico Cipriaso, SVP Digital Strategy & Transformation, Concentric Health Experience: Artificial intelligence and machine learning are accelerating innovations in our industry at an unprecedented pace. Whether it is Roche’s new relationship with Flywheel.io to develop new data models to aid in drug discovery or Sanofi’s deal with AI startup Owkin to find new biological indicators of cancer, the trend of ingesting and curating data signals and patterns to drive innovation is now unstoppable.
The ability to harness signals intelligence is at the heart of our future here at Concentric Health Experience, starting from determining who is (and is not) a promising candidate for treatment, or may be misdiagnosed, or even at risk for relapse. These signals and, more important, the patterns and algorithms they generate will become increasingly valuable and monetizable, particularly if they can be shown to improve outcomes, reduce costs, or pre-empt problems before they happen.
It is not just clinical or diagnostic data that create signals and patterns. Everything we do from the individual consumer to discernible populations can be quantified and measured, including signals from our daily digital lives. Everything from what we post and share, to when we consume content, to the location, speed, and duration of when we are active (or not) are the bases of rich datasets. Integrating these with clinical and diagnostic data allows us to create baselines, norms, and predictive models. Predictive models allow industry to create interventional strategies. The future rests not on data, but on signal intelligence and pattern recognition, and the future is here.

Bryan Roman

Bryan Roman, Executive Vice President, Creative Technology, GSW: COVID-19 has changed the way we do business, creating a sea of uncertainty throughout the world. No more handshakes, more virtual and less personal interactions, restrictions, quarantines and future unknowns. The key question on the minds of clients is how does engagement change in this new world?
While the uncertainty of COVID-19 lingers, one thing we do know is that virtual engagement with pharmaceutical reps is here to stay, requiring new ways of creating meaningful connections.
Immediately after the COVID-19 shutdown of 2020, GSW realized that brands had a business problem related to reps detailing in person. This inspired the introduction of RepConnect, making GSW the first to market with a viable solution to rep communication in this time of social distancing. The game-changing platform enables reps to deliver an engaging sales call via their existing CRM platform while maintaining social distance by “beaming” content directly to healthcare professionals or nurse practitioners’ mobile devices. RepConnect uses Cloud technology to let reps stream their detail to an HCP’s device from six feet away using either Wi-Fi or cellular data. The rep brings up a QR code, the HCP scans it, and you are in business!
The solution has become the presentation medium of choice for select clients, including some of the world’s largest biotechnology and pharmaceutical companies. In addition to making the remote detail experience easier, it has opened doors to new communication strategies, such as presenting to multiple HCPs at once and allowing HCPs to receive a detail in a setting where an Internet connection and mobile device are present.

David Sakadelis

David Sakadelis – SVP, Technology, Heartbeat: Any technologies that create greater interconnectivity of data and digital experiences across channels are well positioned to disrupt the marketplace. Evolving our clients’ data capabilities, making them truly actionable, empowers us to drive a more consistent and relevant narrative across audience journeys. Enterprise solutions like Adobe Marketing Cloud and Salesforce Experience Cloud, or our own Publicis proprietary solutions in concert with our agency partner Epsilon – such as PeopleCloud and ARIS – make this increasingly more possible.

Graham Johnson

Graham Johnson, Chief Product Officer at FCB Health, an IPG Health company: Inflection points along the patient journey are ‘moments that matter.’ Healthcare is increasingly driven by those moments to create ecosystems that deliver accessible, personalized care – spanning diagnostics, communications, medicines, and digital therapeutics. There are a few key trends that will continue to disrupt the marketplace as we move into 2022, including:
The rise of digital health and the increase of self-directed learning. Because many patients faced challenges or were scared of accessing healthcare during the pandemic, they found ways to fill the gaps. For instance, YouTube saw exponential growth in terms of watch time of videos focused on mental and physical health, and new ways to stay healthy. Consumers sought answers to health-related questions on social media platforms which created new opportunities for brands to connect using media and influencers.
Conversational AI, often personified by smart assistants like Amazon Alexa and Google Assistant, will become the dominant form of human-computer interaction (HCI), replacing the mouse and touch screen. Health systems faced a flood of questions around COVID-19 during the pandemic – from understanding symptoms to getting tested to finding out when vaccines would become available to scheduling boosters. Chatbots were increasingly used on websites and apps to lessen the strain on overburdened systems. The technology is getting more powerful and natural, and AI interactions often surpass the ease and efficiency of human ones. Conversational AI graduated from an emerging technology to a foundational one during the pandemic.

Jim Mittler

Jim Mittler, PhD, Partner, Director of Medical Strategy and Health Economics, Peregrine Market Access: The pandemic forced the healthcare industry’s hand in accelerating the adoption of digital technologies. Telehealth is one of the standout technological breakthroughs of the pandemic, as it provided convenient, safe access to care amidst social distancing and quarantine mandates, especially for those in rural areas. Even with limitations, the value of virtual telemedicine healthcare provider visits became evident and resulted in increased coverage by insurers. Its demonstrated utility gives telemedicine staying power even as the COVID-19 threat dissipates. Look for a lot of competition and continued disruption in this space in the years to come.
Big data and electronic health records (EHRs) are another example of technology that the pandemic is forcing the industry to revisit, not only for its usefulness and obvious benefits, but for the threats and gaps that became more visible because the U.S. healthcare systems lacks robust interoperability. The pandemic exposed our vulnerabilities in not tapping technology to make our systems more efficient and effective. Now’s the time to fast track the implementation of EHRs to improve data collection and analysis of patient data. This will be especially important as the industry contemplates value-based contracting. It’s also an opportunity to utilize digital technology to better monitor data from the medical and supply chains. In all cases, cybersecurity must be top of mind.
Disruption will continue to be the name of the game in healthcare for the near future, so building trusted relationships with a wide spectrum of stakeholder partners is integral for success. The silos in the implementation of technology – and in every other aspect of healthcare – need to come down in order to increase collaboration and communication.
No matter where technology takes us, we must never lose sight of the patient at the center of healthcare and ensure that the tech advancements honor the patients’ best interests.

Kim Johnson: Artificial Intelligence (AI) and machine learning is not new, but its impact is accelerating, providing the opportunity to process data with both speed and a greater accuracy than ever before. AI will likely increase in use as a way to decrease healthcare costs while also affording healthcare professionals the ability to place greater focus on patient care. AI can help solve problems of misdiagnoses, which in turn can lead to more effective treatment earlier in the disease course and also help hospitals operate in a way that is smarter and more efficient.

Julie Hurvitz Aliaga: Faster and more accurate ways of testing for viruses is here to stay. We are now all accustomed to receiving everything quickly – whether that be information at our fingertips through news outlets on our phones, or social media to see what your family and friends are up to. When the pandemic hit, the first thing many of us were thinking was: How do we roll out technology to test (accurately) for COVID-19 at rapid speed? How can that help slow the spread if we can test even faster? This will continue to evolve. I also predict more technologies that track, record, and help disperse this data to those who will need it – schools, places of business, entertainment, etc. Of course, this comes with privacy concerns, but the idea will continue to evolve in new ways.

Jose Ferreira: Walmart, CVS and other retail giants are developing and expanding the scope of their health services. This isn’t a specific technology that is disrupting the industry as much as a world of advanced customer insights and data from the retail sector getting applied to healthcare delivery. In some more rural towns and counties large retailers are already, for better or worse, the center of the community. They can draw on all of the data they already collect on customer activity to expand to targeted health services where independent providers and/or hospital systems may be scarce. This trend will be interesting to monitor in more urban areas where there are greater options for the healthcare consumer.

Eileen Yaralian, Nadia Cervoni, Michael Schreiber, and Eddy Rodriguez: Like many industries, Artificial Intelligence (AI) is poised to cause a major disruption in healthcare. AI applications are already pervasive in healthcare, in medical offices and pharma companies. Predictive analytics will affect new drug developments. The abundance of data from patient intake and electronic medical records are fuel for better patient care in the future. AI has already replaced some conventional labor-intensive processes in healthcare and is delivering rapid, remotely accessible, real-time solutions for diagnosis and treatment.
If anything positive can come out of the COVID-19 pandemic it is the swift adaptation of telemedicine. Governments, healthcare systems, and clinicians were forced to embrace the technology and it has yielded promising results. In fact, most patients say they are interested in continuing with virtual care in a post pandemic world. This bodes well for patients who do not have easy access to healthcare facilities and may go a long way toward alleviating overcrowded systems.
DDB Health is currently working on several gene-based therapies. Genomic knowledge and processes are starting to make their way into clinical workflow. Gene therapy will revolutionize clinical medicine and specialty care as we know it. In the coming years several unmet clinical needs will be solved by genomic innovations.

Additional Disruptive Technologies in Healthcare

Blockchain
The ledger technology has a wide range of applications and uses in healthcare. It facilitates the secure transfer of patient medical records, manages the medicine supply chain, and helps healthcare researchers unlock genetic code.
Blockchain’s ability to keep an incorruptible, decentralized, and transparent log of all patient data makes it a technology rife for security applications. Additionally, while blockchain is transparent it is also private, concealing the identity of any individual with complex and secure codes that can protect the sensitivity of medical data. The decentralized nature of the technology also allows patients, doctors, and healthcare providers to share the same information quickly and safely.

Internet of Things (IoT)
Medicine has long been driven by data, from making diagnoses to prescribing treatments. Now, healthcare is taking a major step forward in the collection and analysis of high-quality data, thanks to the power of AI and the IOT.
The IoT can be thought of as a device (or a network of devices) that connects to the internet, allowing data to be sent to whomever needs to use it. On a grand scale, the IoT consists of billions of devices and sensors – such as across a supply chain – that transmit a continuous stream of data. For business leaders in every industry, access to better, more accurate, and real-time data enhances decision-making.
While the most popular example of the IoT in healthcare is remote patient monitoring – meaning IoT devices that collect patient data such as heart rate and body temperature – there are many other examples of the IoT in the healthcare industry.
The following are ways the IoT is changing healthcare:
• Remote patient monitoring
• Glucose monitoring
• Heart-rate monitoring
• Hand hygiene monitoring
• Depression and mood monitoring (“mood-aware” IoT devices)
• Parkinson’s disease monitoring
• Connected inhalers
• Ingestible sensors
• Connected contact lenses
• Robotic surgery

Voice Search
From its novel start to its rapid infiltration into more of our lives, voice-enabled tech (or voice assistants) is changing the way we access and use healthcare. In fact, Amazon recently greenlit 6 healthcare companies to develop apps for Echo (Alexa), and HIPPA-compliant apps are already in the works for several major players.
Voice is a huge healthcare marketing technique that’s been on the rise since smartphones and smart speakers were first released (with Amazon’s Echo first hitting the market back in 2014). And, more importantly, it can be an effective tool in the industry. So how does voice search apply to marketing? Healthcare access is predominantly local. In other words, most Americans look for healthcare options within the proximity of their place of employment or their residence. A voice-enabled phone helps patients go from a vague and general search of a “doctor near me,” to asking a more involved, conversational question like: “Hey Google, find a 5-star rated orthopedic surgeon near me who does knee replacement.”
Because of this reality, healthcare marketers must optimize their digital platforms for local searches. Voice has become one of the main health technologies in which healthcare marketers must invest. If one in five are using voice to find out about healthcare options, it’s imperative to not miss out on the potential customers.

Virtual Reality (VR) and Augmented Reality (AR)
It was some time ago that VR and AR were exclusively devoted to the gaming industry. In 2021, both VR and AR are experiencing a keen interest from various spheres, including healthcare.
More and more healthcare companies are ready to strengthen their digital solutions with VR and AR technologies for enhanced data analysis and healthcare practices. By implementing these technologies, some companies have found new ways to establish connections with their patients in pandemic times, providing remote and personalized care. Others use VR and AR to improve medical training or prepare for presurgery activities.
Here are some examples of how the technologies could be used in healthcare and medicine:
• Medical training – medical students, doctors, and surgeons can learn how to treat their patients better or perform complex operations without the risk of making any surgery mistakes
• Robotic surgery – when robotic devices perform high-precision operations controlled by a human surgeon with VR technology
• Physical therapy – VR helps patients to more easily overcome high pain levels and ensure faster recovery when performing physical therapy
• Posttraumatic stress treatment – when a person is placed into the environment with a traumatic situation and they try to find the solution and overcome the crisis situation
• Anxiety, phobia, and depression treatment – patients can use VR for meditations or relaxation in safe environments
• Emergency treatment – with AR maps layered over reality people can find medical centers, pharmacies, and other healthcare facilities
• Personalized approach to patients – VR and AR can help doctors better explain to their patients how their operations will be performed or which steps a patient should take for more-effective recovery
Virtual and Augmented realities are quickly gaining popularity in healthcare and medicine. They are already able to provide high-quality assistance to doctors and medical specialists in patient treatment and educate healthcare consumers on how to better care about their health.

Harrison and Star: We see two key disrupters in the marketplace:
• Virtual Care / Remote Medicine / Telemedicine
The virtual care space is certainly one to keep our eye on. The pandemic accelerated remote managed care, specifically through Telemedicine. The advances made in Telehealth to accommodate its surge during the pandemic are facilitating a shift to a hybrid care model. Skyrocketing from a mere 11 percent pre-pandemic to ~46 percent, Telehealth has found a solid space in how patients experience doctor interactions. We anticipate that as this space expands how patient data is handled will also evolve with patient expectations shifting to a more “amazon prime”, get it next day model. This will be incredibly disruptive as it challenges the traditional slow paced, long wait at the mercy of the doctor schedule that patients have been accustomed to. With that in mind, some organizations are expanding their Telehealth programs to include digital portals that offer a variety of self-service functions and messaging services.
• Digital Therapeutics (DTx)
In the fight to close critical gaps in care for underserved populations Digital therapeutics (DTx) deliver medical interventions directly to patients. Regardless of patient age, language, culture, income, disease state, or geography, the DTx methodology uses a variety of digital implements to help manage, monitor, and prevent illnesses in at-risk patient. DTx’s purport to extend clinicians ability to care and offer at-home convenience and privacy. Such an offering could be a game changer in eradicating such social determinants of health like, stigma, language barriers and access to care.

Ari Schaefer: There are several health technologies that are already disrupting the marketplace and others that are just starting to nibble at the edges of what might eventually become a seismic impact. One area that seems to be growing rapidly, stems around the use of direct-to-consumer and at-home lab testing.
The comfort with at-home testing increased significantly during the pandemic. The limitation of access to in-person testing during lockdowns coinciding with common-place usage of at-home rapid COVID diagnostic testing has created an incredible opportunity for the healthcare industry. Self-administration of diagnostic tests could remove access to care hurdles that exist among people who live in suburban and rural areas, are immunocompromised, or have mobility challenges. We expect tele-diagnosis to increase in scope and impact for conditions that historically would have been unlikely to be able to be diagnosed without in-person tests. It should also lead to early detection of many illnesses without the cost burden of a visit to a doctors’ office or lab. Beyond diagnosis, tele-monitoring of patients with chronic conditions can improve outcomes using regular self-administered tests.

James Tinker: I think we’ll see a variety of technologies hopefully coming together to disrupt the space. Ultimately, even the greatest technology is only as good as the extent to which it can be used, and the healthcare system is a complicated one. We have many layers, systems and stakeholders and navigating all of them is the challenge – ultimately to improve the patient journey across the spectrum. I like the companies and organizations who recognize this, and look to bring the stakeholders together from beyond industry through to payers, PAGs, policymakers, tech, investors etc. That’s how we’ll see real disruption, efficiencies and ultimately benefits to patients.

Andrew Cournoyer:
Real-time benefit tools (RTBTs)
In January 2021, CMS issued a final rule that would require Medicare plans to offer an electronic health record (EHR) integrated tool that informs providers when lower cost drug options are available under a beneficiary’s prescription drug benefit. These tools are required for the 1/1/2023 benefit year, but some plans have already begun to launch their own solutions. RTBTs are a significant step towards efficiency and transparency. They support efficiency with respect to prescription fulfillment as providers can select covered products at the point-of-prescribing. From a transparency perspective, providers will have a line of sight into the out-of-pocket costs for their patient in real time. The ability of RTBTs to provide efficiency and transparency is quite disruptive as it can positively influence point-of-sale pharmacy operations via reduced administrative burden of utilization management (UM) edits and subsequently support an improved patient experience. A lesser evident disruption, but no less significant in its magnitude, is the ability of RTBTs to elevate the urgency for obtaining optimal formulary access. Preferred access among payers leads to lower tier placements and fewer UM restrictions, which will have real-time influence for provider drug selection at the point-of-prescribing. As such, drug manufacturers may face increased pressure to negotiate for steeper discounts that yield preferred access.

David Lubofsky and David Brungard: Most of the industry would rehash the same things we seem to claim disrupt the industry annually – AI, wearables, and robots. But let’s be honest – there are no technologies disrupting the marketplace – they are an integral part of our lives now, and they’re inundating the marketplace. These technologies are useful when incorporated in a meaningful way into pieces. It’s about how to use them to make individual projects capture attention. These technologies will continue to evolve, and we need to ensure that we are using them in ways that make sense and are useful to the intended market(s).

8. What are your predictions for the healthcare industry in 2022 and/or beyond?

Tim Hawkey

Tim Hawkey, Chief Creative Officer at AREA 23, an IPG Health company: I’ll try to keep my prognostications inside my wheelhouse, and stick to things relating to creativity. For 2022, get ready for an even bigger explosion of creativity. The creative wildfire which was sparked a few years back is spreading. You can see the newfound investments agencies are making in creativity just based on their hiring patterns. Expect bolder pharma clients too. There was a pullback in creative risk taking in 2020-2021 due to the pandemic, as we all went into a more conservative emergency mode. There was a bigger focus on delivery and deployment compared to “what” exactly was being delivered and deployed. Well, the world is feeling a bit more comfortable again, and the desires to push the boundaries are blossoming once again.

Debra Polkes

Debra Polkes, Creative Partner and Co-Managing Director at FCBCURE, an IPG Health company: This year has felt like a very strange brew of existence. On the one hand we’re busier than ever with blurred lines between work and home making time accelerate, and at the same time we’re in suspended animation spring loaded to return to normal. As I look ahead to 2022, I think the feeling of uncertainty and in between-ness will continue to permeate our lives, and with that comes a few predictions for creativity in our industry next year:
1. Pandemic influence. We’re still living in a world of uncertainty, and I believe that the pandemic will continue to influence creativity and we’ll continue to see brands leading with emotion.
2. HCP Empathy. We usually think about the human drama of disease or patient experience – but now, the people we are communicating to – healthcare professionals – are living in their own drama-filled existence as a result of the pandemic. This will and should shape how and when we promote to them and the roles our brands can play in their world.
3. Trust Building. Truth and Facts continue to be debatable, and people have become even more wary of the messengers of health information. This is especially heightened in communities that are already wary of healthcare professionals and pharma. We will need to find more authentic channels and trusted sources of influence if we are to effectively find and reach them with our messages.
4. Conversational AI. On demand information will continue to grow so I expect we will be creating more lifelike interactions between human and machine.

David Ormesher

David Ormesher, Founder and CEO, closerlook (a member of Fishawack Health): After nearly 2 years of uncertainty and conflict, it’s clear that in 2022 and beyond, marketers will need to focus on relevance, engagement, and partnership to build brands.
Consumers now expect Relevance, especially in healthcare, and that needs the deep expertise of analytics-driven agencies who can proactively understand the needs of individual customers to deliver relevant messages, frame the right questions, and offer personalized answers through the appropriate media.
Effective engagement with healthcare professionals and patients requires agencies to demonstrate an unprecedented level of empathy, creativity, and responsiveness in order to move them from consideration to action. Data analytics serve a critical role advising the strategy, guiding the creative, and following the cadence of the customer need.
Finally, Partnership between the brand and the agency will take on greater meaning in 2022. To provide relevance and engagement with patients and physicians, ambitious brand leaders will need agencies that fully understand their role as strategic partners. This type of partnership will require a shared understanding of goals and metrics and a commitment to investing in deep expertise, affective creative, and the force multiplier of data analytics.

Mark Willmann

Mark Willmann, Fingerpaint leadership team: We are going to see the healthcare industry continue to tap into emerging technology to advance every aspect of the industry, from therapeutic discovery to global marketing. Leaning into data and analytics, and using it as a foundation to maximize the full potential of engagements by personalizing experiences in real time, will be a game-changer.

Yolanda Macias

Yolanda Macias, Director of Diversity and Inclusion, AbelsonTaylor: The Chinese philosopher Lao Tzu famously said that, “The journey of a thousand miles begins with a single step.” As the newly hired first director of DEI at AbelsonTaylor, my first step is a sizable one . . . building a culture where no employee lacks psychological safety and all feel empowered to be their authentic selves at work. If I can imagine and help realize a workplace where this is fundamentally true, then ATers can become ambassadors for this culture not just at work, but within their homes, communities, and larger networks. Ultimately, the ripple effect could be so wide that we begin to think about living in a world where we build one another up, free of greed and power struggles, and no one gets hung up on things like skin color, background, disability, size, sexual orientation, gender, race/ethnicity, religion or age.
In my new role, I see myself as a resource to help ATers navigate their internal journeys to fully understanding the origins of racism, patriarchy, power and privilege in order to be better attuned to its impacts so we can create a workplace where everyone can thrive. Our commitment begins with deeper reflection and the courage to experience what’s uncomfortable in order to grow. This type of personal and organizational investment is massive, but the rewards are even greater.
Since I started on the job eight weeks ago, I have accomplished a discovery phase, diving into policies, procedures, and workplace culture to understand the organization and employee needs. I have connected with ATers every day over that time, aiming to meet with all of the agency’s employees. The goal is to ensure that the voices of AT’s people are embedded within our DEI strategy in order to truly build a culture where no employee lacks psychological safety and all come in as their full selves. We’ll continue to take steps toward diversity, equity and inclusion because, after all, when we look at the goal of DEI, it is obtained only through a continuous journey.

James Talerico

James Talerico, Co-President & Executive Creative Director, Heartbeat: Hybrid healthcare will become the status quo: curious patients will move from online content to telehealth appointments to in-person exams to bot follow-ups and back to online content that promotes adherence and good health decision-making. Continuity and careful guidance will become a necessity to keep patients engaged. Simultaneously, patients will expect more from their care experience and brand interactions. This isn’t news. It’s been a long time coming and recent events have only catalyzed it.

Craig Romanok

Craig Romanok, President, CDMP: I can’t stress just how exciting the field of health has gotten in the last few years. From a therapeutic perspective, we are seeing more and more novel, lifechanging drugs getting approved than ever before. For reference, in 2020, the FDA approved 21 of 53 novel drugs as breakthrough/first-in-class therapies. These are drugs that have a mechanism of action different from those of existing therapies. To date, the number of innovative new products approved in 2021 has hit 38. And to make this even more exciting, we are on track to have the highest annual number of regulatory approvals of new gene therapy and gene-modified cell therapy products, with three already approved and an additional four to receive regulatory decisions across the US and Europe in the very near future. These lifechanging therapies present new challenges – strategic, clinical, and operational – that require a different approach. And a different kind of partner. Emerging biotech companies are looking for agencies who have the experience, can help support their infostructure, and offer human resources required to bring these lifechanging brands through to a commercial launch.

Jonathan Isaacs

Jonathan Isaacs, Global Chief Creative Officer, TBWA\WorldHealth, and Paul J Pfleiderer: While it is fairly well documented that human beings are generally not great at predicting the future, that’s not stopping us! One trend that we are consistently seeing take hold and grow, shaping 2022 and beyond, is the consumerization of healthcare.
We believe that the experience of healthcare will continue to shift toward a model akin to what is seen in the consumer space. While the physicians will always play a key role in influencing, they will continue to become operationally stifled as patients seek new, more consumer-like experiences (frictionless and personalized) in obtaining both a diagnosis and therapies. This will continue to be enabled by new technologies and nontraditional players in the space (eg, Amazon). Furthermore, both physicians and patients will continue to want/demand that they be treated like the true consumer they are – their choice and trust must be earned, not assumed.
So basically, our prediction for the future is this: The experiences created by healthcare systems and brands need to be as exceptional, if not more exceptional, than the science or technology behind the advancement of health.

Steve Hamburg

Steve Hamburg, Managing Partner, Chief Strategy Officer, Calcium: The global COVID-19 pandemic has dramatically amplified the need for healthcare that’s smarter, faster, and better. In 2022, this trend will assert itself in several key areas.
Accelerated drug development is a long-sought goal that COVID-19 has brought into sharp focus. Red tape and bureaucracy are so over. The world wants and needs drug discovery, clinical trials, and regulatory processes to proceed more expeditiously – more at the speed of innovation – without sacrificing scientific integrity and human safety. Advances in artificial intelligence (AI), natural language processing, and computer simulation models can help decipher even heavier loads of biological, clinical, and real-world data, enabling NDAs and approvals to move more swiftly. Until recently, going from molecule to market would typically take up to 12 years and cost $3 billion. The current and future challenges of healthcare are forcing those numbers downward.
Therapies are also moving further beyond the pill. Now, as a critical part of drug marketing, pharma companies are increasingly building extensive, digitally powered educational and support systems “around the pill.” What once simply were “treatments” are now evolving to become entire immersive, ongoing experiences, often employing novel VR/AR and other interactive technologies. While the medical benefits of this are clear – holistic health, lifestyle improvements, better compliance, etc. – the implications for healthcare marketing are also profound. The ability to identify and target patients with extreme specificity has never been stronger.
The science of precision medicine will also continue to advance. While the concept of matching drug therapies to patients isn’t new, the degree to which this matching can now occur is unprecedented. In fact, an entire new discipline – pharmacogenomics – has arisen to study the ways in which an individual’s genome will determine their response to drug therapies. Eventually, certain drugs – particularly in oncology and rare diseases – won’t be developed in a “one size fits all” manner; rather, they’ll be specifically engineered to match individual genomic profiles.

Alyssa Battaglia

 

Alyssa Battaglia, Supervisor, Media, CMI Media Group: I pre- dict an increase in next-best engagement and use of machine learning to deliver smarter and more potentially impactful messages to HCPs. NBE is not new to the advertising industry outside of pharma, but the fact that pharma is working on ways to adopt this into their strategy means a hope for increased engagement and reduced waste in reaching their key HCPs.

Brian Ericson

Brian Ericson, Director, Video Investment, CMI Media Group: Holistic video strategy is more important than ever. Buyers across multiple “video” channels will have an understanding of the full ecosystem of opportunity and break down silos between traditional TV, digital video and programmatic to create a truly customized plan that can work within client budget parameters and deliver goals. With this, also a keen understanding of role of channel, feasibility for inventory availability and targeting based on purchasing path to ensure campaign success.

Andrew Miller

Andrew Miller, SVP, Search & Emerging Media, CMI Media Group: Now more than ever, clients should be invested in truth- ful and relevant content. Over the last two years, we have seen the Health Trust Gap in full force. The overwhelming amount of content available to users urgently looking for information can be dangerous. It’s amazing that we have access to immediate information. However, not all of that information is accurate. Clients should be looking to create and promote truthful, vetted content that their audience can trust. Creating authority in the space by sharing sources and linking to other trusted properties can help instill confidence in their audience.

Alexandra Gilson: Digital media consumption is up, however TV continues to drop off, which makes it more important than ever for marketers to take a digital omnichannel approach to their media plans, to meet consumers when/where they are. OLV and streaming services are continuing to corner the “traditional” TV market, while social media, which saw an unprecedented spike in growth due to the pandemic, will continue to be a mainstay on media plans.

Justin Freid: The metaverse provides significant opportunity to disrupt the healthcare marketplace. As consumers shift to living more and more of their life online, interactions with health will be a significant part of that. Why not be ‘live’ in the metaverse for a telehealth appointment or Peloton class? The metaverse will allow us to be immersed in the experience, instead of starring at a screen. As technology continues to advance to support the metaverse, the opportunities for healthcare are endless.

Jose Ferreira: 2022 will be the year when digital medicines start to scale. The metaverse is getting a lot of attention, and we know there’s been a lot of talk about the promise of digital medicines for a long time. I wouldn’t be surprised to see a few unicorns emerge as pharmaceutical companies of the future – offering only digital solutions, probably using some form of AR and VR, to deal with a host of medical conditions. We’ve seen glimpses of this trend at CES and other places, and now that a lot of business is transacted virtually it seems only fitting that healthcare is due for a similar kind of virtual/digital disruption.

Kim Johnson: I believe we’ll see the experience economy meeting healthcare in a model that is increasingly consumer-driven, virtual, and personalized, with data being shared through a wide array of digital services, apps and content.

David Stemler, Joel Jacob, Kristen Gengaro, and Sharon Callahan: Advocacy is everything. With a genetically informed, AI-empowered, data-driven population of patients and caregivers, there will be two competing needs at the forefront of communications and care. The deluge of real-time, real-world information will not automatically equate to intervention and prevention. On one hand, it will take consumer education and empowerment on an unprecedented scale. Patients and caregivers will need to know what to do with this new wealth of health intelligence, and they will need to be convinced and compelled to act on it. On the other hand, HCPs and healthcare systems will need end-to-end solutions that translate this exponential increase in insights into intuitive, actionable next steps that feel like a natural progression of their practice – as opposed to an intrusive, cumbersome interruption of it. The future is bright, indeed, but it’s going to be all-hands – and algorithms – on-deck to make it a reality.

John Guarino: Consolidation and integration are the most impactful market trends in healthcare today. The integration of payer, pharmacy/PBM provider, distribution channel, and provider networks will change healthcare significantly moving forward. These giant integrated networks place the insurer, provider, hospital, and pharmacy all under one umbrella. United Healthcare’s recent $13 billion deal with Change Healthcare is the latest in a line of 15 acquisitions for them, and will make what is already the largest health company in the world larger with even greater information capabilities to drive their model into the marketplace. United is the largest insurance company, providing coverage for ~40 million members across commercial and managed government products. Combined with Optumhealth provider services, and Optum Rx PBM and pharmacy, United Healthcare touches the care of an estimated 99 million Americans. By sheer size they are a force to reckon with and usually dictate to the market the terms with which they will engage with providers and suppliers. This new acquisition will give them the engine to analyze what is an unprecedented amount of data to drive higher quality outcomes. Although some detractors fear the monopoly and antitrust potential of a company this big, we believe the amount of data that can be analyzed will change the face of healthcare. Once again, the private sector is doing what the government couldn’t.
Another trend we are watching is the continued attempts to sunset fee-for-service reimbursement payment policies in favor of new value-based models that emphasize quality and lower costs. The “perverse incentive,” where providers make more revenue based on providing more services and infused drug care, is going away.
Things like ASP (Average Sales Price) and the Oncology Care model, which are seeking to limit the benefits a physician or hospital can gain from prescribing, have inadvertently created a system where drug companies must constantly raise the price of therapies or risk placing a substantial number of practices underwater on reimbursement from Medicare where they lose money. The goal is to remove all dollar incentive to use drugs, but this is challenging, as ~65 percent of an oncology practice’s revenue is recognized through drug therapy. The current version of the budget bill will allow Medicare negotiation on drug prices, caps the out-of-pocket maximums for beneficiaries (historically there was no cap on Medicare Part D), and pushes the health plans and the drug companies to pick up the slack. However, these changes are for the pharmacy benefit; supplemental insurance makes patient impact of drug coverage incident to a physician’s office visit negligible.
This creates a different perverse incentive. In this system, Medicare patients are drawn to physician-provided therapies, because for them, there are little to no costs. So, if there are two options the more costly one is chosen. Real change, here, can only come when we realign our definition of value.
Finally, the increase of gene, cell, and innovative orphan therapies is another trend that will continue to place pressure on the healthcare system. A new report released today finds there are 289 novel cell and gene therapies in development for a variety of diseases and conditions. The therapies represent the translation of scientific insights into new treatment options for patients. But this innovation comes at a cost. Gene and cell therapy costs range from $373,000 for a single dose of the CAR T-cell therapy Yescarta to $2.1 million for Zolgensma, a gene therapy for spinal muscular atrophy.
Let’s suppose only 10 percent of those therapies make it to market, which is 28 new products that will cost, on average, north of $500,000. Some will cost millions. Many of these therapies are transformational in their benefit. Some are cures. Some, however, are not. In a system that does not consider the cost impact or transformational nature of the clinical benefit of a therapy, an oncology CAR T-cell therapy that delivers weeks of progression-free survival will be evaluated the same way as a cure for a costly chronic disease.
Take the case of hemophilia. On average the healthcare system spends ~$25 million on a hemophilia patient over the course of their life. So, in this case a cost of millions of dollars to cure it is a no-brainer. But if the goal of the system is to just make costs lower, we may miss the opportunities that may be found in those 289 therapies. We must shift to the value of something. What is the transformational nature of the clinical benefit: if it’s large, the value of the therapy is large? If there is significant cost offset, the value is large. We have a society that demands innovation, and the U.S. drives most of the innovation in healthcare for the world. We are watching to see if the system can align with that mandate and find ways to value the innovation we so aggressively demand.

Harrison and Star: Change, change, and more change! But likely for the better. Although we believe that telemedicine is here to stay, the future of physician visits will likely be a hybrid of in-person and remote, vs the heavy shift toward remote visits during the peak of the pandemic and a heavy focus on in-person visits pre-pandemic. We predict that patient and physician access to diagnostic testing will also continue to expand – not just highly technical therapeutic areas like oncology and virology, but across the board. Likewise, we believe that we will see an increasing number and variety of digital therapeutics, from personal health and wellness aids and monitors to disease management and treatment tools. And we expect (and hope with all our hearts) that 2022 will mark a shift toward understanding, destigmatizing, and prioritizing emotional and psychological well-being for everyone. These last 20 months have placed significant strains on everyone’s mental health and now is the time for our industry to lead and make positive change.

Chris Hatton: Despite all the politicization and public friction surrounding the need for vaccination, I think it’s fair to say that the value of research and development in the pharmaceutical space has been elevated in the court of public opinion. Everyone can agree that the world economy is inherently linked to overall health. The race to develop a vaccine for COVID-19 was likewise linked to the race to get back to normalcy in the workplace. By “winning” that race, Pfizer, Moderna, and J&J once again solidified pharma as one of the most important industries in the US – if not the most important. We’re far past the days when America was the automotive leader or US Steel was the global standard. But as we flip the calendar into 2022, Americans can, or least should, take pride in leading the way in healthcare manufacturing. The manufacturers can leverage that goodwill to rationalize pricing structure for all new blockbusters not just vaccines. Sure, congress can empower Medicare to negotiate pricing on common treatments, such as capping insulin prices. That’s reasonable. But the Pharma industry is now the #1 “too important to fail” industry in the world.

David Lubofsky and David Brungard: Our healthcare industry has been hit HARD the last two years. They have done an incredible amount of work in every area – research, development, treatment, and prevention. We think the healthcare industry will continue to go all in on the fight against COVID through vaccines and more refined treatments.
On the other side of the coin, we’ve seen a shift in recent years to a more patient-centric approach: people want a voice in their healthcare. They have so much information at their fingertips – some of it factual, some of it not quite true – and they’re not afraid to share it or voice their opinions. It’s up to doctors to provide the best options, dispel the rumors, give accurate information, and work together to come up with treatment plans that work for a specific individual. Healthcare is a team effort and is not a “one size fits all” industry.

Eileen Yaralian, Nadia Cervoni, Michael Schreiber, and Eddy Rodriguez: 1) We believe the healthcare industry will strive to focus on improving health inequities and healthcare for underserved patient populations. We have already seen several large pharma organizations focus on improving screening and earlier diagnosis of diseases that disproportionately affect underserved populations. We have also heard clients focusing more on inclusivity when it comes to messaging and communications. We believe 2022 will bring more emphasis on these areas.
2) One of the challenges related to inequity in healthcare has been a lack of trust of the pharmaceutical industry. This has resulted in very poor representation of minorities in clinical trials. Through the pandemic, pharma has made some inroads in improving its reputation among the general public. In 2022, we hope to see more authentic attempts by pharma at building trust among minority populations, because to truly improve health equity, the industry needs to be developing treatments that have been proven effective in a diverse population.
3) In 2022, we’ll continue to see more limited sales rep access to hospitals and physicians’ offices. Accordingly, digital communication channels will continue to grow in importance. We believe the healthcare industry is ready for “smarter” communications. We hope to see healthcare marketing catch up to where consumer product marketing has been – data-driven, dynamic communications, customized to each person’s needs and situation.

Andrew Bast: Many consumers are returning to the healthcare system, but with different expectations and demands developed from their experiences in the past two years. The consumerization of healthcare is attracting new players daily, offering new services, new technologies, and new experiences. The delivery of care now has a new meaning. It used to be that we needed to be in a “brick-and-mortar” location disclosing symptoms and concerns to a healthcare professional in real life. However, the rise of digital therapeutics is upon us. Most of us have engaged in some form of digital exchange, whether it is telehealth consultations to filling electronic prescriptions to analyzing and sharing datasets from our devices. Digital therapeutics offer an entirely different level of care delivery experience.
The sophistication, importance, and value of these novel modes of care delivery will continue to increase in 2022 and beyond. Expect approval for devices like Fitbit to be able to detect undiagnosed atrial fibrillation, or wearables to continuously measure lung health and provide a prognosis. Our interconnected, integrated physical and digital worlds will become ubiquitous and invisible. So instead of hoping and praying that patients remain in concordance, vital as they go out “of the line of sight” from their doctor, digital therapeutics, operating in the background, will become a reliable extension of the healthcare professional, and a trusted resource to the patient.

Jackie DeAngelis

Jackie DeAngelis: In 2022 and beyond, we expect that:
1. Major therapeutic advances in oncology and rare disease will increase by way of continued biomarker driven therapy approvals and a ramp up of cell and gene therapy introductions. Over 90 cancer drugs have a biomarker in their label already, and with a pipeline that could yield 60 cell and gene therapy approvals by 2030, healthcare stakeholders will need to be prepared to adjust coverage, patient access, and care delivery to allow patients to take advantage of innovation while managing costs.
2. Specialty drugs will continue to dominate the marketplace with the vast majority of FDA approvals for specialty products while many are covered under the medical benefit. With this, patient access and provider reimbursement will become increasingly complex, requiring best in class access and reimbursement programs supported by manufacturers. In fact, since most payments are now made through value programs, and more than one million clinicians are participating in CMS value-based reimbursement programs, access and reimbursement will grow as an important healthcare stakeholder educational need.
3. Care delivery will evolve to address many things brought to light by the COVID-19 pandemic. A patient’s social determinants of health and the social risk factors that cause people not to attain good health will increasingly be screened for, sometimes using data and analytics, to ensure that issues, such as lack of therapy adherence, get addressed. And with telehealth now in the care delivery mainstream, the future will optimize the telehealth experience for both providers and patients. Finally, since more than a third of adults have delayed healthcare due to the pandemic, care delivery will include a much needed catch-up in preventative care.