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6 reasons why the patient is the pharma customer

I really enjoyed the opportunity to be challenged on the “patient = customer” thinking at a discussion with Mark Doyle and a virtual audience earlier this year.

Summarizing my rationale, those are my 6 reasons why the patient is the pharma customer

  1. It is not about how we call people … but the mindset how we look at them
    Accepting patients as customers is about taking them serious and doing things based on their actual needs … not how we address them.
  2. The patient plays a role along the whole buying process
    The only stakeholder actually being involved at all 4 steps of the buying process is … the patient.
  3. The patient (more and more) decides on treatment
    That is what customers do: deciding what they get.
  4. Pharma has established business models for patient customers in place
    B2C models for patient customers do exist.
  5. Without the patient, there is no business
    The patient is the (ultimate) customer of the whole healthcare system.
  6. Being the customer is a good thing
    Being a customer is simply fabulous.

Now, for those of you who would like to know more about one or the other of the ‘6 reasons’ (e.g. for challenging me on 😉 ) I feel free to provide some more details of the thinking behind …

Reason #1 why the patient is the customer:
It is not about how we call people … but the mindset how we look at them

It really is the #1 concern I am frequently exposed to. “Patients don’t want to be called customers.”

Yes. Perhaps. But many patients also don’t want to be called “patients”, right?! Especially in chronic diseases or with more substantial impact on life. Actually, patients simply want to be addressed as human individuals, what they are.

To be very clear. For me, the patient being the customer does not mean that I am calling the patient “customer”. I am calling them “Bob”, or “Frank”, or “Ruth”, or “Isabelle”. A patient is a human individual with a name. Which is also the most appropriate way to call or address her or him.

For me, accepting someone as a customer means how I look at someone. It is about being interested in someone. Being eager to really understand the person with its needs and expectations. Focussing on listening first. Taking people in their particular situation serious. That is what customer-focused business does. The people in your favorite clothes store as well as Amazon & Co. with their big data approaches.

So, cutting a long story short: accepting patients as customers is about taking them serious and doing things based on their actual needs. Not how we address them.

Side note: Some healthcare companies call patients “consumers” aligned to e.g. food industry concepts. Whatsoever, this is for me personally is a clear no-go. I really invite those colleagues to think about if “drug consumer” is really an appropriate terminology.

Reason #2 why the patient is the customer:
The patient plays a role along the whole buying process

As an Amazon customer, when you are buying a book, you as a customer control all 4 steps of the buying process …

  1. You have the need you are bored and what to read an exciting book
  2. You decide you select the book to buy
  3. You payyou give your money
  4. You have the benefitby having the joy of reading a nice book and not being bored anymore

Now, in healthcare, this model is less simple. There are quite a few players involved in each of those steps. Different types of physicians, health insurances, governmental & regulatory bodies, nurses, caregivers, etc.. The only stakeholder actually being involved at all 4 steps of the buying process is … the patient:

  1. Definitely, the patient has the need
    … of having a better life again. E.g. being cured or getting his disease managed. Certainly, other stakeholders in the system also have their needs. But none of these would exist without the patient’s need.
  2. The patient has the benefit
    The actual and ultimate benefit is with the patient. Yes, sure, also doctors have a benefit of being able to provide their patients effective care and treatment as acknowledged experts. But, again, without the patient’s benefit, e.g. the treating/caring physician’s simply wouldn’t exist.
  3. The patient pays
    I think we can agree that HCPs typically don’t pay, right (so they are out of this feature of being a customer). Depending on the healthcare system and type of reimbursement in their home country, patients pay directly, or partially, or it is covered by a health insurance or public/governmental institution. Where the latter have their money from – exactly – patients being contributors/tax payers.
  4. The patient has a stronger influence on treatment decisions than ever before
    … and this is continuously further increasing. Which is a nice handover to …

Reason #3 why the patient is the customer:
The patient (more and more) decides on treatment

Looking at my own family. My mother did already question her doctors’ suggestions more than my grandmother had done. I certainly challenge my physicians’ advice more than my mother and only follow where I agree. And my daughter will show up at her appointments better informed than any generation before.

Patients influencing treatment and disease management decisions are not the future. This is already reality today.

Sometimes, I still listen to colleagues who continue being stuck in a very traditional, old-school referrer/prescriber business model, including a “the physician decides on treatment” thinking. I just can say “open your eyes guys”.

Or another former colleague who told me that for the disease he was working on there anyhow is just one medication in place = no alternative = no decision needed. I am afraid that I have to strongly disagree. Have you ever joined an oncological treatment consultation with your partner? Did you ever have to attend a funeral service for a friend who had decided to go for an ‘alternative treatment’? There is always a decision, as there always is at least one alternative … which is no treatment. Or a so-called ‘alternative therapy’. Or just symptomatic treatment. Or preferring a medication with less potential side-effects over the more efficacious. Those are real-life patients’ decisions of today. Competing with scientific evidence. But personal decisions of human individuals.

More and more patients do more and more influence if not co-decide on their treatment. And the tendency is growing. The earlier we seriously consider the patient’s growing role with disease management decisions, the better. And that is what customers do: deciding what they get.

Reason #4 why the patient is the customer:
Pharma has established business models for patient customers in place

Sometimes you might hear the concern that Pharma wouldn’t know how to do business with patients as direct customers (B2C). I have to disagree. OTC is doing business with patients as direct customers. We have specialists inside the industry who basically know how to do business with patients. Certainly, OTC approaches cannot be generally copy-pasted to treatments for more severe diseases. They would have to be further refined and customized. But saying that the industry wouldn’t know at all is simply wrong. B2C models for patient customers do exist.

Reason #5 why the patient is the customer:
Without the patient, there is no business

Let’s do a mind experiment. Imagine a map of stakeholders in healthcare. Then conceptually remove any stakeholder from the equation and think about if and how the contribution of this stakeholder could be replaced or compensated. Would this work? Would the value created continue? Would business continue?


visual of the pharma external stakeholder ecosystem
©2020 Christian Velten

Let’s do this for pharma industry. Let’s remove pharmaceutical enterprises from the system. Would the system continue to work? Yes, sure it would. Perhaps not as good as before. But I am able to imagine that the provision of health & care and related business would – at a lower level – continue.

Let’s do the same for payers (health insurances). It might be a bad system without, and more patients would have to pay themselves for having access. But basically, healthcare provision and business would continue.

Next one. Let’s take physicians out. Again, it would be a much worse system. But others, like nurses and caregivers, might potentially grow into at least partially compensating roles. Somehow the system would continue providing healthcare and there would be business.

We can continue this journey for all stakeholders, and there would always be an alternative. Except one.

The patient.

If you remove the patient from the system, there is no more system. Without the patient, there is no need for healthcare provision, no added value, no business. All other stakeholders are grouping around the patient. The patient is at the center of healthcare provision and any business associated with. So, it is fair to say that the patient is the (ultimate) customer of the whole healthcare system.

Reason #6 why the patient is the customer:
Being the customer is a good thing

Why are people resistant of being a customer in healthcare … who at the same time enjoy being a happy Amazon customer? Is it so different?

I refer back to reason #1 above. And in that context, for me personally, it is even more important being treated as a customer in a situation where I might suffer from being sick and being more vulnerable. I don’t want to be an item processed in the medical center. I don’t want to be a “treatment subject” who is unthinkingly ingesting whatever is placed in front of me.

I personally want to be treated as a human being. I want people to listen to me and to seriously consider my needs and expectations. In other words, as a patient, I personally want and expect to be seen and treated as a customer.

Being a customer is simply fabulous.


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