Winds of change in healthcare

COVID-19 is impacting the world in ways we could not have imagined only a few months ago, and our healthcare systems are bearing the brunt of it. Alongside the huge strain and increased pressure that the virus itself has placed on services; it has also pushed forward some wider and potentially lasting changes. Historically, we’d be forgiven for thinking our healthcare systems are slow to adapt to change, or to embrace new ways of working – we’ve often been told ‘Pharma/Healthcare can’t do agile’. However, during this crisis we have seen exactly that, with both responding in agile and inspired ways. It got us thinking: is this the trigger that the healthcare sector has needed to adapt, how might these behaviours stick and how might pharmaceutical companies adjust?

What is happening to consultations?

1 / The rise of virtual consultations

Previously virtual appointments sat within the realm of primary care, and even then, they were infrequent – only 1% of GP appointments were previously carried out by video.¹ With recent NHSE directives advising thousands of clinics to switch to remote consultations,² suddenly our GP services and specialist consultations have adapted and are using video call appointments on a regular basis.

2 / The implications of fewer consultations

People are becoming averse to visiting their doctor or hospital for fear of being unnecessarily exposed to COVID-19. In response, we are seeing lower levels of presentation and thus diagnosis of numerous conditions. This is a concern highlighted by Oncologist Professor Karol Sikora – “In a usual April, we would normally see around 30,000 people diagnosed with cancer. I would be surprised if that number reaches 5,000 this month”.³

Alongside changing patient behaviours, the NHS were quick to introduce guidelines to reduce the strain on GP surgeries through a reduced number of consultations, including the deferral of routine medication reviews, deferral of annual patient reviews and health checks for over 75s.⁴

How are prescribing habits being impacted?

Reduced face-to-face contact with patients may lead to a reprioritisation of treatment attributes. We are already starting to see prescribing habits change in favour of treatments that require less HCP time and contact, thereby promoting oral/sub-cut administration, long-acting formulations and those that require reduced monitoring. These changes are not only being driven by HCP behaviour and patient request, but also being supported by NHS directives and national guidance – as evidenced in addiction services, where patients are being transferred on to take home doses and there is new guidance on what to initiate new patients on to as a first line treatment.⁵

Alongside this reprioritisation of treatment attributes, an increase in late presenters and decrease in preventative screening will shift HCP caseloads in terms of severity. As a result, we are likely to see an uplift in prescribing of treatments for more ‘advanced’ stages of conditions.

Will these changes stick?

As change has been rapid, it will be key to understand the extent to which any changes made will be upheld in the coming months and years. If changes to consultations and prescribing have merely been a knee jerk response to the pandemic, when emotions subside and systems return to ‘normal’, will the changed behaviours remain? Which parts will become ingrained? Which parts will our short term memories quickly forget and which parts will have a detrimental ongoing impact on the healthcare system?

What does this mean for the pharmaceutical industry?

The pandemic has not merely been a pause in the evolution of healthcare services and patient management. As pharma engages with HCPs going forward, they may be entering into an evolved healthcare landscape, which will mean more than just a restart of previous initiatives.

It will be key that the pharma industry understands how services, the landscape and behaviours have changed over this period in order to support HCPs and patients going forward. Whether it’s helping them to navigate online consultations, digital health solutions, or adapting to their evolved decision frameworks.

Equally important, will be understanding the extent to which these changes to behaviours and services will remain intact. By listening to what is working and what is not sooner rather than later, pharmaceutical companies can begin to understand what changes are likely to continue. Adopting a customer and patient centric appraisal of the market will enable pharmaceutical companies to understand how they should adapt and when they need to act.

To find out how we can help you understand the role your company can play in the evolving healthcare system, get in touch.

References:

¹ https://www.theguardian.com/world/2020/mar/06/gps-told-to-switch-to-remote-consultations-to-combat-covid-19

² https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/preparedness-letter-primary-care-19-march-2020.pdf

³ https://twitter.com/ProfKarolSikora/status/1253003690816012289

⁴ https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/preparedness-letter-primary-care-19-march-2020.pdf

⁵ https://www.gov.uk/government/publications/covid-19-guidance-for-commissioners-and-providers-of-services-for-people-who-use-drugs-or-alcohol/covid-19-guidance-for-commissioners-and-providers-of-services-for-people-who-use-drugs-or-alcohol

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