The gap between drug efficacy in clinical trials and drug effectiveness in the real world has been a conundrum in pharma for years. Sanofi believes one of the keys to closing that gap is patient behavior. So it's created a behavioral science advisory board to beef up its knowledge and practice, and it's hired Dr. Bernard Hamelin as head of medical evidence generation to manage its implementation.
Recently, the Paris-based pharma held a press briefing to talk about the importance of behavioral science and Sanofi’s progress in the field. As Sanofi noted in the session, while 50% of health outcomes are determined by patient behavior, most physicians aren’t well-trained to deal with that part of treatment.
What "we’re trying to do within the context of patient solutions is think about when we have products that are really good under ideal circumstances but there may be a gap under real-world circumstances, how can we bridge that gap to make sure patients are getting the most out of our products?” Dr. Anne Beal, Sanofi chief patient officer, said during the session.
Sanofi’s two-pronged approach to the problem is first to gather evidence and research to understand patient behaviors, and then to use that information to build interventions and programs for those patients.
Hamelin said, in an interview after the session, that the steps Sanofi is taking are the first steps in a transformation to build up the skills and capabilities needed to inform solutions at the local level, where it is most relevant.
One reason this kind of patient behavioral data hasn’t been used widely in pharma yet is that it hasn't been available. But new digital sources of structured and unstructured behavioral data, along with new platforms and analytics, now allow companies to better understand and inform patient treatment and adherence. Sanofi is also working with partners who do collect and analyze those different types of nonclinical data.
Evidation Health, which Sanofi-Genzyme BioVentures invested $10 million in earlier this year, is one of those partners. It gathers real-life data from patients to help companies quantify outcomes, and one of the projects it's working on with Sanofi is understanding medication adherence in diabetes patients.
Through its behavioral research, Evidation found, for instance, that if people gain weight after they first start taking diabetes drugs, they’re more likely to drop the medication. By recognizing that, and then tracking patients’ weight, activity and adherence through pharmacy claims data, Evidation believes it can help physicians see the signals before patients drop treatment, and then they can possibly intervene.
“We’re trying to collect data that’s outside the clinical system. Historically, the clinical data might include claims data, electronic medical records, maybe genotypes, lab tests, etc. But what we’re trying to collect are things that the healthcare system does not traditionally see. It could be location data, it could be steps, sleep patterns or social interactions,” said Christine Lemke, Evidation’s co-founder and president, adding that the data is collected directly from patients with their consent.
Sanofi is not alone in its patient behavior quest. Other big pharmas, including Johnson & Johnson, Pfizer and Merck, are building or have already built similar capabilities around behavioral health, Hamelin said.