Challenge, change and champagne moments: just another year in pharma

By Claire Gillis, CEO, VMLY&R Health

2022 has been a year of challenge and change for pharma. But there’s also been some champagne moments that could potentially transform the future of health. As we look ahead to 2023, here’s my take on the past 12 months. 

First let’s look at the challenges. 

Health equity continues to be the biggest challenge facing global health systems, industry and society at large. Equity is about access, which is driven by affordability and our motivation to ensure there’s equality and diversity in all aspects of healthcare.  

Health systems have always been under pressure but the fallout from the pandemic – and its impact on the global economy and health infrastructure – took the challenge to a whole new level in 2022. It’s unlikely to get much easier in 2023.  

The affordability of drugs is massively under the spotlight. As medicine advances and transforms possibilities in the treatment of disease, the escalating cost of innovation has become headline news. For example, the FDA recently approved the world’s first gene therapy for haemophilia B – but its anticipated list price of $3.5 million would make it the most expensive single-use gene therapy in US history. Its manufacturer says the current lifetime cost of treating people with moderate-to-severe haemophilia B can exceed $20 million per person.As a result, it argues its premium-priced gene therapy will actually generate big cost savings as well as major health gains for patients. This example epitomizes industry-wide challenges where the time horizon for ROI drives decision-making to suit the affordability argument. 

Cost-effectiveness analysis has real-world implications in health. For example, in the UK last month, NICE ruled against NHS use of a ground-breaking breast cancer drug that’s cut the risk of death in women with BRCA1 or 2 mutations by almost a third. NICE said the treatment wasn’t cost-effective compared with routine surveillance. Clinicians described the decision as a ‘missed opportunity to help more people remain cancer free and survive breast cancer’.  

Once again, this is a textbook example of the cost/value equation that’s dominating health decision-making, shaping industry thinking and – one way or another – changing lives. 

Availability and access to medicines are also huge challenges for industry. For example, earlier this year, data from PwC showed that more than a million patients are missing out on lifechanging treatments that are approved for use in the UK. When you consider that its research only focused on 13 medicines in 4 disease areas – stroke, asthma, kidney disease and diabetes – it’s clear that, right across the board, patients are being short-changed by the availability and access to treatments. It’s a global problem. And it’s compromising health.  

Another facet of health inequity that the industry has been grappling comes at the other end of the product lifecycle; drug development.  In 2022, the clamour for diversity in clinical trials reached fever pitch. 

The call for better representation in clinical trials isn’t new – it’s been a common refrain for more than half a century. However, the issue has not only grown in prominence this year, there’s also been greater visibility of intent and commitment to take action. Global disparities in patient outcomes across diverse demographics – age, race, ethnicity, gender and socio-economic status – show a clear correlation with disparities in representation across the health ecosystem, beginning with clinical trials.  Data repeatedly shows that trial representation from diverse, ethnic populations consistently falls well short of real-world demographics. The ramifications reveal themselves in poorer health outcomes for those same populations. For example,black women have an 8% lower incidence rate of breast cancer than white women, but a 12% higher mortality. Moreover, this difference is most pronounced in HER2- (HR+/HR) breast cancers. Clinical trials do not represent this and we should be asking ourselves why. 

Inclusion and representation in clinical development is one of the biggest issues of our time. In 2022, the global pharmaceutical industry – along with its partners in patient advocacy groups, biomedical research and health policymaking – have stepped up and are taking action. We’ll no doubt see more of it in 2023. We must. 

Moments to celebrate 

Despite ongoing challenges in a turbulent 2022, the industry has enjoyed some ‘champagne moments’ along the way. One of the biggest highlights has been the huge gains in therapeutic innovation, made possible – in part – by advances in drug development through AI and machine learning. In many diseases, these advances have the potential to transform both clinical practice and patient outcomes. It’s no exaggeration to say that these advances are truly ground-breaking and will change lives. Few other industries can make that claim. 

Some of the biggest leaps have come in cancer. Back in February, on World Cancer Day, I wrote an op-ed outlining ‘reasons to be cheerful’ about the future of cancer care. It raised eyebrows. I make no apologies for having an upbeat outlook on a disease that kills so many people each year. That optimism has been borne out as we’ve moved through the year.  

For example, advances in immuno-oncology and antibody drug conjugates – presented this summer at ASCO and ESMO – will change clinical practice and set new standards of care. Their potential impact of is genuinely astonishing. For instance, neoadjuvant immunotherapy could transform outcomes for patients with hard-to-treat cancers and metastatic disease – raising the remarkable prospect of ‘cures’ for advanced cancers that have, to date, proven untreatable.  At ESMO, data presented from the NICHE-2 study in colorectal cancer and the SWOG study in stage III-IV melanoma showed such impressive results (in terms of major pathological responses and event-free survival) that a moderator described it as “one of the most exciting scientific sessions of any scientific congress in oncology – ever!” That’s a clear highlight and one from which the industry can only build. 

These advances, and many more like them, can rewrite pathways and change the lives of millions of patients worldwide. In some cases, new innovations are eliminating the need for surgery, thereby reducing costs and improving the patient experience.  

Better still, our ability to detect and treat cancer more quickly is being galvanized by the use of AI and machine learning. Digital innovation is reimagining clinical trials, facilitating ‘best match’ algorithms (based on biomarkers) that identify patients with ultra-specific cancer types and quickly match them with the most appropriate treatments. It’s accelerating the development and optimization of personalized medicines. 

These are breakthrough achievements that will propel patient outcomes. And they’re not just happening in cancer, they’re taking shape right across the therapeutic spectrum.  

The big job, of course, is to ensure these innovations are affordable, available and accessible to patients. That folds back into the health equity challenge that’s dominating industry thinking. 

Flipping the script of creativity

Finally, 2022 saw pharma take some big steps forward in its efforts to adapt to the changing environment.  Arguably the biggest change has been in its approach to creativity. Right across the industry – and certainly among many of the clients we work with – brand teams are shifting the balance of creativity and ceding ‘creative control’ to the ultimate end-users: patients. Increasingly, pharma marketers – who have, for years, focused on shaping messages then testing them with target audiences – are flipping the script. They’re partnering with patients, up front and early, and then allowing them to lead the narrative and draft the storyboard. There’s been much talk in recent years about ‘co-creation’ but often that claim has been more rhetoric than reality. That’s changing – and it’s beginning to bear fruit.  

The new approach – which has coincided with society’s growing engagement in health – has taken health creative to new levels and catapulted it onto the world stage. In the past, health has been unfairly dismissed as a ‘creative backwater’ – heavy on regulation, light on imagination. This year, however, everything’s changed. Health advertising is now part of the mainstream and our work is winning prizes all over the world. Better still, health– once considered a no-go zone for consumer creatives – is earning amorous glances from those outside. We’ve transitioned from creative also-rans to become a magnet for creativity. Everyone, it seems, fancies working in health. 

A huge factor in that shift has been our ability to tell stories that change lives and do something meaningful for humanity. That storytelling has undeniably been assisted by the advances we’ve made in our use of data and technology; award-winning campaigns show an industry now in full control of the tools at its disposal. However, I believe that the single biggest driver of our success has been how we’re connecting and partnering with patients throughout the creative process. That open and trusted engagement is helping us develop our real-world understanding of disease – not from a scientific point of view, but through the lens of its impact on everyday life. This, in turn, is unlocking new perspectives on creativity and allowing us to tell meaningful stories that we could never have imagined on our own.  

Pharma’s growing reliance on patient partnerships is one of the most important developments of 2022. In a world where health communications can make life and death difference, patient partnerships are helping us develop campaigns that win the hearts and minds of target audiences – and change lives. If we continue on this trajectory, we’ll be better placed to overcome inevitable challenges in 2023 – and bring about more champagne moments for the good of global health.