Smart Metering in the Energy and Utilities Sector (Executive Presentation)

Table of Contents

• CHAPTER 1 EXECUTIVE SUMMARY
  • Scope of the report
  • Key findings
• CHAPTER 2 INTRODUCTION TO PATIENT EMPOWERMENT
  • What is patient power?
  • How patient power is measured
  • Factors influencing patient empowerment
    • Increased access to information
      • The internet is an important tool for patient empowerment
      • Direct-to-consumer advertising
    • Healthcare systems: US versus EU
      • In the US there is an increasing out-of-pocket cost for the patients
      • Cost-containment measures in the EU are likely to shift the cost of healthcare to the patient
    • Differences in patient empowerment between the US and the EU
    • The nature of the disease
      • Life-threatening diseases with poor prognosis have higher prominence
      • Chronic non-urgent conditions affecting mostly older populations attract less public sympathy
      • Social implications of the disease are gaining importance
      • Rare and genetic diseases
      • Stigma has a dampening effect on patient power
    • The changing patient-physician relationship
    • How do these factors influence patient empowerment
      • Effect on patients asking for prescription of particular treatments
  • Overall trends in patient power
• CHAPTER 3 PATIENT ADVOCACY GROUPS
  • What are patient advocacy groups and what do they do?
    • Patient education
    • Support for patients and caregivers
    • Fundraising
    • Lobbying
    • Patient representatives sit on boards of decision-making bodies
    • Characteristics of successful of PAGs
  • Empowered patients can change healthcare outcomes
    • Equal access to drugs
      • HIV/AIDS patients are very vocal and have achieved wider access to drugs
      • Postcode prescribing in the UK is leading to unfairness in access to drugs
    • Influence on reimbursement of expensive drugs
      • Multiple sclerosis patients in the UK have achieved reimbursement of disease-modifying therapies through risk-sharing schemes
      • NICE' s refusal to reimburse acetylcholine esterase inhibitors for mild Alzheimer' s disease has lead to legal action
      • Can empowered patients achieve reimbursement of lifestyle drugs?
      • Lobbying for reimbursement of costly therapies will remain one of the priorities of PAGs
    • More efficient clinical trial recruitment and design
      • PAGs' websites can help disseminate information about clinical trials
      • Recruitment of subjects for clinical trials involving rare diseases is particularly challenging
      • Patient feedback on post-marketed drugs can lead to faster identification of previously unnoticed safety problems
      • Communicating results of clinical trials to the public through PAGs can reassure the patients and build trust
    • Faster approval times for drugs
      • HIV/AIDS activists were instrumental in the establishment of expanded access and expedited approval programs in the US
      • Empowered breast cancer patients won access to Herceptin for early breast cancer in record time in the UK
      • Early access to drugs is not without risks for both pharmaceutical companies and patients
    • Increased funding for research
    • Improved patient compliance
      • Discontinuation of obesity therapy could be solved through better patient education
      • Some causes of discontinuation of anti-psychotic drugs could be tackled through patient education
    • Empowered patients can lead to increased prescription rates and sales
  • Empowered patients can change healthcare outcomes in a way that is beneficial for both patients and drug producers
    • Case studies - outcomes beneficial for patients and the pharmaceutical industry
      • Herceptin and NICE in the UK
      • Disease-modifying agents for multiple sclerosis - risk-sharing scheme
      • Money-back scheme for Velcade for multiple myeloma
  • Activities of patient advocacy groups can have a negative impact on pharmaceutical companies
    • Threats - lowering drug prices
    • Case studies of damaging relationship with PAGs
      • Abbott' s Norvir for HIV/AIDS
      • Schering-Plough' s Rebetron for hepatitis C
    • Negative publicity can damage the reputation and public perception of pharmaceutical companies but can also impact sales
  • Working with patient advocacy groups - how to achieve a win-win situation
    • Effective communication and exchange of information is crucial
      • Involvement of pharmaceutical companies in PAGs' disease awareness campaigns
      • PAGs can have a valuable input into pharmaceutical companies' disease and drug websites
      • Patients can have a valuable input into clinical trial design
      • Listening to patients' needs can lead to the optimization of treatments and better compliance
    • Co-ordinating activities
    • Nurturing the relationship
      • Dedicated patient advocacy group liaison personnel
      • Act early and think long term
      • Equal and independent partners
    • Sponsorship
    • Advantages of a patient-centric approach
    • The relationship between PAGs and pharmaceutical companies is under increased scrutiny
      • Disclosure of funding is crucial in order to maintain transparency
      • Tightening of regulations is used to ensure adherence to ethical codes of conduct
    • Communication with PAGs can improve company' s public image with the patients
    • Ideal PAG partner for collaboration with pharmaceutical companies
• CHAPTER 4 MARKETING STRATEGIES IN A PATIENT-FOCUSED AGE
  • Shift towards consumer-focused healthcare
  • The internet as a marketing channel
  • DTC advertising
    • Not all therapy areas are suitable for DTC advertising
    • Brand versus disease awareness
    • Communication of medical information through PAGs is the only route for disseminating drug specific information in Europe
• CHAPTER 5 THE FUTURE OF PATIENT EMPOWERMENT
  • Drivers and resistors of patient empowerment in the future
    • Patients' desire to inform themselves and the availability of information through internet will continue to drive patient power
    • The aging population
    • Information overload - quality marks are needed
    • The cost-containment pressure contributes to rising patient power
      • In Europe cost-containment pressures will become more intense
      • Escalating costs of healthcare will push payers to limit availability of drugs
  • Direct-to-consumer advertising - any changes ahead?
  • Relationship between PAGs and the pharmaceutical industry will be closely watched
  • Cases to watch
    • Avastin and Erbitux are not approved for colorectal cancer
    • Court challenge for NICE' s ruling over acetylcholine esterase inhibitors for mild Alzheimer' s disease
    • NICE has blocked Macugen, and Lucentis is approved with restrictions
    • FDA' s decision not to approve prostate cancer drug Provenge angered patients
    • Patients are voicing their opinions regarding the legislation surrounding biosimilars
  • Consolidation of PAGs
    • Consolidation and collaboration have advantages but also challenges
• CHAPTER 6 BIBLIOGRAPHY
  • Publications and online articles
  • Datamonitor resources
  • Websites
• GLOSSARY
  • List of Figures
    • Figure 1: Drivers and resistors of patient empowerment
    • Figure 2: Internet penetration in the seven major markets
    • Figure 3: Disease characteristics influence the level of patient empowerment
    • Figure 4: Trends in patient power
    • Figure 5: Characteristics of a successful patient advocacy group
    • Figure 6: Empowered patients can change healthcare outcomes
    • Figure 7: Attributes of an ideal patient advocacy group for partnering with pharmaceutical companies
    • Figure 8: Drivers and resistors of patient power in the future