Everybody Wins: Elevating the Patient Voice

In this episode of The Syneos Health Podcast Tyler Cowan, VP, Commercial is joined by colleagues from our team in the UK, Dr. Natalia Barkalina, Medical Director and Gareth Powell, Clinical Recruitment and Retention Strategist, to discuss why patient-centered communication is essential to improving clinical trial awareness, recruitment and engagement, particularly for small and mid-size biotech companies competing for patient and investigator attention.

Listen and gain a clear understanding of how integrated, patient-centered communications can help clinical trials cut through the noise, build trust with key audiences and create stronger foundations for commercialization.

This podcast episode also appears on our commercial-focused podcast stream, Conversations on Commercialization. Check it out here.
 

The views expressed in this podcast belong solely to the speakers and do not represent those of their organization. 

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Transcript

SPEAKER_02 0:00

Welcome to the City of Health Podcast. Conversations on commercialization. I'm Tyler Cowan, Vice President of Commercial at City of Health. In this series, my co-host and I are having discussions on how biopharma leaders are rewriting a commercial playbook and what it takes to succeed as commercialization takes on a more strategic role earlier in product lifecycle. We're sharing cross-functional perspectives on the decision shaping commercialization today, from value and access to evidence, stakeholder strategy, and engagement planning. Enjoy this episode. We're glad you're here.

SPEAKER_01 1:00

Thank you, Tyler, for having me today.

SPEAKER_00 1:01

Fantastic to be here. Looking forward to the discussion.

SPEAKER_02 1:04

So for everyone listening, this episode is really going to introduce and discuss the value of how integrated communications can shape the broader ecosystem around clinical programs, especially for small to mid-sized biotech companies seeking credibility, visibility, and engagement. Both Gareth and Natalia have significant experience specifically in this space. I guess I'll start a little more broad and we'll work from there. And really, I'd love to discuss with you and get your inputs on how innovation sort of needs to be included as a foundation right from the get-go.

SPEAKER_00 1:43

So it's a really interesting thing because that when we're talking about um patient engagement, patient recruitment, innovation, we're often looking at things such as fully decentralized and virtual clinical trials. But what we're often overlooking is actually at the very root of this is some of the most basic things we can do, which is involving the patient right at the very start of that process to ensure that all the fantastic things we're doing to make trials more successful, to make patients' lives more uh easier effectively to participate in these trials, to be involved in that. Ultimately it all comes down to are we actually delivering what these individuals need to provide them the opportunity for participation and ultimately what we're going to be producing is relevant to them, it's going to actually meet their desires and their requirements and their needs effectively. And a lot of time that's overlooked in in chasing the that next kind of exciting new product. But that's not to say that a lot of what we were doing originally, I mean, I come from the very b beginning of the patient centricity movement where we're talking about decentralized and virtual clinical trials and that was to be the future. And we're seeing the hybridization of that successfully being managed. And it's you know, we're jumping ahead in leaps and bounds with what we can do now to make trials more accessible and more uh attractive and easier to participate in. But ultimately, we also need to consider not just the next AI tool to uh kind of write our protocols and what have you, but also how do we ensure we're we're making it as easy as we possibly can for that uh individual to participate in the trial to ensure it's a success. But it's not technologically advanced and doesn't recruit effectively.

SPEAKER_02 3:22

No, I I love that. It's one of the things that's been so interesting throughout my 25 plus years in the industry is this idea of being able to actually attract and identify patients for clinical trials. So let's call it 30 years ago, they were large-scale cardiovascular trials, and you know, hypertension wasn't unfortunately difficult to find. But now, as we look as, especially as we've talked about these small and emerging biotechs, where you're talking rare or ultra-orphan medications, actually being able to identify and find patients, communicate, bring them into the trial space is incredibly difficult. In fact, I've worked with a number of clients who have been held up because they just can't fill the trial quickly enough and they get delayed just due to acquiring the required patients they need.

SPEAKER_01 4:11

And you're raising a very important point here, Tyler. I think that we are at a time where biomedical innovation is a very exciting space to play in, but that comes at a cost because in the innovation space, even in indications that are more common, for example, oncology, we end up in a situation where our trial might be competing for the same pool of patients with another sponsor. And this competition is as fierce as competition for uh investigator attention or our expert attention, um, used to be say 10 to 15 years ago. So now we compete for patients in the same way, it's absolutely the same way. So kind of brings me to a different point that maybe we need to think a little bit differently about how we build the bring these clinical trials into the world so that they start grasping that attention as early as possible.

SPEAKER_00 5:06

Try to just off the point of your comment there, Natalia, as well, because obviously working in communications, that idea of engagement is really key. Especially as uh patients now that everyone's got Google and Equivalent for search engine, ultimately a lot of people that'll be their first point of contact. And that can be a really powerful tool for not only identifying these participants, but giving them engaging with them and giving the opportunity to raise awareness of your trial you're trying to recruit these participants into as well. But as you say, with competition, there's lots of different messaging out there, so you ensure that yours is the one which is not only reaching those individuals, but directly engaging with them. And it's something they are interested in.

SPEAKER_01 5:44

Absolutely. And I think today science increasingly more often exists with this within this ecosystem of uh audiences' attention, right? And uh, you know, sometimes when we hear the word ecosystem, many people will think it's just stakeholders, right? Stakeholders who do we talk to. But actually for us, for my team at Seniors, it's a lot more than that. It's uh uh it's the environment that determines whether our clinical trial is understood, but it's trusted, and whether it ultimately gets followership. And uh, yes, investigators and research sites and referral networks and patient advocacy groups and healthcare professionals are an incredibly important part of it. But sometimes it's also they're also less tangible pieces. It's not so much what we're saying, but also what the type of conversations that our audiences are having around the information that we give them. It's what they encounter, it's the confidence that they have in the sponsor, and if they genuinely believe that the trial has the potential to make a difference.

SPEAKER_00 6:55

One of the things which I always found really interesting is is the idea with if they are being, say, an oncology trial, they're being approached for multiple different options, and they see a logo which they recognize or a brand identity which they recognize, that can sometimes be enough to tip it in their favor. So using trusted sources and getting your message across that way, so it's they're going to those locations and they they trust what they're seeing, what they're reading, and they have a good understanding of that can really make a huge difference.

SPEAKER_02 7:21

So, you know, I've spent a line share of my career really around the commercialization. So this is sort of as this has been, let's call it, submitted to the FTA, the Padoof has been granted, and I've largely worked in that space. Obviously, you're earlier on in the decision making, but it's fascinating to me that on the commercialization perspective, you have fierce, largely and almost always, fierce competition for time, for patience, obviously for dollars and return on objective and things like that. And what's fascinating to me is that there is the same level of fierce competition for patients. And so that brings me to something that I absolutely wanted to ask both of you about about, which is you know, you've got the Pfizers, you've got the Gileads, you've got the Genentech Roche, you've got these large Regeneron, you've got these large companies that are well known by patients. So, how do emerging biotech companies build credibility, reputation, and make sure that they're not getting lost in the shuffle when they too are looking for maybe exactly similar patient, but they just don't have the name recognition?

SPEAKER_01 8:29

As customers, we tend to have a certain level of brand loyalty. And once you've established that brand loyalty, I'm going to use commercial terminology there, although I'm not a marketeer, I'm a medic and I work mostly with medical affairs and with clinical teams, but the patterns of our behaviors as individuals are very, very similar. And once you've built trust with a sponsor and you've brought some of those big names up, it's highly likely. And we see that from our customer insights, that as a big organization we have the luxury of access to, we do see that that loyalty tends to stick. And this is actually where we come in because we try smaller to medium-sized companies play in the same field using the same tools that the big pharmaceutical companies take for granted. And uh the uh the nature of what my team does and what gets us out of bed in the morning, we're very proud of that, is uh storytelling. We take uh evidence and we take data and then we break it into pieces when assemble them into stories that are evidence-based, robust, trigorous, and then we get these stories to our audiences at the right point in time so that it nudges somebody out of the behavioral inertia. And that behavioral inertia might be I'm not really I'm a little bit reluctant to see what this new technology is about because I don't think it has the big machinery behind it to, you know what, this is a really exciting science that is rooted in evidence with a highly promising product and an incredibly driven team that has a strong ethos and a strong vision for their solution. I'm actually going to get behind it. And I'm gonna be a little bit uh idealistic about it, but you know, having worked with clinical teams, I think we all know the absolutely uh scathing statistic of eight out of ten clinical trials failing to meet their milestones. And sometimes I challenge my clinical colleagues by saying, yes, absolutely, we've got operational complexity, we've got difficulty finding patients, we've got complex protocols, we've got resource issues, we've got all of that. But how much of it is actually down to the lack of belief? How much, how much is, because we're not willing to problem solve around a technology that we believe in, and we're not seeing ourselves as part of a tribe that advances medical innovation for the benefit of patient lives.

SPEAKER_02 10:59

That's a fascinating stat for me to hear, and certainly everyone hearing this, is that eight out of ten clinical trials failed to meet their milestone. That's a staggering number. If you think about it in the commercialization space, if eight out of ten products failed to meet their revenue targets, that would be a massive stakeholder and shareholder issues. Now, I want to move a little bit further on to what's the best way, what's your best case and your experience tell you about making sure that we embed the patient voice within the clinical trial and within all of the efforts around that.

SPEAKER_00 11:31

Well, I think we can actually go back a little bit, we jump into the idea of excitement, uh, which Tala was touching on, that idea of a value, which we can embed right from the very beginning in that trial development stage right through to the actual commercialization of that product. And then you've got you've already built that kind of uh interest and uh kind of excitement generation around that already. And a lot of that comes to ensuring we're actually meeting the needs and requirements of these individual patients, these participants. And that sense of excitement, I've seen that firsthand from patients speaking to each other on forums on the completion of a phase two, for example, the forthcoming phase three. Because it's meeting what they need and they it was a good experience for them. It meet it's the quality of life measures which are important to them rather than being dictated. What we assume, I think, that is the worst case, is we assume is going to be important for these individuals. Sometimes it's just giving them the opportunity, especially in chronic conditions, it's giving them the opportunity to be able to have a social life again, for example, to make uh their own income or just have more time with their family, for example. A lot of these are key measurements which are important to these individuals rather than say longevity of life or just minimization of symptoms. So a lot of that we can really capture, ideally, by involving patients early in that process, ideally in that in that trial design space, where their voice is gonna ensure that we're putting together the most impactful strategy to make it easier for participation, and ultimately it's gonna be attractive and appealing for participants all the way through that journey. And that also comes back to the idea of that excitement, that accessibility is that's also gonna get onboarded, uh onboarding, I should say, um, by patient advocacy groups and patient support groups for a much wider network as well to amplify your voice and your kind of vision and effectively of your product, what this may achieve. And likewise that will be amplified by the patient's voice on social media, for example, or amongst their their fellowships. It's a little different, I suppose, um in chronic conditions compared to those w which are more unexpected, I'd say. Um this comes back to that idea of brand loyalty, I suppose, as well. Because if you're kind of talking about a soft drink you have a preference for, for example, you're very familiar with um what's on offer. Or likewise I mentioned a search engine Google, for example. Obviously, it's one of my preferred search engines I use on a regular basis. But if you were suddenly uh informed you have a condition and you've had no experience of the internet previously, where would you go first? You're very much reliant on your trusted sources, whether that be a clinician directly engaging with you, or if you were to likewise look for uh again, patient support groups, advocacy networks who are amplifying that message about your potential product. That's where that messaging is really going to resonate with those groups as well.

SPEAKER_02 14:23

I had the opportunity uh to work in hepatocellular and renal carcinoma and you know understood that there's this decision-making cascade, which goes from first this what's called the shock and awe, um, around I've been diagnosed with this disease to your point, Gareth, unexpectedly, and then it's sort of dealing with that reality, and then it shifts to a problem-solving mentality, which is okay, what do I do now? What are my patient advocacy groups? Where do I need to go? What innovative medicines are are out there depending on the condition? So it it's so important, I think, when you talk about, you know, even the role. I mean, again, I I I dislike the term of social media using it here because it's so broad, but there is a very diverse uh amount of capabilities and tools that people have, depending on how you you mentioned a search engine. Some people are quite comfortable with the search engine but don't use AI. Others use AI. So there's a what there's a very disparate uh um set of skills within someone who's by been diagnosed with a chronic or an acute disease and now has the opportunity to or the need to get into clinical trials. What I'm hearing is really that strategic alignment, right, from innovation as a foundation, how do they build, ensure, and reinforce credibility so that they are seen as an innovator and that their trials are accessible to patients, and then carrying through that uh strategically aligned, let's call it, with the patient voice to make sure that as that trial takes hold and takes root, that the patients stay with it and that they're they're involved throughout the throughout the process. I guess, you know, as I start to funnel down, you know, what we're really talking about is how the collaboration that happens between clinical, medical, and then of course further on commercial, and how those three elements work together. I was hoping you guys could share some insights on that piece for the for those listening to the podcast.

SPEAKER_01 16:27

I think we do it really well. Um and I don't want to blow our own trumpet, but I think we have the absolute luxury of working as a joint up organization. We can tap into each other's expertise and find the right person who's going to be the best person to solve a very specific problem. In the end, what happens is that we're all in the same orbit. We work with the same stakeholders, we work with healthcare professionals who might be our primary investigators, there might be our key opinion leaders, there might be physicians who make prescribing decisions, we work with other relevant decision makers who are regulatory organizations, insurance companies, et cetera, et cetera. And we, of course, work with and for patients. And uh so we are in the same audiences, and then the same rules of behavior should apply because people still value the same things. So audiences don't experience us isolated functions, they experience us as one journey. Clinical, of course, brings scientific rigor, it brings the deep understanding of the science itself. Medical insights help shape future clinical strategy, and it's often at this point where the patient perspective starts coming in because medics are historically a lot more, I would say, uh, accepting of having an um external stakeholder come in and not help, not criticize the clinical trial protocol or clinical development program. That's not what they're there to do. They're there to demonstrate and inform us on what is going to deliver true value. Because we still operate within the guardrails of regulatory approvals and processes. You know, our trials have to be designed to a specific endpoint so that we get regulatory approval with the FDA or EMA or any other regulatory organization. But what can we have in the exploratory list that is really going to make the difference to patients? And I think this cross collaboration has already generated like grassroots movements, seeing how regulators are a lot more amenable to look into patient-reported outcomes as high grade endpoints for studies, looking into really the beloved patient perspective of being treated with product A versus product B. And I think that's that's a great example of this collaboration. And of course, commercial, although again, medics and clinics are sometimes skeptical about commercial colleagues, but it is the commercial teams that hold those incredibly valuable insights about how do our audiences interact with information? What do they value? Where do they meet us in this information dissemination journeys? Rather than so, we've historically worked in a sequence, but I think now we're a lot more amenable to learning from each other, of course, within the principles of ethics and the guardrails that we need to have so that they might maintain the absolute integrity in bringing innovation to real life. But I think we're a lot more receptive in having those conversations and ultimately benefiting from each other's expertise.

SPEAKER_02 19:31

Gareth, any anything to add there?

SPEAKER_00 19:33

I think the only thing which came to mind really is, and apologies for me thinking about uh the earlier topic, is uh a couple of things about where we consider um patients being an individual per se. When ultimately a lot of the time it is a joint decision whether to participate in a clinical trial or just in their day-to-day living and quality of life, for example. Especially when we're talking about um childcare management, for example, or or uh managing their own condition. A lot of the time it's it's not just one individual, it could be family, friends, children involved in that process as a whole. So engaging with that unit effectively can be incredibly important above just saying, oh, we're looking for this very specific demographic which fits our patient type. You need to think above and beyond that effectively. And that's where that communication strategy is so important, so vital, I'd say.

SPEAKER_02 20:27

Yeah, I I I love that, especially when you're talking about pediatric indications where now you're pulling in parents who are principal decision makers, and this is not only just their child who may be suffering with the disease, but they're integral to getting into the hospital or being involved. It is uh important to remember that they're also people that have their whole life and a whole ecosystem of their own within their own their own families and what have you. So, where do you see the potential to be holistic and integrated? Is there an opportunity to be more integrated earlier on that will actually benefit not just the clinical trial but the commercial outcomes? And I don't want to make commercial a dirty word here, I want to be careful because at the end of the day, the the whole idea of being in commercial is that you get these out to patients, so that's a positive. And then maybe on the dovetailing out of that integration, what does a fully integrated, patient-integrated ecosystem-shaped model look like in the future?

SPEAKER_01 21:24

I think we should absolutely continue learning from each other. And uh I totally agree with you, Tyler. I don't think we should be painting one function with a pharmaceutical company uh with uh uh as a villain, uh because uh, like I said, we all operate in the same landscape and we all have seen the natural transition of our uh behavioral change led engagement principles that classically sit with commercial intermedical affairs, where they are now absolutely at home. Because to build the uh belief in the scientific principles and to create that innovation on which uh scientists. Foundation will flourish, which is effectively what we do in a medical launch. You need to be playing with the same principles. And I think now is the time to start thinking about how do we bring clinical trials to the world in the same way that they already grasp attention of our audiences even before the first patient is in. Because when the trial is launched, it's probably too late to start building awareness in the trial. We all know the incredibly fast-moving landscape we operate in, it's unprecedented speed of information exchange. It's so difficult to cut through the noise. So those foundations need to be laid a lot earlier than we normally do that. So I totally agree. We need to continue learning from each other. And uh when it comes to your second part of uh what would the what would the blue sky thinking look like? I think it's uh um obviously uh clinical development programs are complicated, operationally complicated processes with uh um variety of milestones that we need to hit. But I think the next evolution is going to be when we start thinking, the next step of evolution is gonna be when we start thinking about them not as a uh a sequence of milestones, but as a human journey.

SPEAKER_00 23:23

Yeah, I'd definitely add to that, Natara. It's the idea of um you're building up champions of your product right from the very beginning, whether that be a patient, their care partner, whoever it may be, or likewise even a physician, you know, it's someone who's actually involved in that as a a either as the participating site and that site team or potentially a referral network. And we're looking at exploring kind of our engagement strategies above and beyond that with digital advertising, for example, but equally targeting uh or at least engaging with is probably a better word, um, is these HTP networks, uh the uh conferences and equivalent, building awareness of this upcoming trial. And again, that idea of building that excitement for this, so you be you that awareness converting into excitement and and ultimately desire. Because what we're trying to do is meet that unmet need. And a lot of these individuals working in um medical aren't necessarily doing it for the money. Some of them will have good intentions as well, of course. Uh probably the majority, certainly. Um and they want likewise, especially the specialists, want to give the opportunity to their patients to gain access to these new and novel medications. And when we're speaking about uh novel as well, a lot of the med tech space, especially where it's driven by patients with their own unmet needs, developing these products specifically for that, that's an area of of real kind of innovation we're seeing, kind of patient-delivered patient um patient-developed, patient-delivered as well. So we're trying to capture that mindset throughout, I'd say.

SPEAKER_02 24:54

Gareth, you've you've used the word excitement a few times here, and I think I I really want to double-click on that. Physicians almost always got into that job because they genuinely want to change patients' lives and improve patient outcomes. The only reason I'm in this business is that I get to impact patients positively, and I when I lay my head down at night, I feel great about that. And I know that that is echoed by both of you here, certainly within your roles. I want to close out with that idea of this excitement around identifying patients, around integrating solutions, around starting to think strategically early on between stakeholders that may impact to your term, Dr. Barcalina, around the patient journey and how that patient and their family, as Gareth mentioned, goes through this with them. You know, we talked about pediatrics. We certainly we see this in oncology. Someone's diagnosed with non-small cell lung cancer, their spouse, their children, there's other people involved that are part of kind of that patient's ecosystem, and then ensuring that, you know, and I do believe this wholeheartedly, that when a company like Cineos looks after the clinical trial from the get-go and does a great job, almost always those companies have future products, and you've started to create a narrative around your company and the way you design clinical trials and the patients' experience you I do think that matters and certainly matters for HCPs who have been involved as a principal investigator or what have you within that clinical trial. Um, they're working with you to help find identify patients because the reality is there will be these diagnoses, and it's um our role in concert with our customers to make sure that we can get the patients the correct opportunities that we can through clinical trials. So I really want to thank both of you for the time around this conversation. Dr. Barcalina is certainly available for Europe or otherwise. Gareth, as well, you can tell by his New Jersey accent that he's also in the UK. But we are here to answer any questions. Um, and I want to thank everyone listening and both uh Gareth and Dr. Barcalina for your commitment to this and look forward to future conversations within the program. That's it for this episode of the Sydney O's Health Podcast: Conversations on Commercialization. Subscribe wherever you get your podcast so you never miss an episode. If there's a topic you'd like us to explore, send us a message at podcast at Synioshealth.com. For more actionable, future focused life science insights, visit the insights hub at cineoshealth.com.