Inside the Patient Mind: Patient Psychology and Its Impact on Pharma

In this episode of The Patient Experience Podcast, Bob Miglani, Founder & CEO of Hoot, sits down with Dr. Sukumar, President & CEO of OSG, for a candid conversation about what is really happening inside the minds of patients today.

Thirty years after the first DTC drug ads aired, patients are drowning in information. Between AI, social media influencers, Reddit threads, and a flood of well-meaning advice from family, the result is not clarity. It is a patient confusion crisis. Bob and Dr. Sukumar dig into why more information has led to more hesitation, why trust has become the single biggest barrier to treatment initiation and adherence, and why the people patients trust most are their doctors and other patients who share their lived experience.

Dr. Sukumar shares a provocative idea: stop calling them patients and start building fans. Drawing on the fandom model behind K-pop and K-drama, he makes the case for pharma to engage people as advocates for their own treatment, and to understand the friction between a patient's beliefs and the motivations that move them forward.

Whether you are a brand leader, marketer, MSL, or anyone working in pharma, hospitals, or healthcare, this conversation will change how you think about reaching the people you serve.

The Patient Experience Podcast explores how pharma patient services leaders and patient-facing teams can navigate a growing patient confusion crisis as therapies become more complex and the industry moves Direct to Patient. Hosted by Jason Grossman, a 25-year pharma commercial, patient services, and marketing executive, and Bob Miglani, former Pfizer leader and CEO of Hoot, each episode delivers practical insights leaders can use and reps can apply in the field to better educate patients, build trust, and drive better outcomes.

New episodes are recorded live on Bob Miglani’s LinkedIn and published across major podcast platforms.

Follow the hosts:
Bob Miglani on LinkedIn
Jason Grossman on LinkedIn

Learn more at GetHoot.com.

Transcript

SPEAKER_00 0:00

This is Bob Miglani. Hello, everyone. How are you? We are live. This is Bob Miglani. And I'm delighted to be with you this afternoon, Thursday, June 25th. Everyone watching the World Cup, you're having a good time watching FIFA the World Cup. It's phenomenal. It's great. I love it. With the Knicks uh winning the championship in the NBA, Sukumar and I are super delighted to be with you today. If you're in pharma, you need to pay attention. If you're in hospitals, if you engage in health care, you need to listen to this very important conversation today. I'm having with none other than Dr. Sukumar. Sukumar, how are you? Welcome.

SPEAKER_01 0:40

Very good. Thank you, Bob. Thank you for having me.

SPEAKER_00 0:42

Of course, of course. So what we're going to talk about, Sukumar, today, is inside the patient mind. Patients, as we talk about, are our customers, are the people we serve ultimately. We serve them through the work we do, both of us do, Sukumar, in pharma, in hospitals, in clinics, with governments across the nation. And one of the things that's really important to understand is people change. Patients have changed. So what I want to do is today, I want to talk, especially, so pay attention if you're a brand leader, if you're a marketer in pharma, if you're in commercial operations, if you're doing medical uh uh information, if you're doing clinical trials, if you're in pharma, you need to pay attention to what Dr. Sukumar is going to share with us because he has decades of insights. And I want to first have give him an opportunity to introduce himself. Again, my name is Bob Biglani. I'm the founder and CEO of Hoot. I spent 20 years, um, a little bit over 20 years at Pfizer, uh, one of the largest pharma companies in the world in New York City. I also spent a lot of time in doctor's offices nationwide working with clinics and patients, uh, hundreds and hundreds of, you know, thousands of patients and lots of lots of different clinics, pharma companies, and healthcare organizations. So that's kind of what I do. So, Von, would you mind introducing yourself to uh other rest of us, please?

SPEAKER_01 2:12

Sure Bob, thank first thank you for having me here. And obviously, uh, this is a very important topic, Bob, uh, that you're talking about. And and people with various kinds of ailments. You know, we call them patients, but I think we should call them people with with ailments, and it's a very important topic to help drive uh and understand their mindsets, both current and future, and how you might change them and how you might get them uh to be more engaged. Uh, my name is Sukumar, I'm president CEO for a company called OSG. Um, we do a lot of work in areas like uh broadly called as customer insights. We also analyze a lot of data and then more importantly, leverage technology to engage and to drive engagement with humans. And so it's all about uh people, it's all about customers, consumers. Uh and in your instance, you're very much about healthcare and the minds of the people uh who take the medications that pharma companies put out. Uh, I've been an academic, I'm a PhD in marketing uh and um uh analytics. Uh post my PhD, I spent uh close to 15 years in academia, teaching at a number of universities, like University of Houston and Rice, um, as well as uh my last position at Rutgers. I also served in between as an academic dean for a global business school. Uh after I left academia and administration, I decided I decided to found a company uh called OSG. And here, one of the things we do is to help understand what drives the behaviors of individuals. So we learn more about how to nudge them and how to change those behaviors. Again, thank you very much for having me here. Delighted to be here. Uh, and as you pointed out, we work quite extensively with pharmaceutical companies as well as medical devices and the healthcare organization in general.

SPEAKER_00 4:14

Wonderful. Thank you, Sukamar. Uh, you're the right person to talk right now because the world is changing very, very quickly. Um, we know that one pharma is launching more specialty care products than ever before. Uh, immunology, oncology, rare disease, ultra-rare diseases, med devices, everything today is complex. So let's talk about what's really changed over the last couple of years. Let's let's talk, let's say, decade away. What has changed, Sugumar, from the patient perspective? What were patients, people with lived experiences, right? As we say, it's not, you know, patients is maybe the wrong term sometimes, but we just let's just use the word patient or person with lived experience. What was it like for them 10 years ago? And what is it like now? And how has it changed? How have how have they changed as a result of the last 10 years, would you say? What are the some of the two or three insights there? What have you seen?

SPEAKER_01 5:14

Yeah, no, I I think, you know, I uh I recall uh early 90s when the first DTC ads came out for a pharma uh product in the US uh for the first time. Not sure if you remember Seldane and it was the very first one where individuals could or consumers could actually hear about a prescription drug being advertised on live linear television. Fast forward 30 years now, and what we have uh is mammoths, mammoth amounts of information about medications, new medications, and even before the medications can actually hit post-clinical trials, actually hit the market. And consumers uh live in a in a digital frenzy where that information is available to them on their mobile devices, on their fingertips. And we live in a world where there is both information and misinformation. So if I were to characterize what has has changed over the last 10 years, is tremendous amount of information, number one, number two, extensive use of the digital platform, the mobile platform. It's almost become another organ of our body. Yes. Uh, and therefore we live and and wake and sleep with that. And then the third thing is that the type of information that gets presented to us, the amount of information and the content of the information is so varied. You know, you can get truth and not so truth. You can get lots and a lot little, you can get uh brevity in that information that might make you imagine the worst, or you might get such long answers that you might have to sit down and put your hands on your forehead and read it and wonder what am I getting out of it?

unknown 7:22

Right, right.

SPEAKER_01 7:24

Um so it there is there is no scarcity of that information. And then the last thing I want to say is that we have AI some of this information, and we all know that AI is not always perfect. You know, 10 years ago we had to train uh Watson in order to be able to access QA's, and now uh it's just readily available to every individual on the planet Earth. Um, and that information is not always accurate. So I'll pause there. I hope that makes sense.

SPEAKER_00 7:56

Yeah, no, I think I I I I love I think I agree with all of your points, and and I think what I'm seeing is exactly what you said is a massive amount of confusion. We call it the patient confusion crisis. And as you say, it's fueled by not only AI where there's you're you're just overwhelmed. Like, what am I supposed to do with this? Um, and then you know, you hesitate. Patients hesitate a lot more because they have too much information. And then the other big, big impact, I I gotta be honest with you, for me at least, has been social media. Social media influencers uh shape a lot of the healthcare conversations today more than ever. And I remember uh speaking years ago to a friend of mine, he was the chief scientific officer at PepsiCo, Dr. Mahmoud Khan, and I said, Mahmoud, what you know, in your world of food, uh what is the biggest impact shaping food? And he said to me, Food babe. I'm like, what's food babe? And it was a blogger, she's a blogger, and I forgot her name right now, but I'm speaking of her name, but she is a force in the food business, and she forced the the reduction of dyes and colors in cereals and frosted flakes and cherios and and fruit loops and all that. And so she's a big driver. So social media influencers are a massive, massive impact and influencing the patient mind today. You know, as a patient, as a person with with with with conditions myself, I follow Brian Johnson. Some people don't like him, you know, and he's this longevity guy who's trying to do things. So my point is that today the influence, you're right, is it's and it's also very confusing and conflicting. The information we get from the the digital world, if you will, Reddit, AI, social media is very confusing to patients, more so than ever. And then the so I agree with you 100% there. The other part I will kind of you know weigh in here a little bit from our experience, what we've seen patient goes into the clinic, they see the doctor, the doctor says you've got this condition, you know, God forbid it's you know, it's an oncology, you know, it's a condition, it's just cancer. Okay. Patient is completely overwhelmed with emotion. It's not logical, it's not reasonable, it is emotion. And their eyes glaze over, they're just and the pay and the doctor is trying to educate them about something. Then they go home and they tell their spouse or their family members and so on, and everybody is trying to influence. Your aunt, your uncle, your mom, your dad, your children are trying to influence that patient. And the patient not only has to deal with you know all the paperwork and the doctors and the verification of benefits, then they AI it and their social media, and then the slew of uncles and aunts and relatives who are forcing information in their head. Don't do that. Do this. Somebody did this, this happens when you do that. So there's a massive confusion crisis because we post on WhatsApp and text messages, and that's a that's really causing a major problem. So, what we see is patient, you know, pharma companies. I don't know if you're telling me about what you're seeing in the terms of a business change in pharma today. How is this patient confusion crisis, the patient, the evolution of the patient? How is that shaping the pharma business strategies? You work with lots of pharma companies, so you you have your your ear to the ground. How do you see that playing out? This confusion problem. Are they coming to you more and saying, hey, Tumar, help us figure this out? Like, what are you what are you seeing? Tell us.

SPEAKER_01 11:43

Yeah, no, Bob, I think um, you know, it's a great point you make there. Um, Doria Pharma is is beginning to make that move towards consumer-friendly information. And um, I think there's been a little bit of uh, what should I say, uh, you know, the package inserts that kept kept getting longer and longer and longer. And while uh we, you know, pharma still kind of continues to test those and and insert those in the packages, uh, they've also now begun to recognize that uh all these other channels that you're talking about, the influencer, the capture on TikTok, the you know, yeah, channel of the live television, uh, all of these have become important. Uh, not just the paper insert in the office uh of the physician, uh, but all of these have become extremely important and that the digital transformation is so critical in making sure that, and you know, it's actually added a lot of burden. Uh, it's added more burden that you have to continuously evaluate what content is getting disseminated and how the uh you know uh AEOs and other engines are picking up information about your medication and the competing uh drugs that are in the market. Yeah. How do you assess that? How do you evaluate that? So the crisis and the headache around information, call it information asymmetry, information confusion, information diffusion, all of these aspects has kind of increased, and pharma is beginning to recognize it. Uh, but I don't think, I don't believe that they have a perfect solution for how to fix it.

SPEAKER_00 13:38

Yeah, yeah. And I think that's where the dilemma is. Like, you know, is like how do we address this problem? We know our abandonment rate is 40% of our product. We know patients drop off on month seven, right? We know that um the six different infusions or the three different infusions uh a patient has to dig, uh, they lose some of those uh in the um uh you know, they lose some of that. So uh they they they they lose patients. They know that. They know that this happens. And often the reaction or the strategy Sukumar has been, well, let's get a call center and to call patients. Does that really work today? I mean, what's your what are you seeing? Like do pe are are patients picking up the phone? When you do research, how how are you doing research? How are you getting insights? Tell us about that.

SPEAKER_01 14:32

How do you think so? So great, great question. One thing is uh I'll I'll break it up into two or three different responses, right? Um there's sort of a the call center has to be staffed with the right kind of people in order to answer the questions. Yes, the burden on that is huge, the cost associated with that is huge. Uh, so there's a lean toward AI, and then there's a problem in AI, people are getting frustrated. They don't want to call in somewhere to get an answer and uh be in a position to you know just get answers that are incomplete, inappropriate, or whatever the case might be. So uh I think there's a little bit of backlash along that channel. Now you asked a different question about how do we find the crew and interact uh with individuals who might have very specific ailments, right? So it's it's no longer uh, you know, there are patient panels, there are groups where we can actually go find people and have a good conversation with them. There are advocacy groups, um, there are doctors who would um within the laws be able to help us find those individuals with who we speak. Now we do speak with a lot of patients, uh, both from you know, just like we are having a dialogue here, we would have those dialogues with with individuals, but we also do very structured quantitative service and we have a good sense for what's going on in people's minds, right? Uh depending on the severity of the of the ailment, there's everything from I'm concerned, I don't know how to live my life, to um there's so much of noise, I don't know who to believe. And I don't know how to address that. And I myself I have certain beliefs as an individual who has a particular ailment. I have some beliefs today, right? But I don't know whether I should take that medication. I think a classic example is there's so much of noise even with GLP ones today, um, that you don't know what to believe. There is, you know, there was a lot of noise that was made about GLP ones talking about uh retinal uh issues, uh but you know, we we lose the context around what that is or how that that happened, etc. And um so I think we have to be very cautious. I'm I'm being very cautious not to defer to specific drugs here on this conversation, but there is so much of noise, Bob, that people are even more confused, their caregivers are even more confused, yes, uh, and you don't know who to trust. And the only person you want to trust is your doctor, and the doctor has very limited amount of time for you because they are overwhelmed with the volume of patients that they see. So, how do you actually solve for this problem? Um, and it's very important because you have to solve this problem in a in a day and age of information overload.

SPEAKER_00 17:43

That's right. So I think you said the word that I think I want to really highlight for a second. And I just want to make sure that we put it up on the comment here, and I'm gonna just put it in the comment. It's called trust. We're seeing a massive uh trust gap. And I think you said it absolutely 100% right. Patients, people with lived experiences who will have a disease don't know who to trust and what information to trust. And so this is this is and and the doctor and the doctors don't have time. And so it's not just about the channel, right? It's not just about how you're reaching patients today, right? It's which is the digital, which is the phone, a text message rather than a phone call, perhaps. Um, you know, but it's it's it's important who's sending the message. And I guess the so doc the patients trust doctors more than they do anyone else. Okay. They also trust another patient with a lived experience. So that's really important, right? So they trust them. But the question becomes do they trust pharma? When I was at Pfizer, this was there was a massive trust problem in the pharmaceutical industry. This is you know, some years ago, where you know, consumers and patients didn't trust pharma, and it was this big backlash against pharma. I don't know if it's still there. So, come on, what do you think? Is there, I mean, you know, it does when far when a pharma company says, you know, Miss Patient, we're going to educate you about this problem. Do you think they trust the pharmaceutical industry?

SPEAKER_01 19:23

Well, that that's that's an excellent question. I think um I'd say there are segments of people who trust. Yeah. And there are segments of people who begin to question whether uh it has some ill effects. So let's say and I think about it, um a small risky event that does happen causes mistrust, but but more and more patients are or in or individuals with experiences are willing to listen if it means something that comes from a trusted source, as you pointed out. Uh, if it comes from a trusted source, they're willing to learn about it. It has to be very objective for them. Now uh that is very critical for them to be willing to um, you know, I'm I'm working right now on a particular rare disease, and individuals with this rare disease are looking to, you know, they're willing to switch medications if it happens to be a trusted source from who they get the information about the new drug. Because it's a very rare disease, it's it's a it's a very critical ailment, and you cannot live this for even a short amount of time not knowing whether the medication is in you and whether it's working. Yeah, if I'm already using something I uh and it's working for me, I have a strong belief that it's working for me, and my willingness to switch to something that you claim is working is sometimes under suspicion. Yes, and therefore the it's only a trusted source and it's only their own belief systems that need to be confirmed before they can be nudged to take a new medication. So I don't think I've given you a one size fits all answer there, Bob.

SPEAKER_00 21:27

But um, but it's a thoughtful answer. No, it's a thoughtful answer, so I I think you're right. I think um if there's a lot of nuances in trust and understanding the messages. I mean, let's, you know, let's let's let's let's shift a little bit um what as we're talking about trust into clinical trials, right? Clinical trials, there's a big trust gap here, right? We know in clinical trials, a pharmaceutical industry has a problem with recruiting patients, we're recruiting diverse patients, and then keeping patients in the clinical. Trials for completing the trial, right? Is that I mean it's due to a number of factors, but it's also an electronics problem, isn't there? And do I trust this industry to do the right thing for me and to safeguard my health uh when I enroll in a clinical trial? And you know, a lot of patients, you know, I suspect that's one of the drivers of not completes, right? And abandonment. What have what's your experience been like in clinical trials?

SPEAKER_01 22:34

No, I absolutely and I think you know this, that uh trust is a biggest factor in you know in improving patient retention as well as engagement in clinical trials. And uh that fear is a big barrier. That fear of what will this do for me, and uh, you know, laws are passed uh in order to let patients bail out of a clinical trial and uh and and and go back to their original medications if they so choose. Uh and and so I mean I could be talking about this this subject for hours and I don't want to bore you, but but certainly, and I don't want to bore the listeners, but certainly uh trust is maybe at an all-time low as it pertains to patients participating in clinical trials. Yeah, yeah. Uh it's important though to keep them uh trusting the trial originator and staying engaged to make sure that they're taking their medications. Because imagine the costs associated with the patient either dropping off or not being compliant or persistent with the medications that they are on can be extremely high. I mean, just one patient dropping out of a clinical trial, the cost estimated were anywhere between $50,000 to $75,000. So you can see what it does if the data is kind of skewed by people who are not necessarily taking their medications. So very, very important to recruit, to build trust, to keep them engaged, to nudge them to be persistent with their medications.

SPEAKER_00 24:22

Yeah, absolutely. I think you know, there's a study that recently uh came out, and um they were talking about usability of information, and it's called online page education and breast reconstruction, and it was um in the Journal of Plastic Surgery, okay, plastic reconstructive aesthetic surgery published in June this year, this year, and uh basically stated that um when when you give patients uh educational materials, okay, whether it's clinical trials or whatever, but you give patient information, they understand 61%. 61% of patients understood it, but only usability score was 21%. So they kind of got it. They're like, yeah, I get it. I get what you're trying to say, or what you understand, but the issue becomes like, how do I use it? How do I, what am I supposed to do? Like, what's the next step? So that's a real big problem, I think we're seeing is the disconnect from understanding to action and to be nudge. So I think that's really important. Let's let's there's a comment here. I want to address it uh because it's I think it's important. So uh Alexandra, thank you for writing this. Thank you for your comment. I appreciate it. I think, and here she says, I think a current big problem is that people don't want to put the effort to find the information they need. They rather go for what's easily available than accurate. Okay, uh, then and then accuracy. People don't know how to research properly and objectively anymore. This alone can influence information the patients receive through the internet and people around them. I think that's absolutely spot on. And it's, I mean, you know, peep human beings generally want easy and they want fast. And the problem is with so much information available, it's really hard to get something easy and fast. Yes, ChatGPT may give it to us. I don't know. Are you seeing this, uh, Sukumar? Like you might get this from ChatGPT, but is it accurate? Is it comprehensive? Is it useful? Is it valuable? Does it help you move forward? That's another whole equation. So I think you're right here, Alexandra, that you know, I see your views, like yes, you're right. And patients, by the way, are they really supposed to be expert researchers? They're not. When you're diagnosed with a condition, you're a patient, you know, working, you know, you know, as a teacher, as a school teacher, for example. I don't know, you're doing your profession. Your job is not to be a professional researcher, right? And so the notion of you and the patient looking for out for themselves and you know, going in and doing thorough research is really hard to do today. So I think that's a real big problem that you see. What do you think? Um, Sukumar, what's your thoughts on that?

SPEAKER_01 27:09

So, Bob, when when the internet first came up, uh, there were sites like WebMD and others that came up very quickly and became sort of the universal uh truth where patients would go in and look for information. I don't know if you've gone into WebMD recently and tried to look for any information as if you were a patient. I think it's so uh populated and technical that most of the time you you kind of get out of it very quickly. I mean, I gotta be careful, I don't want to call them out, but I think sites like them uh have become a lot more difficult to interpret and understand. So there is, you know, Alexander's point is is spot on. A, there is too much of information, B, as you point out, patients are not researchers, they're not supposed to get as technical. Most importantly, they don't know what source to go to in order to confirm whether that information is correct or not. I'll give you an example. Um I got two pieces of information sent to me. Um one from my son, who took a picture of a normal bone and a foot bone, and and another one that was on a GLP one. And he says to me, Dad, is this what GLP1 does to people? I mean, and if you had looked at one that of what was claimed to be a person on GLP1, you would have been really scared when you looked at those two things. Okay, so that's a literally a visual piece of information that is so scary that the minute you look at it, you'll kind of run away from that medication and you know, maybe complete disinformation. And I know it's complete disinformation, but still. And then there's another piece of information. I got I I got a call from one of my very close friends and chief marketing officers who comes in and says, Hey, Sukumar, do you know that there was a study done, and uh osteoporosis is a common case for people about X age, whatever it is, and there was a study done, blah, blah, blah. Now, how accurate is that study? How many patients had it? What percentage? Then I when I said uh, you know, how how many what percentage of patients? It was like less than 1% or something like that, you know. So now all of a sudden, you've got one that looks very factual because there's some so-called data behind it, and because the public he said it was a publication, but there's nothing actual factual. And then the other is a young man who decides to show images and says, Look, look, look that how how how crazy it looks. Now, these images are easily created on AI and thrown out there. So missinformation is so huge. So then to turn around, Alex Point to ensure that the information that's made available there is accurate, that the information reaches individuals who have these experiences, and that there is a single truth, single source of truth that people can go to and trust. Because I think we lack that today, and I think we need that, and we need some sort of a an approach to get at that in a more systematic fashion across a number of disease areas. I hope that makes sense. Yeah, no, I know a solution, but there needs to be some sort of a body of code that everybody can provide.

SPEAKER_00 30:53

Yeah. I I don't know, but you know, I guess the question is, you know, given you know what we've seen in COVID, can patients, can consumers, can human beings have trust in anything anymore is my fundamental question. Because one could say, uh, you know, um, you know, you know, you know, one could say, well, everything, I don't trust anything from the government. Okay? Someone can say that, I don't trust anything from the government. You know, all these large, just, this, this large organizations that are representing doctors, groups, and so on, they're all in on it. You know, one can have that view. And it almost seems like people don't have faith in institutions. However, they may have faith in other people who are authentic, who are sincere, who are somewhat experts. And I think that is where the opportunity lies for pharma as we're talking about this. Like, okay, so if I were to, you know, if you were to design something that helps a pharma company earn trust and understand how to nudge patients forward. Okay, where would you start? How would you design a program? What were the ingredients? What are the recipes of the program that would help you know trigger the psychology of patients in a way that they move forward, that they nudge forward? Give us two or three insights on what you would see you would recognize strategic recommendations from you on that.

SPEAKER_01 32:27

Um, so Bob, I I think um we we want to take this in in two parts. So the first part is um making sure that we have the right data to design those messages and nudges that patients, when you deploy them in whatever channel you want to deploy them, that they are well received because they happen to A speak to the language of the patient, B motivate the patient to take the right actions, right? Um, and and C continue to nudge them so as to change behaviors. Now, this is a very big ask, but I'm saying you take a careful step of patient, you know, we we give a lot of lip service to patient centricity, but we never really involve the patient directly in the design and development of this information and you know, capturing the data that is most relevant to them, right? So that to me is very critical. Um, and I'll give you an example. I was in a conversation with a pharma company recently where it was how do I get uh patients of a particular diversity to begin to trust providing data in clinical trials, right? I mean, yeah, gene data and so on, especially when there is a certain amount of uh of lack of trust with what the government had done many years ago uh in a in an experiment or a trial that was not really formally announced. So without getting into all the statistics and details. But the question is that you go out and test messages as to how to attract patients to get involved without actually involving them in the design of these messages, in being able to get to understand what motivates them. So patient centricity starts with bringing the patient into that con into that conversation. The second part of what you asked is how do I deliver this? Because as an individual with an ailment, whatever that ailment is, it could be hepatitis, it could be you know HAE, it could be diabetes, it could be hypertension, name it, right? As an individual with this experience in my life, who do I trust? Yeah, I don't trust the government. I don't, you know, if you said there's 10% or 20% who don't trust the pharma company, but I'm actually willing to trust someone like me. I'm willing to trust another individual, another patient who has similar experiences. And so farmers first, you know, if it's patient first or if it's patient-centric, not only do you have to design it with involving the patients, but you also need to deliver it with patience. And we have to get away from throwing huge amounts of data into AI and expecting that AI will shape the conversation and will take it forward. It really almost has to be involving those individuals or patients. Perhaps the next group there would be patient advocacy groups, because there's a lot of people who are patients like you. And then there is the third, which is I care about my caregiver, who, if well educated, can can guide me in the right direction, as well as I would put the third person third person there as the caregiver and the provider of uh healthcare, so that my doctor uh has been third on that list to deliver that. Um, so I I believe that that we have to find an institutional way to scale that, where um the other individuals can can communicate that in a very effective manner. So uh let me I hope that that makes sense. I kind of divided that into two buckets because I feel like we give lip service to patient-centric uh care, but we never actually involve the patient itself in designing how to engage them in that care.

SPEAKER_00 36:40

Yeah, yeah, I think you're right. I think the lip service is it's it's pretty bad out there. I mean, I've seen companies, you know, invite patient groups, and they have a person, you know, a colleague uh at the company who's responsible for you know patient centricity and so on. And what I've seen is they invite a patient group, uh, advocacy leader, uh, who you know they might be funding, they might be funding them, right? They invite them to a town hall meeting, and there's all this conversation, it's a panel, and then they go home. But are they really involved in the design of the message and the program to help you know guide that program to make sure it makes sense to people? I don't see that happening as much. So I think you're right. I think that lip service, it's terrible, and I think it needs to be improved. I think it absolutely, absolutely needs to be improved. I think having patients fully engaged, having people with lived experience fully engaged in the development of marketing programs, clinical trial programs, um, that are really vital to you know to succeeding in driving the therapies to, you know, having patients to get onto therapy. I think that's really important. I think the second part of it is um, you know, I guess the question for you, Sukumar, is that all right, so you've given us the hierarchy, patient with livid experience, patient centricity, bring them in. Um, what do they, you know, what the messages look like, and then go to caregiver and provider. Do you think um most patients make decisions on an emotional level? Or is it a couple of other elements? Talk to us about like how to nudge patients forward.

SPEAKER_01 38:20

Yeah, I think you know that's a great question. I I want us to I want to suggest something very radical here, Bob. Um, and and let's see if my radical notion here will get stones thrown at you or flowers sent to you. Okay. Uh but but you know, some years ago K uh K-drama became very popular, and there was a lot of, yeah, yeah. K-pop, yeah. K-pop and k-drama, and yeah, and and fans, uh fandom was became a common word for uh people who watched these shows and talked about it in social media and became very much engaged in all the activities, right? So you you if you lifted that concept of fandom, and if you said uh that patients are people living experiences just as they are, you know, watching a k-pop or a k-drama, they're now essentially living those experiences, reality TV of themselves, and they become a fan of themselves. Yeah, can pharma actually think in terms of developing fans of their or fandoms, meaning activities around fans. Now I'm gonna use the word fans uh for patients, uh, people who have great experiences with the medication they have that they take, whether it's for a GLP1, or whether it's let's say a cure for hep C or a cure coming out for F. And can these fans engaged that they are the voices that you begin to leverage in order to get across the value of treatments that are made available to those who are happening uh happening to be part of this reality show? So, can we move away from the term and can we create fandoms of medications and and um you know through that process begin to actually understand what these people want, what will motivate them to change their behaviors in order to so so you know that I as an individual, when I'm first hit with the fact that I have cancer, whether it's prostrate or breast or whatever it is, I'm first and foremost in a state of shock. Yeah, then I start to build my beliefs. Yes, right, those beliefs are actually barriers to my moving forward. Some beliefs are good, some beliefs create a friction to making me move forward and do certain things that are meaningful. Yes. Can pharma understand the friction between the beliefs and the forward-looking motivations in the mind of an individual, one individual at a time, not just a collective, you know, here's what everybody thinks. And can you find those motivations that will get them moving away from those beliefs that are causing the friction from them getting to take you know have better experiences? And in doing so, can we create fans of a pharma brand? And can we can we actually be able to excite them to take their medication? That's that's what I would I would suggest. And Bob, believe it or not, we do a lot of work in non-pharma-related stuff, and and the idea of building fans is something that uh we are we are working on for media companies. So why not think about that same concept? After all, what a media is doing is it's it's providing entertainment, putting us in those experiences. What pharma is doing is beginning to give me a better quality of life. We use the term quality of life all the time, right? Um, so why not create fans of GLP1, fans of the new happy drug that is a cure, fans of cures for various kinds of cancers. Why not create fans? Why do we still want to call them uh patients and why not engage those fans in being the better voice for pharma?

SPEAKER_00 42:52

I love it. I love it. I think this is a billion-dollar idea, Sukumar. I really do. I mean, Ken Blanchard wrote the seminal book, How to Create Raving Fans. Uh, in business, we deploy the strategies for our clients, our customers. How do you create raving fans? This is what we do every single day. In my company at Hoot, our team has read the book, knows the book, understands what we have to do to create raving fans. And that's one of the reasons we, by the way, we do live streams like this is we want to try to create raving fans, give massive value. But that experience, to your point, has to be exceptional, right? The experience for pharma has to do, I think that's a great idea is to have you know have a vision what pharma could be doing, which is creating raving fans. And the great thing about what you know is what you say is that raving fans help you get more fans, right? So it's one of those influential you know, influence techniques. Uh a patient who is hesitating, taking your product, is more inclined to start if they see another person. Patient with the same lived experience. Oh, she's just like me. And so from fan, it you can create another fan. That's sort of the concept. I love it. I think this is a brilliant, brilliant concept. I think you should write a book about it, Sugamar, by the way. I think you should write a book about it. I think, I think it's a really brilliant idea. But one of the things you have to do to create rating fans is give massive value. You've got to give better experience than a brochure that about your drug. You know, there's a drug for very serious rare disease. And I went into their um, I looked at some of their materials. We looked at some of their materials in the company, and it's a very long brochure. It's like the state, it's like huge. And it's like you unfold it, unfold it, and it's like the journey. I was like, oh, somebody spent a lot of time, months and maybe years, designing that patient journey and making it, getting it approved, MLR approved, everything, and putting it out there. And like, do you understand nobody reads that stuff? Like, where's the experience in that? So I think you're right. It's this notion of like, okay, great, we can create raving fans, but you've got to deliver value. You've got to deliver something that's unique, that's differentiator, right? And and I think, you know, having digital, going back the digital is the way to do it. I mean, we work in the world of text messages and what is now known as RCS. Uh, we do not believe that, you know, giving brochures to patients. I mean, in some cases, yeah, I think it's helpful, just as a reminder, but they often get tossed or left in the back of the car. Uh, you know, I used to work in uh years and years ago, I used to help my wife who's a doctor, and she used to ask me to create this beautiful brochure. Um, and I spent six months on VistaPrint designing the beautiful thing, and the patient, I saw a patient of a child and you know, put it in. Oh, it was beautiful, it's great. And then one day I noticed the trash bin outside my wife's practice was filled with a brochure. And I said, What are we doing? This makes no sense whatsoever. And you need to live in the hip pocket of patients today. So I think you're right, any creating raving fans, you've got to give them a beautiful experience. I think that's really important. And then the other part, I think, is it it sounds to me, Sukumar, is that um it's got to be well thought out. Meaning it can't be in a boardroom or the conference room or Microsoft Teams of pharma executives talking to each other. It's really bringing those other patients in. Do you guys bring in patients frequently into the work that you're doing in terms of understanding insights for clients?

SPEAKER_01 46:41

We do. We we have several sessions where we get patients' input. And and you know, remember, you you use the term patient experience. Pharma's definition of patient experience is what does a drug do for the patient? Um, but it's focused on the drug. But patient experience today is not just, yeah, there are two drugs that do the same. Um, they both have the same chemicals, they both have, they're both called GLP ones, and and they have everything the whole you know uh concoction is the same. Um, but the reality is that the patient experience goes beyond just taking the pill or the injection or the you know uh our injector. It it needs to be a lot more than that, and I think that's where the real differentiation is, and that's where uh understanding the patient expectation is so critical. So, to your point, the patient expectation is something that we uh we understand very well, and we help you with hyper-personalizing it because that is um what patients will tell you, you know, with everything, just as physicians will tell you that the first thing they want the drug to do is no arm, so they want the drug to work, meaning efficacy is most important the same way the patient's gonna tell you, I want it to work. That's the top of mind. But what really is different is when two drugs work the same, it's other aspects of that experience. So knowing that whole, you know, what the expectations are, how do we deliver on those expectations uh is very, very critical. It's the first step before you can design the right experience. Yes, and the right experience is not just a pill or not just the information, there's so many other things, which I'm sure you know, and we can rattle on that for hours. Yeah, knowing what matters to each person individually is critical in order to create that ability for them to interact with other people just like them and uh be able to disseminate that more effectively.

SPEAKER_00 48:50

Yeah, yeah. Well, one thing I I I think about is often is that patients today make healthcare decisions in the kitchen, not in the clinic. And they often do it with a spouse, you know, like next to them. Because, you know, especially in a serious disease, in a complex specialty condition, patients want somebody they can talk to about it, and they're overwhelmed with emotion. And so it's not just reaching out to the patient, but and I don't want to you I want to use the word caregiver very lightly because it's not, you know, it's not necessarily a caregiver, but it's a a collaborator. A collaborator who helps you make a healthcare decision is as important to touch as the patient herself. Because they're the ones who are going to be maybe the voice of reason, if you will, where the patient might be very emotional, you know. So I'm a you know, 56-year-old guy, Sukumar. I can tell you I've been I've been married now 27 years or something. I don't know, 26 years, 27 years. I cannot make a health a decision without my wife about healthcare for our children. I'm like, honey, I have no idea. You're the doctor in the family. You have to help me figure this out, or you have you have to kind of lead this here. So anytime we go to the doctor with our children, you know, I'm like, hey, doc, can you just record the video? Can I just put you on video and share with my wife? Because she's the one who's gonna do it. So we have to understand it's multi-dimensional now. It's not just one person that you're touching. And and often also we see this with parents who are have young children. So, you know, as I as parents are myself, three kids, we have severe, severe food allergies. The kids have severe nut allergies. And, you know, there are treatments and and immunotherapy for for these allergies, and I am, you know, we're hyper, hyper sensitive. So the patient is a child, but the decision makers are the two parents. So it's not just one patient. I want to emphasize that when pharma is thinking about marketing and and addressing programs for patients, you know, the patient is the child, but the decision makers are two, which is the mom and dad in this case, and who don't often speak to each other until the kids are in bed at 10 o'clock at night. And then, you know, where's the brochure? It's in the car, right? So it's it's there's it's multidimensional here that we're we're talking about as we have to really think about this. So, Sugumar, as we come to the close in the next two to three minutes here, please give us some advice. Okay, let's talk specifically to a brand marketer who is launching a new product this year, okay? Commercializing a new product this year. Um, what is your advice to them as they think about launching this product and in terms of understanding you know, HCP doctors and patients and that that relationship? So, what is your advice in terms of helping them launch a successful product when it comes to understanding patient psychology?

SPEAKER_01 52:06

Well, um let's let's put this into a maybe a five or a six-step process, right? To make it easier as a checklist. Um so the first thing is understand what patients expect. What are their expectations? What do they want? What matters to them? Uh and I think that's that's a critical aspect where you begin with engaging the patients in the very design and development of how you want to speak to them, where you want to speak to them, when you want to speak to them, who all do you need to speak when you speak to them? You know, you you made a very good point about um it's important that you're not just speaking to the patient, but you're speaking to the patient's family and other caregivers, right? So step one is understand what they want. Step two is capture sort of that whole um, you know, what are their current beliefs? What have they understood about you know what they're going to be facing when they see that particular uh disease? Uh to how would you get them off of those beliefs with what would really motivate them to be engaged with their care? So my my step two is is sort of understanding the friction between the beliefs and the motivations to change their behaviors. Step three is is is with all of that, you know, knowing what they expect, knowing that friction between the beliefs and and what would change their behaviors, you now are in a position, you're you're armed with being able to go back to them, and and don't make it a one-size-fits-all, because that's what pharma and everyone tends to do. Because keep in mind, with the digital age, there is so much more segmentation than there was before. Patients are not one size. So it's important, therefore, as you go back to implementing that you recognize the value of hyperpersonalization and you recognize the value of being able to go back and test with those individual groups if things that you intend to message and communicate actually resonate with them. Now, you know, there's always legal regulatory challenges, and pharma can never get itself out of that. So, my step four is whatever you do and whatever you test, uh, start from the very beginning with knowing what that space is within which you can be freely moving around and recognize that engagement is not just message or educational, engagement is also about actual experiences. How do you get them um their medication faster? How do you reach audiences that are socially challenged or challenged by their incomes and and so on, or challenged by education levels, where you know that that crumpled, you know, 50-page thing that is put into an insert is not easily read by everybody, right? So that that step four is is bringing everything together and and uh ensuring that the experience is more holistic and is not just a piece of paper or a few more digital messages. Um and then realistically, that step five is leveraging digital, but leveraging it with patients, for patients, built by patients, so that you can communicate with them uh in very much in the context of what I would call creating fandoms, fandoms of your treatment, and just as you would have fandoms of the next K-pop or the next K-drama, you want to create fandoms of of your medications and and recognizing also that you can have fans, not just, you know, we we as humans don't have just one disease, we tend to have a constellation, two, three sometimes.

SPEAKER_02 56:30

Yes.

SPEAKER_01 56:31

The older you get that that that comab with conditions can tend to be a lot more. So you almost have to get we make fans, not of one show, but of multiple shows, so that they're fully understanding of how they engage in in making life experiences more real, in getting more involved and engaged in sourcing information that is truthful, trustable, and realistic and easy to digest. Let's not make it so difficult to digest that it's as hard to swallow as a big pill that you might be asking. I'll pause there. I hope that makes sense.

SPEAKER_00 57:12

It does, it does. You've provided a very clear and thoughtful path to success for a launch. Um, I would add just one piece to it, um, Sukumar. I think you've given us five very important pieces, but I would add one, which is really understanding um if you want a successful launch today, you certainly need a very effective patient engagement strategy. Um, but more importantly, you need to differentiate yourself with physicians today, with HCPs, with doctors. And doctors today are doctors today are overwhelmed with so many reps coming at them for so many complex products. Just overwhelmed. I mean, you talk to a doctor, they have 30 or 40, 50 sales reps, field force, MSLs, okay, MSLs calling on them, and they're just overwhelmed with too much information, and everyone is being asked to educate the patient with a complex problem or complex condition and a complex treatment. So you've got massive info, and everyone is counting on that one doctor, every sales force, every MSL QCAP manager is counting on that one oncologist who works for an MSL, counting on her or him to explain the therapy. So I think understanding from a farmer perspective, you're launching a new product, you've got to understand you can't, you have to lift the burden, the heavy burden, or understand at least the heavy burden is on the shoulder of the HCP. And you've got to reduce that burden in order to make a difference. And one of the ways to do it is to develop a very effective patient education program that lifts some of the burden off of the doctor and takes some of that responsibility onto the pharma company, which is, you know, has to be, you know, accurate, you know, MLR, right? You have to be medical, legal, regulatory, correct, factually correct, scientifically accurate, and thoughtful. So I do think that when you're launching a new product, there's got to be some better thought to put to put to this. Because as we know, fuel force is very expensive. We know that you know, there's there's there's there's issues and initiatives out there in pharma looking at MSLs and saying, can we rationalize MSLs? Right? So I think there's that trifecta, if you will, of pharma HCP, you know, sales rep patient, you know, that that trifecta, if you will, or I guess it's four people here, pharma feel, you know, pharma field force, if you will, pharma field force, HCP, and that patient, the trifecta, there's something there that needs to be improved in order to have a very successful launch. So to me, that's the way I look at the world is like, how can we transform our sales rep? I was a I started my career as a sales rep at Pfizer, you know, back many years ago when we carried the bag, and it was very difficult then to get five minutes with the doctor. Now it's five minutes, maybe it's three, every three months. So, how can you really be effective at communicating information that the doctor already has on their phone? So it's that we have to think differently. And I think what we've talked about here today is understanding patient psychology, Zukumar, and how that shapes not only patient behavior so that we as a pharma industry we can we can we can engage them better, but also I think you know, as as as as as strategic people who are thinking differently when it comes to launching new products with doctors. We lost you here, Sukumar, but I know you're with us. I know in in in presence and spirit you're with us. We lost Sukumar. Are you coming back? You come is he coming back? There he is. Here's back, he's back. So uh Sukumar, last um words uh to share with our audience today. Any tips, advice, if you could sum up um you know, uh today's conversation that we had about patient psychology? Well, last remarks, please.

SPEAKER_01 1:01:23

Well, I think patient centricity starts with understanding what patients want. So to your point, patients um want to be involved in their care. And doctors today are willing to have patients before decisions. Um so the more we can uh common expectations between those two, the better we can design the right communication, the right digital platform, the right experiences. And my last thought on it is make patients your fans. Stop thinking about them as as patients. So thank you so much for having me. And I um really appreciate the questions, the conversation, the dialogue here. Um, and I hope it has been useful for those in FARM.

SPEAKER_00 1:02:23

Yes, it has been useful for me. So Dr. Sukumar, thank you so much again, everyone. My name is Bob Miglani. I'm the founder of CEO of Hoot. Delighted to have uh Dr. Sukumar, CEO of OSG. Um uh and we'll be posting this on LinkedIn. You'll be able to watch it anytime and share it. Please share it, we'll like it, uh, and subscribe to our patient experience podcast. All we do is talk about patient experience. And uh anyway, thank you all very much for tuning in. Uh, have a beautiful rest of the day. Thank you, Sukumar. Have a great rest of the day. Take care. Bye, everybody. Thank you.

SPEAKER_02 1:02:56

Thank you very much.

SPEAKER_00 1:02:57

Bye, bye, bye.