Inside the Mind of the Provider: How a Stratified View of Patient Risk Factors Can Inform New Drug Strategies
Commercial strategies for new therapies typically are developed and refined over the course of months and years as a drug methodically makes its way through the clinical trials process, market sizing exercises, and comparative effectiveness studies. At each step, go-to-market and provider engagement strategies can be nipped, tucked, and refined to maximize impact.
In the whiplash world of COVID-19 treatments, however, those timelines were dramatically compressed. Seemingly overnight, the entire world was on the hunt for any kind of therapy – from vaccines to antivirals – that could tamp down the effects of the novel virus. The first antiviral approved for treatment was launched in late 2020. Not long after, competitive therapies were also in the market.
It was a moonshot that hit the mark — a legacy-making accomplishment for the Life Sciences industry. But that doesn’t mean there weren’t challenges for the companies that helped lead the charge, including a Komodo client that was on the cutting edge of this landmark development. In addition to the challenge of developing a drug in a compressed timeframe, they had to get it to market as quickly as possible, all amidst a global pandemic.
Cutting Through the Chaos
A day in the pandemic era often felt like a month, as the news cycle zigged and zagged its way through volatile ebbs and flows in infection rates, the emergence of virus variants, and constantly changing hospital protocols. The pharmaceutical development life cycle is difficult to navigate under the best of circumstances, but against this backdrop, it created entirely new challenges.
Most notably, Commercial teams were unable to rely on traditional business performance reporting and volume metrics to get an accurate sense of the behavioral, systemic, and patient-specific variables that were driving utilization of their new drugs. Overwhelmed hospital staff didn’t have time to provide detailed clinical notes, and rapid-fire changes in treatment protocols and best practices were creating chaos in their data.
To better understand what was really happening when it came to real-world patient experiences, a large biopharma came to Komodo to help get inside the minds of providers to better understand the specific patient variables and risk factors that were driving prescriptions for its drug and its competitors’ therapies. Komodo’s payer-complete data enabled the client’s Commercial team to see the complete view of a patient’s medical history and contextualize prescription volumes by patient risk level, comorbidities, and concurrent treatments. Ultimately, the effort allowed the team to understand patients within the frameworks created by national guidelines and the healthcare organizations they work with.
Agile Strategy in a Fast-Moving Landscape
Coupled with the challenges of navigating healthcare treatments amid a global pandemic, this particular drug was physician-administered and required a rigorous set of protocols to ensure its efficacy. As hospital protocols and international guidelines for the treatment of COVID-19 began to evolve away from hospitalization in all but the most severe cases, the drug’s prescription rates were affected. This pushed our client to probe deeper into understanding the specific risk factors driving providers’ treatment decisions and the specific patient attributes linked to those behaviors.
By analyzing real-world patient journeys, the Commercial team quickly found that patients that were prescribed its drug tended to have significantly more comorbidities and were at higher risk than the overall COVD-19 patient population in both inpatient and outpatient settings. Most common comorbidities included hypertension, diabetes, chronic lung disease, and chronic kidney disease.
Based on this analysis, which was conducted on Komodo’s platform, accessed via Sentinel, the team learned that the segment of the at-risk patient population that was least likely to receive the drug was patients with chronic kidney disease. While the treatment was contraindicated for patients with severe renal disease, its use in those with milder levels of renal impairment had been highly effective. Armed with this information, the team was able to use this information to inform their provider outreach strategies and — ultimately — expand the market opportunity for their therapy.
The research also identified which outpatient settings were seeing the patients most at risk and provided important insights into the typical healthcare journey for these patients. This information was used to expand the market opportunity for the drug and get the treatment into the hands of patients who could most benefit from it.
Together, these insights helped inform a supplemental new drug application to the U.S. Food and Drug Administration (FDA). The application was ultimately approved, which expanded the availability of the drug to patients with renal impairment.
The Lesson Learned
The COVID-19 pandemic wreaked havoc on the healthcare landscape, and while things have since stabilized, the lessons learned during that period of extreme disruption are helping to inform a more nuanced, detailed view of real-world patient behavior. By utilizing data-driven insights, Commercial teams can direct their resources to where they’ll make the most meaningful difference. And when the stakes are high, that information can be a lifeline for the most vulnerable patients.