Pharma R&D Today
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Humans: What we say and think does not always predict what we do
Posted on March 22nd, 2017 by Dr Andrew A. Parsons in Pharma R&D
Actions speak louder than words. This is a useful adage and was a family mantra. It has been useful to keep this in mind in so many situations, in both my personal and professional life.
We do form impressions of people based on what they do and how they behave. The latest example of high-priced medicines will certainly fuel opinions of the industry (1) and those who work within it. Traditionally, the value of high-priced medicines has been positioned to cover the cost of innovation. This is not just the costs of development but also the cost of failed medicines within the process. An argument could be made for this model in the days of a more closed innovation system, where the value of products would need to cover costs of early research and the risks of subsequent medicines development. The recent example of a “new version of an old drug” apparently did not carry the same innovation risks, and seemed to be at odds with the aims of the organization (1). Many may welcome the position of pharma on clearly identifying companies that carry the high-research risks as part of the community—however, perhaps the impact on people’s perceptions and attitudes has already been made. No doubt time will tell in the future discussions with the U.S. federal government regarding pricing.
Attitudes are important and are often overlooked in how they can drive behavior and decision-making in the real world. This is a large and complex topic covering aspects of human behavior and is therefore perhaps difficult to measure in the setting of medicines research and development. However, a recent study suggests the impact of attitudes can be explored in an empirical way. Annemiek Linn and colleagues (2) studied the attitudes associated with taking oral methotrexate for Rheumatoid Arthritis. They studied self-reported explicit attitudes to the medication and their beliefs about the benefits and concerns associated with it. What was unusual was that they also measured implicit beliefs associated with the treatment. This was conducted using an implicit association protocol, a well-validated method using reaction time to investigate implicit association on a computer-based program. They also measured self-reported adherence and a range of clinical measures and found no correlation of either implicit or explicit attitudes with self-reported adherence.
They noted explicit associations were positive regarding their medication and being well. Implicit attitudes were negative and sickness-related. Half of the individuals in the study were explicitly positive about their medication but exhibited negative implicit associations. Interestingly, implicit associations are thought to better predict actual behaviour. Although this was not assessed in this study, this is perhaps an area for further study and may shed light on why we do not always do what we say. Focusing on the discrepancies between implicit and explicit can perhaps support individuals develop different behaviors and lifestyle choices?
Our implicit patterns of behavior will impact many areas, if not all aspects, of R&D. This incongruence between “what I say (or put on a webpage) and what I do” can be seen in many activities from making a profit to patients taking our medicines. Paying more attention to these human-centered processes may support the application of our products in the real world and create more transparency in the way the business operates. I’m sure minimizing the incongruence between “what is said and what is done” will build consistency and trust in the industry. The global communications firm Edelman conducts worldwide surveys on trust every year. In 2014 (3), the survey identified the pharmaceutical industry as being relatively low in the trust table, 8th out of 15 industries. They suggested building transparent metrics that are communicated frequently as a key strategy to build engagement and trust. The latest survey indicates that the levels of trust are imploding across many sectors (4).
When in doubt, do something (proactively) is another old family saying. With increased complexity in so many areas of the industry, from market access, clinical trial design, reimbursement and new drug modalities being developed against a backdrop of pressure on healthcare expenditure, it seems now is a good time to do something. Focusing on the human at the center of all processes, decisions and applications of our products is one place to start.
- Linn, A.J., Vandeberg, L., Wennekers, A.M., Vervloet, M., van Dijk, L., van den Bernt, J.F. (2016). Front. Pharmacol. 7: 233. doi: 10.3389/fphar.2016.0023.
All opinions shared in this post are the author’s own.
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Dr Andrew A. Parsons
Director of Reciprocal Minds Limited & Chairman of Pharmasum Therapeutics AS
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