Strengthening pharma's contract with society: the value of trusted partnerships between pharma and healthcare facilitated by real-world data

As health systems find themselves under increasing pressure, the pharmaceutical industry has a unique opportunity to broaden the very basis of their engagement with health systems beyond predominantly one-dimensional relationships focused on access to innovative treatments. Instead, the pharmaceutical industry can look to build trusted partnerships around a common purpose of supporting the delivery of better patient outcomes through application of data-driven insights to improve treatment and care pathways, to advance medical practice and to optimize the utilization of healthcare resources.

The term real world data (RWD) describes data that are routinely collected within health systems on a patient's health status, in a purely observational fashion. RWD has the potential to play a critical role in establishing trusted partnerships: its very origin from within health systems, makes RWD particularly suited for generating evidence in a transparent and objective way through collaborations. As such, the generation of RWD can help foster trust and support new research partnerships that build a shared understanding around the intent of collecting data, the purpose this will serve, which trade-off decisions the data will inform and the value such partnerships offer to each party.

The traditional relationships between the pharmaceutical industry and healthcare systems are being fundamentally re-defined, by moving beyond typical transactional roles as seller and buyer, respectively.

As health systems struggle under increasing financial pressures, engagement on the sole basis of providing innovative treatments for payment makes it difficult for both parties to reconcile conflicting priorities. Establishing long-term, trust-based partnerships around broad, shared objectives such as aligning treatment around optimal patient outcomes, enables health systems and the pharmaceutical industry to solve problems jointly.

Health systems and the pharmaceutical industry recognize the value of evidence and insight generated by RWD: alongside governments, the pharmaceutical industry has fueled an increasingly rich RWD landscape, as some health systems lack the expertise or resources to generate insight from those data assets themselves.

Research-focused partnerships transcend the traditional monetization of data and aim to solve the challenge of sustainable innovation for better patient outcomes. However, in order to build these partnerships, trust must be established between both parties.

The defining feature of trusted partnerships is the long-term pursuit of mutually beneficial objectives, in a transparent way, by combining complementary assets, resources and capabilities. As the home of deep scientific, clinical and analytical expertise, with an ability to draw on significant resources, the pharmaceutical industry has a lot to contribute to establish trust-based partnerships. In the case of trusted partnerships between health systems and the pharmaceutical industry, this common ground can be found at the intersection of innovation, efficiency and patient outcomes, with RWD facilitating transparency, objectivity and stakeholder engagement:

However, there are important considerations for defining the common ground between health systems and the pharmaceutical industry, specifically, the issue of scale of such partnerships. We believe two complimentary modes of working should be considered:

Crucially, to reap the full benefits from optimizing along the dimensions of innovation, efficiency and patient outcomes, learning healthcare systems [1] need to embrace a virtuous cycle of continuous improvement and be open to international best practice sharing. While healthcare systems operate predominantly locally, the pharmaceutical industry with its global reach is well placed to facilitate such exchange of learnings across countries.

Historically, many collaborations between healthcare systems and the pharmaceutical industry tended to be transient in nature and only on a need-to basis, with short-term funding and engagement commitments, and therefore they do not always support a long-term and sustainable, mutually beneficial partnership model. Short-term focus represents a major barrier to unlocking the unique value of novel RWD assets. Lead times of 5 years or more are common for such novel RWD assets to reach the requisite data volumes and levels of data maturity needed for high-quality evidence generation, well beyond the typical initial 2-year sourcing and curation period to secure data access; hence, the importance of establishing long-term relationships that enable the sustainable collection of RWD by healthcare systems.

To move to trust-based partnerships, new models are required that ensure long-term commitment, transparency and joint ownership of insights, all in full compliance with data privacy requirements and ethical standards. Recognizing the need for combining the best available data from all partners to solve a common problem is a key factor for successful collaborations, such as public–private partnership projects [2,3], multi-stakeholder collaborations [4,5] or single company-led, multi-stakeholder collaborations [6–8].

For trust-based partnership models to succeed, several barriers need to be overcome which requires a concerted, multi-stakeholder effort. Specifically, the following agreements and clarifications are needed from healthcare systems:

Health systems, and patients, have much to gain from adopting those changes in order to facilitate trust-based partnerships with the pharmaceutical industry and to reap the full benefits they have to offer.

To create momentum in advancing the trusted partnership agenda, the authors of this commentary endorse the following principles. They have been designed to ensure fairness, transparency and, ultimately, maximize the value of such partnerships to healthcare.

By endorsing these principles, we are paving the way for the pharmaceutical industry to place itself even further at the forefront as a trusted partner in delivering better outcomes for patients.

This document lays the foundations for establishing trusted partnerships between the pharmaceutical industry and health systems. Naturally, several practical questions remain such as how to ensure equitable investments in healthcare are made, where long-term value is not solely realized in a small number of specialist centers, but widely shared across the system, and what is the most appropriate mechanism with which to make an investment? Questions such as these deserve their own dedicated discussion in future papers.

The healthcare environment is ripe for embracing trust-based partnerships. Indeed, the long-term sustainability of a vibrant learning healthcare system depends on establishing trust-based partnerships which also involve the patient and medical communities. The pharmaceutical industry now has a rare opportunity to fundamentally re-define their relationships with health systems, healthcare providers and patients, with focus on reconciling innovation, efficiency and patient outcomes, with RWD in a facilitating role as the source of insight, transparency and objectivity.

By ensuring healthcare decisions, including both pharmacological and nonpharmacological interventions, are consistently informed by a growing body of high-quality evidence, those trust-based partnerships will fulfill their promise and unlock unique value for society, with benefits delivered to many stakeholders, including the medical community and the ultimate beneficiary, the patient.

The authors are employees of pharmaceutical companies. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing support was provided by IQVIA.