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      Defining patient centricity with patients for patients and caregivers: a collaborative endeavour

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          Abstract

          Background

          Patient engagement is an essential aspect in the research/development of biopharmaceutical products and disease management. Improving the lives of patients requires a deep understanding of their medical conditions, experiences, needs and priorities. However, a consistent definition of patient centricity is lacking. A series of initiatives was conducted to define patient centricity and its important principles impacting the biopharmaceutical industry.

          Methods

          Interviews, questionnaires and literature reviews were conducted involving key stakeholders to initially identify issues of importance to patients, healthcare providers and payers. Subsequently, two identical workshops which included 22 patients/carers created a definition of patient centricity and the healthcare values important to patients/caregivers. Outputs were tested in a validation exercise involving patients in predominantly US (n=470) and European (n=703) patient forums.

          Results

          Initial research provided deeper understanding of patient needs and key topics of interest that were used to cocreate a definition of patient centricity and 10 associated principles of importance to the biopharmaceutical industry. Wider testing of these outputs among predominantly US/European patient communities confirmed their validity. Patient centricity should be defined as ‘Putting the patient first in an open and sustained engagement of the patient to respectfully and compassionately achieve the best experience and outcome for that person and their family’. Important principles for patients focused on education/information, cocreation, access and transparency.

          Conclusions

          The development of a consistent definition of patient centricity and its associated principles provides an opportunity for biopharmaceutical companies to adopt and use these as a reference point for consistent patient engagement throughout the product life cycle.

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          Most cited references7

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          Culture and Process Change as a Priority for Patient Engagement in Medicines Development

          Patient Focused Medicines Development (PFMD) is a not-for-profit independent multinational coalition of patients, patient stakeholders, and the pharmaceutical industry with interests across diverse disease areas and conditions. PFMD aims to facilitate an integrated approach to medicines development with all stakeholders involved early in the development process. A key strength of the coalition that differentiates it from other groups that involve patients or patient groups is that PFMD has patient organizations as founding members, ensuring that the patient perspective is the starting point when identifying priorities and developing solutions to meet patients’ needs. In addition, PFMD has from inception been formed as an equal collaboration among patient groups, patients, and pharmaceutical industry and has adopted a unique trans-Atlantic setup and scope that reflects its global intent. This parity extends to its governance model, which ensures at least equal or greater share of voice for patient group members. PFMD is actively inviting additional members and aims to expand the collaboration to include stakeholders from other sectors. The establishment of PFMD is particularly timely as patient engagement (PE) has become a priority for many health stakeholders and has led to a surge of mostly disconnected activities to deliver this. Given the current plethora of PE initiatives, an essential first step has been to determine, based on a comprehensive mapping, those strategic areas of most need requiring a focused initial effort from the perspective of all stakeholders. PFMD has identified four priority areas that will need to be addressed to facilitate implementation of PE. These are (1) culture and process change, (2) development of a global meta-framework for PE, (3) information exchange, and (4) training. This article discusses these priority themes and ongoing or planned PFMD activities within each.
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            How a patient advocacy group developed the first proposed draft guidance document for industry for submission to the U.S. Food and Drug Administration

            Among the challenges confronting patients with rare diseases is a dearth of treatment options. The development of safe and effective new therapies is hampered by challenges associated with conducting clinical trials in small populations. In this article, we describe how the Duchenne muscular dystrophy community–led by Parent Project Muscular Dystrophy–created a proposed draft guidance document for industry for submission to the U.S. Food and Drug Administration. This unprecedented undertaking involved a broad coalition of more than 80 stakeholders collaborating across nine time zones to produce a document in only 6 months. We hope that other rare disease communities and advocacy organizations can use our experience as a model for developing their own draft guidance documents. Electronic supplementary material The online version of this article (doi:10.1186/s13023-015-0281-2) contains supplementary material, which is available to authorized users.
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              Patient-centric HTA: different strokes for different folks.

              Patient centricity will initiate a change in healthcare decision-making paradigms. Patient-centered outcomes are a part of the solution to the challenges posed by complex decision problems due to multiple clinical and non-clinical outcomes. Multiple decision criteria require that clinical and regulatory decisions be based on the implicit value judgments of experts. Experts are under continuous pressure to ensure decisions are aligned with patient needs and result in positive performance. To fulfill this role and guarantee efficient decisions, experts must be fully informed about patient preferences; however, this assumption might not necessarily reflect reality. Health technology assessment focuses on the measurement of clinical effects, rather than the assessment of the impact of different outcomes on users' perceived value. Further evidence is needed to ensure that expert judgments are congruent with patient preferences. Therefore, patient preferences can be a valuable source of information to inform clinical and regulatory decision-makers.
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                Author and article information

                Journal
                BMJ Innov
                BMJ Innov
                bmjinnov
                bmjinnov
                BMJ Innovations
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2055-642X
                April 2017
                24 March 2017
                : 3
                : 2
                : 76-83
                Affiliations
                [1 ]AstraZeneca Pharmaceuticals , Melbourn, UK
                [2 ]Patient Project Muscular Dystrophy , Hackensack, New Jersey, USA
                [3 ]11Health , Borehamwood, Hertfordshire, UK
                [4 ]Corvista , Cheshire, UK
                [5 ]AstraZeneca Pharmaceuticals , Gaithersburg, Maryland, USA
                [6 ]Formerly AstraZeneca Pharmaceuticals , Macclesfield, UK
                Author notes
                [Correspondence to ] Guy Yeoman, AstraZeneca Pharmaceuticals, Da Vinci Building, Melbourn Science Park, Melbourn, Royston, SJ8 6HB UK; Guy.Yeoman@ 123456astrazeneca.com
                Article
                bmjinnov-2016-000157
                10.1136/bmjinnov-2016-000157
                5468520
                28890797
                aaf4aa2b-e55a-4d71-a5f8-f669c00de0e5
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 14 September 2016
                : 28 January 2017
                : 6 March 2017
                Funding
                Funded by: AstraZeneca, http://dx.doi.org/10.13039/100004325;
                Categories
                Health IT, systems and process innovations
                1506
                1507
                2268
                Original article
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                patient centricity,patient engagement,pharmaceutical development,health care management

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