Novartis, Takeda and Others Win Innovation Awards

The eyeforpharma 2019 North American winners: Novartis, Takeda and others show the way

At April’s eyeforpharma Philadelphia event, four major awards were given to North American companies, organizations and individuals in recognition of their innovation in various areas of healthcare: patient initiative, HCP or healthcare initiative, collaboration, and patient champion. These join the European winners (NuvoAir, Aptus Health/ Boehringer Ingelheim, Novartis and Teresa Ferreiro, respectively) in being honored for advancing care for patients and the industry as a whole. Here are the North American awards.

MOST VALUABLE COLLABORATION

Winner: Novartis Pharmaceuticals Corporation and Johns Hopkins Medicine Initiative: Ensemble-Managing Cancer at Work

THE STORY: “You have cancer.” Those three words can change life in an instant. Questions about the diagnosis, treatment options and managing work become top of mind. That is why Novartis collaborated with Johns Hopkins Medicine to create Ensemble: Managing Cancer at Work. Ensemble is a supportive community originally developed by Novartis to help associates and their loved ones or colleagues whose lives are touched by cancer. Knowing that the cancer journey can be so complex, the program was designed with simplicity in mind and provides expert support from a renowned research and clinical center. Ensemble provides helpful resources and quality health, emotional and physical support with information on how to prevent cancer, recognize its early warning signs, and manage treatment to optimize health and well-being. Nurse Navigators listen with compassion and complete confidentiality, providing guidance on medical resources and work issues, with the ability to direct questions to other appropriate resources. Novartis recognized the opportunity to partner with Johns Hopkins Medicine – which had launched its own Managing Cancer at Work program with a similar focus – to create the combined EnsembleManaging Cancer at Work offering. Through this joint effort, Novartis has demonstrated its ongoing commitment to the health and wellness of its associates. Nearly two-thirds of cancer survivors return to work after their diagnosis and experience unique challenges as they strive to maintain health and career goals. About 40 percent of the 14.5 million cancer survivors in the U.S. are of working age. Many survivors need to keep their jobs through treatment and recovery to maintain income or because their health insurance is provided through their employer. Going to work can help maintain a sense of purpose, in addition to offering a support network and a welcome distraction serious illness. At the same time, employers report a level of complexity in managing employees’ cancer-related needs beyond that associated with any other type of disease or condition. Gaps exist to adequately address the needs and cultivate optimal outcomes for these employees and their organizations. Novartis sought to identify innovative solutions that could have a positive social impact among its own employees impacted by a cancer diagnosis. In 2014, Novartis created an internal network of medical volunteers, as well as provided dedicated nurse services, through an initiative called Ensemble. The goal was to provide thoughtful support, guidance, information and educational resources to address the concerns of employees with cancer, their caregivers and managers. As Ensemble evolved, Novartis reached out to an expert in healthcare for a potential partnership to expand upon the successful initiative. Johns Hopkins Medicine had developed a similar program called Managing Cancer at Work to help their employees diagnosed with cancer. In 2016, Johns Hopkins decided to make Managing Cancer at Work available to other organizations. The Johns Hopkins initiative had three key elements – an extensive web-based educational tool covering cancer prevention and early diagnosis, education and support for any employee diagnosed with cancer or caring for a loved one with cancer, and detailed education for managers and supervisors who might have a cancer patient, cancer survivor or caregiver on their work team. In addition, a major component of the Hopkins effort is the Oncology Nurse Navigators, who provide personalized guidance to employees and managers on topics including understanding and managing a cancer diagnosis; balancing health with work and family responsibilities; awareness of cancer’s financial impact; caregiving; and survivorship. When Novartis learned of the Hopkins’ initiative, they reached out to explore how to combine the two programs. The result: the launch of Ensemble-Managing Cancer at Work in 2017. Johns Hopkins’ Managing Cancer at Work program includes a comprehensive informational website with content created/reviewed by Johns Hopkins experts, while the Nurse Navigator feature allows for individualized support for Novartis employees, providing help with work-related, healthcare-related, and emotional aspects of dealing with a cancer diagnosis and treatment. Novartis implemented Ensemble as an extension of its mission to improve patient’s lives. Because of the success of Ensemble – and the increased awareness achieved with the Hopkins’ collaboration – the program is growing globally. Project leaders say that “By joining forces with external innovators to pursue shared interests, we can increase the breadth/depth of the impact we deliver. Through active engagement, we can create a collaborative environment to maximize the probability of success.” It is a privilege to be recognized by eyeforphama as a leader in finding valuable solutions for patients. Novartis and Johns Hopkins Medicine wish to share our collaboration with pharma executives, patient advocacy groups, and other health experts to share our idea broadly and facilitate positive change.

MOST VALUABLE HCP OR HEALTHCARE INITIATIVE

Winner: Medscape Education and Takeda Pharmaceuticals Initiative: Clinical Advances in Major Depressive Disorder: Focus on Patient-Centered Care

THE STORY: Nearly one in five adults in the U.S. suffers with major depressive disorder. Although a common, pervasive and serious disease, affecting an estimated 16.1% of adults in the US, it remains underdiagnosed and undertreated – with significant quality of life and mental health consequences and an increased risk of morbidity and mortality from other serious conditions. To help close existing professional gaps in treating MDD, Medscape Education developed 20 Continuing Medical Education/Continuing Education (CME/CE)-certified educational activities and hosted them on a learning destination page dedicated to MDD. The program was supported by an educational grant from Takeda Pharmaceuticals. For the past five years, Medscape Education and Takeda Pharmaceuticals have worked to close professional gaps with the hope of improving management by developing an educational learning destination for healthcare providers to become better equipped to manage and help patients with MDD. Takeda Pharmaceuticals wanted to bring greater awareness to management of depression which was desperately needed. It was important for Takeda to demystify and de-stigmatize depression and they realized that this would require a greater effort than ever conducted before.

The destination page was designed to educate primary care physicians (PCPs), psychiatrists, nurse practitioners (NPs), Physician Assistants (PAs) and nurses so that they may: • Optimize the use of screening tools to capture all patients who may have MDD, residual symptoms, and recurrent or moderate to severe MDD • Improve their confidence in recommending the most appropriate treatments based on patient characteristics and preferences • Stay up to date on the latest data to translate advances into patient care • Improve communication with patients, including administration

of nonpharmacologic interventions that are linked to improved patient outcomes and providing guidance on appropriate treatment expectations Medscape Education reached out to its registered healthcare member audience to deliver this education to the largest online membership of active US clinicians, including 202,789 PCPs, 91,229 primary care NPs/PAs, 39,352 psychiatrists, 7845 psychiatry NPs/PAs, and 903,600 nurses. The education initiative reached and impacted over 166,000 healthcare providers in the United States and made notable improvements in the management of MDD. The most notable impacts included: • 31% of PCPs and 29% of psychia

Winner: Upside Health Initiative: Ouchie

THE STORY: There is enormous pressure on chronic pain patients to manage complex care plans, a reduction in access to medications and treatments that are often time consuming and under-covered by insurance. The pain itself can make patients incredibly isolated and frustrated. It’s an issue that touches more than 116 million Americans trists reported improved confidence in their ability to manage patients with MDD. Participation also led to improved knowledge among 25% of PCPs on concepts related to adjusting treatments.[Thase 2016] • On post-assessment, 34% more PCPs (593% relative change; from 10 to 109 scripts) and 33% more psychiatrists (179% relative change; from 47 to 171 scripts) selected appropriate therapies for a patient with cognitive deficits (case 1).[Jain 2016] • PCPs and psychiatrists dramatically improved their compliance with quality standards, as well as their ability to apply these standards in the real-world management of patients with MDD, with a median improvement of 48% on a year. The Upside Health team designed, developed and launched Ouchie, a mobile companion for pain management – a free application for iOS, Android and tablet that helps support a chronic pain patient on their journey. The application allows for tracking/journaling, connection to others who live with similar pain, access to post-assessment for both target audiences, particularly on switching medications and optimizing treatments (i.e. adding sleep aids). [Gaynes 2016] This was a multi-tier partnership effort led by Medscape Education, in partnership with PatientsLikeMe, and including content on WebMD Education (WebMD is the parent company of Medscape). Each entity filled a key niche and educational need in depression - Medscape for clinicians, WebMD for patients, and PatientsLikeMe for their ability to share real-world data/treatment experiences. Together, this formed a

MOST VALUABLE PATIENT INITIATIVE OR SERVICE

very strong and strategic partnership. valuable and targeted content (including meditations). The platform then rewards patients for recording their daily accomplishments, following their treatment plans and helping others. Ouchie uses evidence-backed tools to ensure no chronic pain patient has to hurt alone. Tracking, CBT, contingency management, community and access to resources comes together on one platform to improve outcomes. Upside Health uses digital/mobile health technology, complex APIs and EHR integrations, along with artificial intelligence and natural language processing to understand what the user is experiencing and

delivering relevant content. It also uses social functionality. The Upside Health team held focus groups with hundreds of patients, spoke with more than two dozen chronic pain specialists and then released a beta version of the application with 300 patients. During that time, the Upside Health team not only sent out surveys and spoke to users via e-mail and phone, but also actively made product modifications and used tracking analytics to get a visual understanding of platform usage and challenges. The #Just1Thing content on the application is all about just one thing a patient can do to find relief, while the data visualization and focus redirecting have both short and long term implications. The new clinical integration allows for better understanding of the patient experience and more precise treatment over longer periods of time. After less than one month on the platform, 89% of the patients felt like they could effectively manage their pain, 83% were more likely to try or adopt a new treatment. They also reported declines in helplessness, hopelessness and frustration. Sample feedback from a user: “Great work you guys! And thank you for giving us all a place to learn about our pain, as well as getting to know others who are in the same boat!” The success of the application has led to additional excitement and interest from health systems and payers, as to how they can integrate this into their offerings. Shortly after launch, Ouchie became the official patient engagement app of the U.S. Pain Foundation. There are also partnerships with Weill Cornell’s Pain Center, NYU’s MS Center and the IASP World Congress on Pain. These partnerships introduced the platform to their members via social media, pamphlets and in-person experiences. They were all managed via the Upside Health team. The data and insight gathered from patients is helping inform new functionality on the platform, including integration with wearables and connected devices, with an enhanced emphasis on accessibility. Ouchie is adding on new features like telehealth and partnerships that add further value to patients. The application, when clinically integrated, is delivering nuanced and personal information beyond the four walls of the health system that strengthen patient-provider relationships, allow for less friction and create opportunities for more targeted, precise care. Lastly, with partnerships in the pharmaceutical industry, the knowledge gathered by the Ouchie platform has the potential to not only improve efficacy of current treatments but also increase the pipeline for new ones.

www.ouchie.com

THE PATIENT CHAMPION AWARD

Winner: Molly MacDonald, Founder,CEO, The Pink Fund

THE STORY: A breast cancer diagnosis can destroy the financial health and well-being of patients and their families. While in active treatment many patients are unable to work and experience a loss of income which can result in catastrophic financial losses. The Pink Fund provides financial support which meets basic needs, decreases

stress levels and allows breast cancer survivors to focus on healing while improving survivorship outcomes. Cancer is one of the most costly diseases to treat. Patients and their families face high deductibles and co-pays, not to mention lost income as a result of some of the toxic side effects of treatment, making it impossible to work. Patients need strong financial navigation and support services to financially bridge this period of time. And while co-pay support is available to some, there is very little to help patients with nonmedical, non-negotiable bills, for housing, transportation, utilities and health insurance. Patients who experience a loss of income may not comply with the prescribed treatment plan, making potentially life-altering decisions if they cannot pay for their care. Molly MacDonald’s 2005 breast cancer diagnosis came at a time of job transition. Having been through a financially devastating divorce with five children, no alimony and sporadic child support, she had no savings to weather the storm. Without her income and the addition of a $1300 COBRA premium the family experienced what is now known as “financial toxicity.” Meeting other working women in treatment on unpaid leave, experiencing similar challenges and not able to find a single organization to help financially bridge unpaid time off during FMLA, she launched what became The Pink Fund. With very little money to launch, MacDonald traded a dining table for the organization’s heart & ribbon logo. She took $50 and purchased a book called, “How To Form a Non-Profit Corporation.” The greatest challenge came in the first year of operation when two people she trusted to help sent her a courier-delivered letter severing their business relationship with her and taking the non-profit and its name as their own. Nevertheless, she prevailed. Despite the obvious obstacles she was enduring she became determined to make a difference, and did. She says, “I believed in myself and that belief propelled me forward despite numerous obstacles and challenges.” Within a month, MacDonald relaunched as The Pink Fund with a donated website and a front-page story written by now retired and award winning medical writer of The Detroit Free Press, Pat Anstett Kiska, on the front page of the women’s section. Other challenges were building a cohesive board of directors who understood the nature of nonprofit governance and their roles and limitations, and a committed and passionate staff. Since founding The Pink Fund in 2006, MacDonald has used her voice to advocate for women in treatment for breast cancer experiencing financial toxicity, sharing her story and theirs. She is a sought-after speaker on this subject, demonstrating the real problems and decisions patients make around treatment, when cost of care and lost income are factors. As a columnist for Breast Cancer Wellness Magazine, MacDonald writes on ways patients can mitigate the financial burdens of treatment. She sits on the board of VBID, Value Based Insurance Design out of the University of Michigan, where insurance companies, pharma, providers, and consultants meet to discuss how to reduce the cost of health care to patients while providing high value outcomes. In 2018, she presented a case study on financial toxicity with respect to breast cancer and sat on a panel exploring potential solutions at the Patient Advocacy Engagement Conference in Baltimore. She led a roundtable discussion at the eyeforpharma I M Patient Conference in Philadelphia, and sat on a patient panel at the Association for Value Based Cancer Care Summit in New York City. She has been invited to join the speaking faculty in April 2019 at CBI’s Formulary, Copay and Access Conference. “At The Pink Fund we look at the number of women and families helped, about 273 annually; and the amount of bills paid on their behalf ($3 million as of November 2018),” says MacDonald. “The program dramatically reduces stress on the patient and their family, allowing them to focus on getting better. The tangible financial support The Pink Fund provides, removes one less worry as they undergo treatment. One cannot quantify or qualify hope, but ultimately hope is what The Pink Fund delivers. Finally, all one needs to do is read the thank-you notes we receive to understand the success of the program.” •