Profit Focus with Rare Disease Confuses the Ends and Means

Before being drawn into the world of rare disease, I coached lacrosse at the collegiate level. I loved seeing young people develop both on the field and in their personal lives. I liked knowing that a something like the pursuit of getting better at lacrosse would mean greatness – first for them and then, overall, for our team.

Still, to this day, I am in touch with a good number of my athletes. We talk about everything — families, careers, lives. One thing we hardly ever cover? How many wins we got in a random season.

It’s not that winning was not important. Anyone who knows me knows that I like to win at anything. But it has been my experience both in sports and in health care, that winning is a natural outcome of daily, intentional behavior. It is a lot of little things. When I would focus only on winning, things would go wrong. The mental pressure and pursuit of winning would distract us from our daily discipline. That made for fewer wins, worser outcomes, and a disappointing season.

I learned that we would focus on our athletes to make sure they had everything they needed and the behaviors necessary to win the day. The little wins each day created the confidence to win on game days.

As simple as this may seem to you, I think that all of us in health care, especially those of us who work with people with rare conditions and their families, can also learn from this mindset and application. How often have you felt the pressure to make your margin or revenue goals for the week or the quarter? When that was your sole focus, how well did you perform? Did you feel pressure to make choices for short-term gains that later cost you?

Chances are that you have. If you haven’t then maybe you have not been in health care long enough. It happens to nearly everyone I know who must answer to shareholders.

However, there is another way to solve that pressure and, by the way, get improved care for patients (the people we are in this business to help). And it starts by placing those people and their families at the center of your strategy. Make their lives and their needs your daily focus. Be vigilant in this. Be disciplined each day, and your profits are sure to come.

It’s simple: You cannot be margin-first and patient-first. Profit is an outcome of outstanding, consistent care. The only way to do that in rare disease is through a high-touch, constantly curious, pandemic-proof model.

Maybe your specialty pharmacy is touting a patient-first approach. Most have websites with the word plastered everywhere. But I would challenge you to look under the hood a little. Unless they have a dedicated team for your therapy, it is hard to make the case that the marketing is true. People with rare disease and their families need constant and consistent care from another person. They must know the first name and last name of that person. They must be available and supported by a team for your therapy and become that trusted source.

Unless that is happening, then the pharmacy is margin first. They are looking for efficiencies and ways to squeeze out more profit. Again: You cannot be margin-first and patient-first. One is a priority. One is an outcome.

Building real trust with a patient and getting to know everything about their challenges connected to your therapy is what your pharmacy should be doing. They should get to know that patient so well that they can anticipate the challenges before they arise. That trust generates a level of compliance. Compliance means improved outcomes. Improved outcomes lead to more patients on therapy. That is more profits. Profits are your outcome. Not your focus.

While many in the pharmaceutical manufacturing world are unaware of a model outside of filling the channel and focus on the margin, there is a different, and better way. At a pharmacy like the one we have built at Optime Care, we don’t live off the margin. With a fee for service, we focus on putting each patient’s care first. While this isn’t typical, I’d argue that deep down, we all know it should be.

I understand the importance of revenue. When you’re a publicly traded company, you must answer to shareholders. So, what if you’re answer is simply: We’re patient first. We do everything we can for the patient. And because of that we know that our revenue will be better. It’ll be the best outcome it can be because we’re patient driven. Not revenue driven.

The concept is simple, yet pharma companies are consistently confusing the outcomes with the means. Revenue is a result and outcome. It’s not the means. The means is the patient-first care. And when you put the patient first, the outcome and the revenue improve.

The insight that started for me in my coaching days is human nature: if you tell someone they did a really good job, give them feedback that they are on the right path, they will continue to do a really good job. They have the motivation to stay on product. And if they are happy, they will work with you. They will advocate for your product.

Here is your challenge: Pharma companies are consistently confusing the outcomes with the means. Revenue is a result and outcome. It’s not the means. The means is the patient-first care. And when you put the patient first, the outcome and the revenue improve.