NPC’s John O’Brien Discusses The Myth of Average on AiArthritis Voices 360 Talk Show

On a recent episode of AiArthritis Voices 360 Podcast, John M. O’Brien discusses NPC’s research on the importance of fostering biopharmaceutical innovation and improving patient access to the right treatments based on individualized needs and patient-doctor shared decision-making. 

Tiffany Westrich-Robertson, CEO of the International Foundation for Autoimmune & Autoinflammatory Arthritis (AiArthritis), is not your “average” patient. As a person living with non-radiographic axial spondyloarthritis, a type of arthritis in the spine, she faced a challenging journey to get accurately diagnosed and treated. That’s why the National Pharmaceutical Council’s (NPC) resource The Myth of Average: Why Individual Patient Differences Matter grabbed her attention.  

On a recent episode of AiArthritis Voices 360 Podcast, “The Myth of Average: Time for Change,” Westrich-Robertson spoke with NPC President and CEO John M. O’Brien about NPC’s research on the importance of fostering biopharmaceutical innovation and improving patient access to the right treatments based on individualized needs and patient-doctor shared decision-making. 

Health care and insurance coverage are often designed for the “average” patient, assuming all people have the same needs or the same treatment responses. This can create barriers for some patients in accessing the most effective care for them. The Myth of Average explores how patients, health care providers, insurers, and other decision-makers can better consider individual patient differences when navigating the complexities of health care and insurance. 

“I was that mystery patient,” Westrich-Robertson said. “When we’re assigned to take certain treatments because that's what is right for the general patient population and they aren't working, then we feel bad, and every bit of time that goes by that we're not on the right treatment, we have the potential of getting progressively worse.” 

NPC’s research explores how rethinking health insurance benefit design could improve patient access to high-quality health care treatments and services. “Health care decisions are often made at the population level, not the individual patient level,” Dr. O’Brien explained. “Health insurance coverage needs to be more patient-centered and fair. We need policies that align patient cost-sharing or access to treatments with what's most clinically appropriate for patients.” 

They also discussed the role of health technology assessment, or value assessment, in the health insurance landscape. Sometimes insurers’ coverage decisions may be informed by value assessment tools that don’t adequately consider the priorities or needs of individual patients. Dr. O’Brien stressed the need for increased transparency in value assessments and better inclusion of factors important to patients and their families, such as caregiver burden.  

Dr. O’Brien also mentioned a recent NPC study examining what health gains might have been lost without the introduction of influential innovations for six serious diseases, including rheumatoid arthritis (RA). Researchers found that the introduction of tumor necrosis factor inhibitor therapy in 1998 improved patients’ functional status by 11.5%, which translates to 50,600 quality-adjusted life-years (QALYs) gained in the U.S. from 1990 to 2017. 

“Innovation is the never-ending search for new cures and treatments,” Dr. O’Brien said. “The research that we do is intended to help patients get access to medicines but also to foster this environment of innovation.” 

Listen to the podcast now.