Fabio Gratton began his career as a Hollywood scriptwriter. There, he learned that storytelling is difficult, but can be made easier by listening to people to discover their innermost needs and desires. And when he co-founded his first healthcare marketing company about 15 years ago, he quickly realized that pharma had an enormous unmet need — listening to patients and their impassioned stories about illness, treatment, and recovery.
Fast forward to inVibe, a voice research company founded in 2013 (and as of January 2022 has become a division of THREAD), where Gratton, as CEO, has applied this same empathy to market research. Somewhere between traditional quantitative (e.g., online surveys) and qualitative (e.g., focus groups and in-depth interviews) research was a gap where patients were not being sufficiently heard. He realized that innovative uses of digital technology could be adapted to collect, analyze, and deliver these stories back to clients.
Drug Development & Delivery recently spoke with Gratton about patient-focused drug development (PFDD), inVibe’s language model, and the value this technology brings to a patient’s treatment journey.
Q: What progress has been made in patient-focused drug development and what are the continued challenges?
A: The good news is that numerous governmental and industry-based initiatives have spawned a new era in patient-focused drug development. Although just getting started, PFDD has documented approaches to data collection, identified best practices and benefits/risk tradeoffs, and analyzed input on patient communications preferences
These efforts tap into the reality that patients are willing and oftentimes enthusiastic to share their feelings about the disease burden and their treatment journey with experts, and actively assist with the generation of evidence and actionable data. Unfortunately, company culture, limited cross-functional collaboration, and leadership hesitancy can create barriers for organizations. But even if those challenges are circumvented, the listening process itself is difficult and demands a new approach.
Human communication is messy. At inVibe, we realized early on that even after we got patients to share their deepest thoughts and feelings, we had another problem: How to extract key insights we could then report back to clients in a way that offers a chance to ask more questions, and provide actionable recommendations.
Q: What is GPT-3 technology and how is it extracting those key insights?
A: Our solution is a combination of human expertise and next-gen technology. Trained linguists sort through the data and help organize it; and the latest machine learning algorithms, such as Generative Pre-trained Transformer 3 (GPT-3) enable unprecedented semantic analysis and search capabilities. Our clients benefit from a more thorough analysis and dynamic reporting, fulfilling our mission for clients to actually hear from patients and listen to them, rather than merely process and regurgitate data.
GPT-3 technology was created by OpenAI and is the most expansive machine learning model of its kind. Without exaggeration, the tech literally scans nearly the entire Internet to contextualize and extract meaning from our voice data inputs. The richness of qualitative data is also what can make organizing and processing that data such a challenge. With GPT-3, we are able to design algorithms for specific tasks that reduce busy work and allow analysts to quickly get to meaningful insights.
Q: How is inVibe using GPT-3 technology?
A: By integrating GPT-3 technology, we have developed an algorithm to identify and extract patient concerns from open-ended questions that lead to increasingly specific and nuanced answers — often revealing concerns never before considered. With our machine learning capabilities and human-powered linguistic analysis, the industry has an unprecedented opportunity to listen to and extract key insights from patients throughout the drug development process. This mitigates potential downstream setbacks, and proactively enables study designers to focus on the needs and concerns of patients before drugs even hit the market.
To cite a specific use case, we recently applied the firepower of GPT-3 to the lupus clinical trial landscape, seeking to reveal patients’ preferences for study design and endpoints, and comprehension of patient-facing study materials. By offloading these tasks to a powerful language model, we were able to reveal rich qualitative insights in a much more streamlined fashion. Our technology worked like this: Patients were recruited and screened directly from their own smartphones; they viewed stimuli; listened to automated open-ended questions; responded by simply speaking; then their voice responses were analyzed using a combination of sophisticated software and human expertise. The results were shared with the client through dynamic dashboards that revealed key insights, and suggested actionable recommendations for the brand team.
Q: How are pharma and patients responding to this drug development approach?
A: Clients have embraced the concept, and inVibe quickly demonstrated value across disease states ranging from diabetes to oncology. By empowering patients to record their candid feelings directly into smartphones and then analyzing it with a hybrid of human linguistic expertise and advanced machine learning technology, we have changed the game in research.
With proven success across the post-launch life cycle of pharma brands, we also soon realized the importance of applying this novel approach to the drug development process. Our hunch that providing a platform where patients could share their perspectives without friction was correct — and so was our belief that regulators would see it the same way, eventually proven by the FDA Patient Focused Drug Development (PFDD) guidance, and Congress recently passing the Cares Act that created new guidance to ensure patient voices are heard early in clinical trials.
Not only are the government and advocacy groups standing behind technology and linguistic integration into the drug development process, but patients appreciate their voices finally being heard. The end result is empowered healthcare stakeholders — and improved therapeutics. Because key decisions at the development phase have a cascading effect throughout the life cycle of a drug, companies can save considerable money and time — and provide better treatments — by accurately understanding the needs and expectations of their end users: the patients.
That excitement and rationale have also been instrumental in our decision to become a division of THREAD, a technology platform helping to decentralize clinical trials. Together, we’re best positioned to infuse the drug development phase with the power of the patient voice.
Q: What will this mean for the future of patient-focused drug development and personalized medicine?
A: I have a Pollyanna outlook on life that permeates all the work that I do in healthcare. Despite the ongoing challenges to listening and understanding patients, I’m confident that the industry will evolve, and along with it so too will our capacity to improve the patient experience to the point where we’re not simply better at managing disease, but preventing it.
The key to accomplishing that goal is to embrace technology so that we empower our humanity. Researchers too often consider what they do, and how they do it, a pure numbers game, mistaking map with territory. In contrast, everything we do is ultimately designed to improve and extend human life. Technology is a means to that noble end. That’s why at inVibe we always start with the problems to be solved on our way to better listening to, and understanding, patients. As we tackle obstacles to data collection, analysis, and reporting, we also keep our minds and hearts on the vision of what an idealized future could and should be like for a healthy society. The future of patient-focused drug development is inspirational.
By better understanding end-users through patient-reported outcomes measures, researchers are already able to integrate these critical insights directly into their processes, methodologies, and even their study designs. The end result is to create more patient-centric trials with increased participation and retention, better study designs, and clinical results that precipitate more effective and safer treatments for all. By combining their dedication to patients and embracing the next-gen in market research capabilities, pharma is poised to catch up to the tech firms paving the way for the ideal consumer experience.
Drug development is only one of many opportunities for personalized medicine to come into its own. The patient experience must be integrated across every touchpoint and milestone in the patient journey. Thanks to this already proven combination of innovative technology and human-powered analytical expertise, those voices are not only being heard, but listened to, allowing for better understanding. Identifying differences between patients and heightening sensitivity to their needs, we are able to create a more personalized experience that improves the entire healthcare system.
Given how healthcare is often a matter of life and death, no initiative is more significant than improving public health. Patients are speaking, and pharma is, with the help of innovative market research, listening more.