One of the most important areas of forecasting in the pharmaceutical, biotech and overall healthcare markets is Patient Flow Modeling. Models that allow the forecaster to predict changes in prescribing behavior down to the doctor / patient interaction across any number of patient types is absolutely essential when looking at products in Phase III and beyond.
Patient Flow Modeling is also the correct method to use when market research collecting preference share data has been acquired. This is a critical point as one of the most frequently asked questions in the industry is still "How do I convert a preference share into a market share?" The answer is that you use Patient Flow Modeling.
The benefits of Patient Flow Modeling include:
- Conversion of preference share to market share
- Multiple levels of market segmentation
- Accurate reflection of real market treatment patterns
- Inclusion of market dynamic effects such as price and promotion response
- Unlimited number of products, classes, segments
- Integration of all relevant data - primary, secondary, proprietary
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Market Definition & Patient Segmentation
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A critical element of the Fitall & Associates Patient Flow Modeling approach is the ability to define the market entirely around the decision making process. In the example to the right the market has been defined firstly in terms payer structure (formulary type) and then divided into patients (first line and maintenance). The system would allow for this to be modified to a "specialty by payer" approach if that was more suited to the needs of the client (or the structure of the available data). In fact, the system can be designed to fit any market structure.
In the case study from which this example was taken the client had high quality data by payer type that showed this to be the most important method of segmenting the patients (MC stands for Managed Care, where high/med/low is the degree of formulary control).
This approach may look complex - that is because it is complex and that is because the market is complex. if you are modelling a market with a simpler structure then the model will look simpler. We're not afraid of dealing with complex issues and you shouldn't be either. As the saying goes, "For every complex problem there is a simple solution - and it's wrong".
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| Example of flow diagram design |
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Modeling the patient treatment pathway is the most important aspect of patient flow modeling. It is essential that the model reflects real market behavior - and this can mean that the model needs to be complicated.
The diagram to the right shows a straightforward treatment pathway where patients see the physician, are treated or not, some need further treatment and so return for a further consultation. Each time the patient consults the physician it is possible that their condition will be redefined and that the patient segment into which they fit will change - this is modeled through the "CPT" or Change Patient Type variable which moves those patients into a different segment of the market.
In addition, there may be an extent to which patients treat themselves, have repeat therapy and so forth and the model needs to reflect these aspects of the market.
In patient flow modeling Fitall & Associates reflects the treatment pathway for each individual market segment. This ensures that each segment is modeled correctly. In addition, this approach means that it is possible to consider each segment as a separate market - if that is appropriate to the needs of the decisions being supported. For example, the drug being forecast may have applications in different indications, but also have different treatment pathways in those different indications (dosage regimen, use with other products, different competitors). The Fitall & Associates approach allows for all of these different market conditions to be taken into account.
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