Johns Hopkins public health expert encourages inclusion of patient preferences in medicinal development
Individual patient preferences for treatments should be taken into account during the development of medicines as well as the progression of health care-related regulations, according to Dr. John Bridges.
Bridges is an associate professor in the Departments of Health Policy and Management and International Health at the Johns Hopkins Bloomberg School of Public Health.
In fact, Bridges told Patient Daily that one of the risks currently associated with qualifying “value” in the health care realm is “not appropriately involving end users -- i.e. patients -- in the determining of those values.”
Additional associated risks with qualifying such health care value, he said, include “not using quality scientific methods to determine values and developing value-based systems only to ration health care.”
Such risks essentially increase the tension between society’s need to allocate health care dollars with the individual treatment needs of patients, thereby limiting the development of much-needed medical technologies.
Generally, experts say, three main issues surround incorporating patient preferences: whether patients’ preferences should play a larger role in resource allocation decisions; how to accurately measure preferences; and determining if patient preferences differ from providers or the community at large.
Bridges, who advances and applies a variety of qualitative and quantitative methods to study the priorities and preferences of patients and other stakeholders in medicine -- and who advocates for understanding the patient perspective -- believes that better value is attainable in health care, while simultaneously respecting the diverse needs of patients.
“Often, I find that preferences of patients are not that diverse as we think,” he told Patient Daily News. “We are increasing our understanding of preference heterogeneity, and better methods need to be used to do this. I think the challenge is when patients have different values to clinicians or policy makers.”
Specifically, he added, greater efforts to incorporate patient preferences into regulatory decisions, especially regarding medical devices, “are promising.”
The U.S. Food and Drug Administration’s (FDA) Patient-Focused Drug Development Initiative, for example, is taking into consideration the voice of the patient, he said.
The initiative is a commitment by the FDA under the most-recent authorization of the Prescription Drug User Fee Act. It aims to more systematically gather patients’ perspectives on their conditions, the available therapies to treat their conditions and any unmet needs, among various items.
As part of its commitment, the FDA is continuing to hold a series of at least 20 meetings, each focused on a specific disease area. During each meeting, patients and other stakeholders are given the opportunity to provide their perspectives on the regulatory process.
Several Voice of the Patient Reports have already been published by the FDA. The most recent was this month's report on functional gastrointestinal disorders. To read the reports, visit www.fda.gov.
While Bridges called the initiative a major leap forward in engaging patients in the process, he also told Patient Daily News that “more needs to be done.”