Patient pathways in cardiology: Should pharmaceutical and medical device companies care?

Abstract

A shared goal of patients, providers and the companies that produce new therapies is to have these therapies used according to guidelines. Health services specialize in patient care and may lack the capabilities to take a product from conception through to everyday use. This results in a mutually beneficial relationship between health services and industry. The market for cardiovascular drugs is significant which results in competition between companies. While traditional methods of observational analysis may be able to determine to what extent drugs and devices are being prescribed or implanted by health providers, there is less real-world patient level insight as to why patients are taking (or not taking) these treatments and why one agent is chosen over another. Considering patient pathways is a novel approach which can be utilized to understand real-world patient activities. This approach focuses on the patient flow across the healthcare system and barriers at each stage including identification of patients, diagnostic testing, the decisions on treatment, and prescribing can help identify ways of improving the utilization based on guidelines. It overcomes several assumptions related to patient and clinician decision making and practical considerations such as geography and availability of health services. In this manuscript, we introduce the concept of patient pathways and why considering them maybe of interest to companies. As significant resources are invested to bring a product to market, this approach can help define if there are missed opportunities for their products to be utilized and potential barriers to implementation.