Gilead’s endeavours in patient engagement may still be in their infancy, but Head of Technology and Innovation Matt Bryant tells Danielle Barron that the organization is striving to use innovation to transform the patient experience of clinical trials

Enabling and ensuring true patient engagement throughout clinical trials is a laudable goal, but as many clinical trial organizers have found, to their dismay, it isn’t always a feasible or even practical one.

Gilead’s Matt Bryant points out that the pharmaceutical industry is built on innovation but admits that when it comes to enhancing the patient experience, they are still playing catch-up. 

“Our industry as a whole has been innovative in many ways and our company certainly has as well. As far as it relates to patient engagement, Gilead specifically is still in its infancy and we are establishing patient engagement and a patient voice throughout clinical development, and we’re in the process of establishing a framework for making that a more sustainable part of everything that we do and part of our culture.”

This framework he mentions is nothing if not ambitious: the goal is ultimately to have patient engagement embedded and scaled throughout the Gilead portfolio as a fundamental part of every program and study that they design, with outcomes from a patient perspective as well as the patients’ experience given equal import. It is no understatement when Bryant says the company’s aim is to “totally transform” the patient experience and clinical trials.

“It’s about human-centered design, thinking and understanding what’s most important to patients. By making sure that our scientific outcomes are aligned number one, that helps align us as well as far as motivations from a patient perspective. It also means we have the right outcome for it scientifically and from a regulatory science perspective,” Bryant explains.

It sounds simple: by ensuring all of the relevant stakeholders align from day one – and he includes payers and providers in that – a trial is designed to succeed. “That’s the first step we will aim to take and if we can, from there, build a simplified experience and target the right objectives from a clinical development perspective then we think we could have better outcomes as a whole and build a better experience.”

Technology will enable this, but it isn’t about using tech for tech’s sake, Bryant notes. “If that means incorporating technology where it makes sense and at the right phase of development, and with the right safety profile of the drugs, then we will certainly do that. But I would say, first and foremost, we’re really just interested in making it more of a patient-centered objective and a better experience for all.”

As with many companies, the pandemic has functioned as the catalyst for the renaissance of the clinical trial. This takes on an even greater significance because Gilead is working on a  range of therapies for use in patients with Covid-19. Understanding people’s perception of the disease, as well as their expectations around treatment, is key to the success of these clinical trials, says Bryant.

“We are starting to engage with patients to understand their perceptions of Covid-19, and that way we can incorporate them into our clinical trial designs and make sure that we are targeting the right patient population in the right country and region,” he explains.

With the initial studies for Gilead’s antiviral drug remdesivir, Bryant says it was quite easy to enrol patients very quickly at the beginning of the outbreak. Over time, however, the landscape has changed, with the company less keen to see patients attending clinical sites due to safety concerns as the pandemic continues. 

Gilead is now seeking to redesign the experience for some of its emerging formulations that it is exploring. “We’d like to try to build an experience that’s decentralized and brings that clinical trial experience directly to the patient and their home. So we’re looking at utilizing home health to try to help augment that, help them with the device and make sure that they’re using it appropriately in their homes as well as being able to monitor them remotely,” Bryant says, noting that this is “a complete transformation” from how things were done even just a few short months ago. “The pandemic has definitely accelerated our strategy.” 

The pharma industry is finally coming around to the idea that a patient-centered approach may be what solves the classic problems that beset clinical trials, such as patient recruitment and retention. By engaging with patients when the trial is in its very earliest stages, it’s increasing its chances of success. Bryant is in agreement. 

“Traditionally, it’s been extremely difficult to recruit clinical trials because it has been based on, and frankly somewhat biased around, the geography of where we’re partnering with investigators and so they’re only able to recruit within a geography or radius around their physical site,” he says.

“By flipping it on its head and going directly to the patient, then we can identify investigators that are near where the patients reside and that’s a completely different paradigm. By fundamentally shifting that design, we’ll be able to accelerate and throttle enrollment and retention throughout those studies, unlike anything we’ve ever been able to do before.”