Over the years, I have prepared a lot of disease summaries that include things like current standard treatments, drugs in development, and unmet needs. We typically think of unmet needs in clinical terms; limiting or stopping disease progression, alleviating symptoms, and decreasing side effects of the current standard treatments.
Perhaps prompted by all the recent drug pricing controversies, I started to think more broadly about unmet needs in the context of the healthcare system as a whole. For example, the interplay and tradeoff of price, efficacy, and safety. I expect this type of consideration will increasingly become standard in disease area assessments.
That led me to think about the jobs-to-be done framework, originally proposed by Clayton Christensen (the disruptive innovation guy, http://www.christenseninstitute.org/key-concepts/jobs-to-be-done/) as it applies to the life sciences industry.
“People don’t want a quarter-inch drill, they want a quarter-inch hole” is a famous jobs-to-be done example attributed to Theodore Levitt, who was a professor and economist at the Harvard Business School. So, who hires the products produced by drug and device makers? What are the jobs to be done?
My purpose here is not to go through all the actual customers, stakeholders and complexities of the healthcare market. Rather, it is to do a thought experiment that comes from a place of caring and curiosity. I genuinely wonder what effect the experiment would have on those of us involved in developing new drugs and devices.
Here is the experiment-
Members from several departments of a pharmaceutical company are given 3 assignments, lasting 1 week each.
The first is to visit physicians in a particular specialty (e.g. rheumatology, infectious disease, oncology) at 4 top academic hospitals in the US. The participants would follow the clinicians on their rounds visiting and treating patients. They would only be able to observe and listen during the patient visits.
The second is to act as a panel of FDA reviewers to assess whether to approve several hypothetical drugs in a specific disease area. No rewards for risky decisions on this one – the penalty is to get hauled into a congressional hearing and lambasted on social media.
Lastly, participants are to act as employees of a major insurance carrier and make decisions about which new hypothetical drugs will be reimbursed given certain constraints of cost, number of lives covered, and the mandate to make a healthy profit.
At the end of the experiment, the participants would answer two questions:
- Who is (are) our customer(s) and why are they hiring our products? (think jobs to be done)
- Will I approach my job differently as a result of the information and experiences I gained? If so, how?