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Pharma has spent decades getting better at developing medicines. But what happens after a medicine exists?
A prescription can still trigger prior authorization, coverage questions, pharmacy substitutions, patient support calls, training requirements, and uncertainty about what happens next. For patients, the medicine itself may be only one part of the experience of getting treated.
During a recent Pharma Talks conversation with host Nataliya Andreychuk, Richard Schwartz expressed his belief that the industry needs to treat the patient journey much more seriously.
Schwartz is an experience management expert who works across life sciences, pharmaceutical companies, providers, payers, and patient advocacy organizations. His personal “moonshot” is an idea he calls Experience as a Medicine (EaaM): the belief that the experience surrounding treatment should be considered part of the treatment itself.
During a recent Pharma Talks conversation, Schwartz explored what that could mean for pharma, from rebuilding trust and redesigning patient support to using AI to identify and solve problems at the moment they happen.
Trust, Schwartz argues, is more than another brand metric.
“Trust, with a capital T, is kind of a metametric to me. It is the one metric to rule them all. We don’t do very much well without it.”
The problem is that healthcare operates within a strange trust dynamic. Patients consistently place considerable trust in doctors, nurses, pharmacists, and other healthcare professionals. Pharma, advertising, and other commercial institutions tend to sit much lower.
Yet pharma often tries to reach highly trusted people using approaches borrowed from industries that people trust much less.
That does not make advertising inherently bad. Schwartz argues that the problem starts when communication is designed primarily to create demand rather than value.
“Trust is about mutual understanding. Trust is about reciprocity and value exchange.”
This can collide with another reality of the pharmaceutical business: quarterly performance. Brands have commercial targets to meet, while better healthcare experiences often require longer-term investment and collaboration.
But the complexity of modern medicines is making that investment increasingly difficult to ignore.
The blockbuster era gave pharma medicines that were often relatively straightforward for patients to access and use. Today, scientific innovation has created biologics, specialized medicines, injectables, GLP-1 therapies, and other treatments capable of producing remarkable outcomes.
But the experience surrounding them has not necessarily become easier.
“They’re hard to get, and they’re even harder to start, and they’re much harder to stay on. They’re harder to prescribe.”
A patient may need to navigate a manufacturer, physician, pharmacy, payer, pharmacy benefit manager, specialty pharmacy, government entity, or other intermediary before starting treatment.
Schwartz describes this patient journey as “pea soup.”
Pea soup is cloudy and difficult to see through. So is healthcare from the patient’s perspective. Inside it are physicians, pharmacies, payers, PBMs, manufacturers, and public-sector organizations. Some make decisions that patients may never even know occurred.
“We think it’s a straight line, right, that the manufacturer is selling to the patient through the prescriber,” Schwartz said. “There’s a lot of ingredients in between a person who needs a medicine and them getting it.”
A physician can prescribe a treatment only for someone elsewhere in the system to delay it, reject it, substitute it, or make access more complicated.
For the industry, those may be processes. For the patient, they are the treatment experience. And patients are rarely prepared for them.
“Nobody taught us how to be sick.”
That observation gets to the heart of Experience as a Medicine. A person who has just received a serious or chronic diagnosis is suddenly expected to understand a system that HCPs themselves often find difficult to navigate.
Manufacturers cannot control every ingredient in Schwartz’s pea soup. But that does not mean they can separate the medicine from everything surrounding it.
“Part of the job, part of the product itself, part of the medicine is making that experience the best we can possibly make it.”
If experience is part of the product, when should pharma start designing it?
According to Schwartz, as early as possible.
When a company begins thinking about developing a therapy, it can also start asking patients, prescribers, and caregivers what receiving that therapy should look like.
“We can’t cure your disease. We can’t take it away. But if we’re going to create a therapy for you, how would you want it delivered?”
That changes experience design from a commercialization exercise into something that accompanies the medicine throughout development.
“The voice of the patient, the voice of the prescriber, go from idea onto the bench all the way to the bedside.”
Schwartz points out that many questions companies address during commercialization or pre-commercialization could have been explored during Phase III. By commercialization, patient services, physician messaging, access support, and other surrounding experiences are being constructed, while valuable insights collected earlier may already have become disconnected or lost.
Starting earlier could help companies design around the realities of treatment rather than trying to repair the experience afterward.
Experience as a Medicine is deliberately provocative, but Schwartz does not frame experience as simply making patients “feel good.”
His thinking has been influenced by research into placebo and treatment effects, compassion, kindness, and the relationship between the circumstances surrounding care and health outcomes.
The molecule, protein, device, or therapy remains central. But the treatment does not happen in isolation.
A frightened patient struggling to access a medicine, understand how to administer it, manage side effects, or find reliable information is having a very different treatment experience from someone who feels informed and supported.
And compassion has a commercial dimension too.
“These aren’t just good ways to live a life. These are good ways to run a business.”
“People need to feel that you really care about them.”
It is a memorable way of describing something that can disappear underneath increasingly sophisticated customer experience strategies: people notice whether the organization on the other side appears genuinely invested in helping them.
That distinction becomes particularly important as pharma invests heavily in artificial intelligence.
AI can help people navigate information, understand their conditions, prepare questions, and manage parts of their care. Schwartz has experienced that need personally. After receiving difficult medical information, he realized how quickly illness can become another full-time job.
“I just got a full-time job I’m going to have forever that pays in reverse, and I’m not qualified.”
Generative AI can potentially level that playing field. Patients can ask questions in their own words and receive information when the need occurs rather than navigating static websites or waiting for someone to respond.
But Schwartz is skeptical of treating AI itself as the source of empathy.
“AI doesn’t really care about empathy. So, it’s how we guide it and protect it.”
If a system is optimized around a sales target, it will optimize toward that target. It will not spontaneously decide that reassurance, compassion, or a patient’s quality of life should matter more.
That means the question for pharma should not simply be, Where can we deploy AI?
Schwartz asks companies something different: What case study do you want to be presenting two years from now because of what you are building today?
“If we don’t know where we’re going, any road is going to take us there.”
The opportunity is to combine what technology does well with what people need from other people.
As Schwartz puts it, healthcare is entering an important moment in the “alchemy of technology and humanity.”
The same rethink may be needed in how pharma measures experience.
Traditional customer experience metrics such as satisfaction, effort, and Net Promoter Score have value. But they are retrospective. By the time someone reports a bad experience, the problem has already happened.
If someone has just been told they have cancer, they should not have to struggle through a website and later complete a survey explaining that the information was difficult to find.
“I needed it two months ago. And I needed it specifically.”
Schwartz proposes thinking instead about a helpfulness index.
“How are you showing that in the moment, in real time, and understanding my needs and resolving them in the moment?”
AI makes that idea increasingly realistic. Companies can potentially move from solicited feedback toward understanding the signals already surrounding an interaction. Instead of measuring how badly something went, they can begin asking whether a problem is about to happen and whether they can prevent it.
“The experiences get more beautiful the more they get invisible.”
The ultimate experience may therefore be one in which the problem the patient would have complained about simply never occurs.
Pharma has become extremely good at counting digital activity: clicks, visits, downloads, views, streams, samples, and interactions with representatives.
The problem comes when those operational metrics are treated as evidence of business impact.
Schwartz calls this a “consensual hallucination.”
A campaign generates engagement, and prescriptions subsequently increase. The organization concludes that engagement caused an increase.
But what about patients or HCPs who engaged and never converted? What about people who never interacted with the campaign and still started the medicine?
“We’re taking credit for the good data that fits the narrative that we want to tell.”
For Schwartz, the missing component is the experience between operational activity and financial outcomes.
That requires companies to ask harder questions about what actually helped people, what created friction, what changed behavior, and what ultimately made the experience better.
Perhaps the sharpest test Schwartz proposes applies to patient support programs.
Many contain familiar components: a website, phone number, copay assistance, sharps containers, testimonials, hub connections, and specialty pharmacy services.
All may be useful. But their existence does not necessarily mean the program has been designed around the lived experience of being ill.
“This is a person who’s sick. This is a person who’s probably scared. This is a person who’s not been trained in having cancer or heart disease or an immunological condition.”
So Schwartz suggests asking a much harder question:
“If I took my drug out of the equation, would this still work?”
And then an even more challenging one:
“Could I put my patient support program through clinical trials, and would it be efficacious?”
That question captures the ambition behind Experience as a Medicine.
Pharma already asks extraordinary questions about science: What if we could alter the course of cancer? What if we could transform the treatment of psoriasis or Crohn’s disease?
Schwartz believes the same ambition can be applied to everything surrounding that science.
“These are miracle factories, these companies,” he said. Now, they have the opportunity to use new technology to “take your brilliant science and create brilliant experiences that sit next to it.”
The medicine may begin with the molecule. But for the person receiving it, treatment is everything that happens around it too.
If this podcast episode resonates with you, follow Nataliya Andreychuk, our host, and Richard Schwartz on LinkedIn for more insights on the future of patient and HCP experience.
And if you’re looking for ways to create better content experiences for life sciences professionals and patients, drop our team a line. We’d love to hear what you’re working on.
