Nuno Camacho

The effect of customer empowerment on adherence to expert advice

Customers often receive expert advice related to their health, finances, taxes or legal procedures, to name just a few. A noble stance taken by some is that experts should empower customers to make their own decisions. In this article, we distinguish informational from decisional empowerment and study whether empowerment leads customers to adhere more or less to expert advice. We empirically test our model using a unique dataset involving 11,735 respondents in 17 countries on four continents. In the context of consumer adherence to doctors’ therapy advice (patient non-adherence to doctor advice may cost about

Grassroots Innovation: A Promising Innovation Paradigm for Pharmaceutical Companies

564 billion globally to the pharmaceutical industry every year), we find that decisional empowerment lowers adherence to expert advice. The effect of informational empowerment varies predictably across cultures and is only universally beneficial when initiated by the customer. These findings have important implications for professional service providers.

Patient Empowerment: Consequences for Pharmaceutical Marketing and for the Patient–Physician Relationship

Pharmaceutical firms face a period of unparalleled turmoil. Major societal, technological, and regulatory challenges require firms to quickly respond to a rapidly changing environment. In particular, the issue of how to improve R&D productivity is considered the key challenge faced by the pharmaceutical industry nowadays. The core thesis of this chapter is that grassroots innovation programs—structured processes aimed at stimulating employees in all corners of the organization to contribute to innovation efforts—may be an essential complement to pharmaceutical firms’ more traditional and top-down stage gate processes. However, academic research to guide pharmaceutical firms in the implementation of grassroots innovation is scarce. This chapter discusses an in-depth case study of a grassroots innovation process (Innospire) at Merck KGaA, Darmstadt, Germany. The process design and implementation was based on theoretical derivation, to facilitate the transfer of knowledge to other firms and contexts. Hence, we also discuss our conceptual framework, grounded in self-determination theory, which managers at other pharmaceutical (or any other innovation-intensive) firms can use to design their own grassroots innovation processes. We also discuss a multitude of possible future research directions in this area, with high dual impact to both academia and business.

Expert opinion of nephrologists about the effectiveness of low-protein diet in different stages of chronic kidney disease (CKD)

Big Pharma’s blockbuster model—which entails developing new drugs for diseases affecting a very large number of patients, promoting it to physicians as the new best-in-class treatment, and profiting from the ensuing volume of sales—is under threat. In the last 2 decades, the largest pharmaceutical firms have lost billions of dollars in shareholder value, due to a combination of factors such as declining R&D productivity, stricter regulatory requirements, more intense generic competition, and an increasingly ineffective marketing model. I review societal, demographic, regulatory, and technological trends and discuss how such trends are contributing to the rise of a new class of empowered patients. I discuss the implications of patient empowerment for the patient–physician relationship and for therapy launch and therapy promotion. Building on real-world evidence, I discuss the benefits and challenges of direct-to-patient marketing strategies such as nurturing partnerships with key patient opinion leaders and direct-to-patient communication via social media. Through a content analysis of the 2005–2010 annual reports of the largest 20 pharmaceutical firms, I show that, despite strict regulatory requirements, several firms have started to embrace patient empowerment as a key component of their marketing models. However, much remains to be done. I propose that now is the right time for pharmaceutical marketers (and scholars) to implement marketing strategies that help empowering patients. In addition, I also discuss the importance of avoiding that patient empowerment results in healthcare consumerism, which could have destructive consequences for patient–physician (and firm–physician) relationships.

Health and Marketing: Essays on Physician and Patient Decision-Making

Abstract No clinical trials have specifically explored the benefits of low-protein diet in patients with different stages of chronic kidney disease (CKD) 3B. In the absence of RCTs, expert opinion may be a valid surrogate to estimate treatment effectiveness. A questionnaire-based survey of a large sample of nephrologists from Southern Italy was conducted to explore benefits of low-protein diet (LPD) in delaying dialysis entry in different CKD stages. For the case vignettes describing eight different patient profiles with various CKD stages, nephrologists reported expected benefits as time delay of dialysis entry. Information was collected through questionnaires filled by 88 nephrologists from different Southern Italian hospitals. On average, nephrologists estimated the highest delay in starting dialysis due to LPD in stages 3B (15 months) and 3A (14 months), and the lowest for 5 stage (3 months). According to opinion of a large sample of Southern Italian nephrologists, low-protein diet may be more efficacious if started in CKD stage 3B than 4 and 5.