Putting Diverse Voices at the Center of the Conversation
As Director of Patient-Reported Outcomes at Johnson & Johnson, Andrea has a ton on her plate, but what exactly does her title entail? What are "patient-reported outcomes," for starters?
Here's a more or less jargon-free primer:
- Patient-reported outcomes (PROs) are one way of measuring clinical outcomes. For example, how do the patients themselves feel and function after receiving a given treatment? What can that tell us about the potential risks and benefits associated with the treatment?
- PROS, as their name suggests, must come "directly from the patient"—according to the FDA's definition—"without amendment or interpretation of the patient’s response by a clinician or anyone else."
- You might think of PROs as primary source materials in the context of healthcare, in other words. It's also worth reflecting on the bit about "anyone else" above. What do you make of a clarification like that? Why do you think it's included in the FDA's definition? However you answer those questions, they're inseparable from Andrea's mission today.
- Finally, note that PROs capture many different data points: perceived changes in a patient's quality of life, for example, or the relative severity of patient-reported symptoms following treatment. PROs are increasingly important to the overall healthcare ecosystem, too, influencing everything from regulatory rulings to clinical decision-making, health policy and more.
So, bringing diverse voices from the periphery to the center of the conversation, improving healthcare decision-making, driving better health outcomes for all—that's Andrea's line. What propelled her on this path?
Andrea's Unique Journey
There's no clearly marked trail to a successful career on the Market Access team at Johnson & Johnson, and Andrea's journey is a case in point. Essentially, it hinges on two parts: the initial velocity—Andrea's aspiration to be a physician, which dates back as long as she can remember—and then the ricochet.
Here's how she remembers it: "In my junior year of college, I began working at the Baltimore City Health Department on a project that tried to answer the question, 'Why aren't Black women in Baltimore seeking out or utilizing neonatal care?' And honestly, it changed my entire life trajectory. Just like that. I decided to pursue training, and then a career, in public health."
That training eventually included a master's degree in public health and a Ph.D. in public health, health policy and administration. Over time, she became an expert in PROs and other types of clinical-outcome assessments, paving the way for her to join the Market Access team at Johnson & Johnson.
Almost as soon as she did, however, she was forced to reconsider the field, and look at it with fresh eyes, once again.
"In 2018, I had to go on my own patient journey, something that I really didn't expect, and the experience clarified how important it is for patients to have access to the medication they need in order to improve their functioning and have better health outcomes," she said. "Honestly, having an experience like that puts a totally new lens on everything you do. In the past, I was certainly committed to my work and passionate about it, but literally moving into that seat gives you such a different perspective. It has made me much more compassionate, and more considerate about my approach."
She went on, "Now, I'm thinking about things that I wouldn't even have considered in the past."
A concrete example: the structure of patient interviews in clinical studies. Today, Andrea feels compelled to ask questions like "Is the patient able to fully participate in the interview during the 30 minutes we've allotted? Should we give them breaks during their interviews? Can we structure the interviews so that patients don't have to walk or drive or travel to get there?"
"My experience gave me so many insights," she added, "and I'm grateful to be able to incorporate them into how I design studies now. I really love hearing what patients have to say.”
What's Integral About Market Access
In light of Andrea's unique journey, how does she define the role of market access now?
"We're essential to the development of life-changing new drugs," she said, "because we're bringing the patient's perspective to the table. For example, we're answering questions like, 'To what extent do the patients think that a given drug has improved their symptoms or quality of life?' These are such important questions to answer, so our role is really integral from end to end."
Integral, indeed. The word, which at root means "whole," is well chosen in connection with Andrea's other recent work.
"Historically, groups such as African-Americans, Latinx, indigenous patients and others have been consistently underrepresented in studies," she explained. "And yet, at the same time, to effectively measure how patients feel and function, it's important that we are not only including a diverse range of patients in our studies, but listening to their diverse voices in that measurement as well."
It's a longstanding challenge in the healthcare space, and recent studies confirm that members of racial and ethnic minority groups (as well as older adults generally) continue to be underrepresented in many kinds of clinical trials. But Andrea knew she could help change that. She decided to raise her hand.
"I told the leadership team at Johnson & Johnson that I wanted to create and lead a new workstream, and that our focus would be on diversity, equity and inclusion in patient-reported outcomes research."
Quickly given the greenlight, Andrea and her colleagues sprang into action. So far, for instance, they've rolled out educational toolkits, revised key policies and introduced ongoing evaluations to measure their progress. In fact, their work is already impacting clinical site selection, patient recruitment strategies and more.
Along the way, Andrea says she has seen Our Credo brought to life in other ways as well.
"When I arrived at Johnson & Johnson, I remembers thinking, 'All of my colleagues are so nice—it's a really collegial and collaborative environment. But later, especially with the murder of George Floyd, my feelings of connection and being welcome and part of a community were really deepened. Initially, we had these Credo-based talks, which I thought were bold and timely and a good idea, but it was more than that. The fact is, the murder of George Floyd affected people of color differently, and there was trauma that we experienced with and through it. To have your company acknowledge, like, 'Hey, we recognize that you probably are not okay right now' meant a lot to me."
As a person of color, one thing I always inquire about with an employer is, ‘What is this company’s position on diversity, equity and inclusion really?’ And I now know the answer to that question at Johnson & Johnson. I've seen it answered firsthand.
Share
Join Our Market Access Team Today
Looking for a career where, like Andrea, you'll take on real-world challenges, spearhead cultural change and make a positive impact on communities around the globe? If so, check out all of the openings we have in Market Access right now, and be sure to sign up for our global talent community, too. The latter is an easy way to stay in touch, learn more about our culture at Johnson & Johnson and even get updates about jobs that might interest you in the future.