Edelman Trust Barometer raises questions

After two years of pandemic fatigue, healthcare trust is at an all-time low, according to Edelman’s Trust Barometer Special Report on Trust in Healthcare. Still, the report may be too generalized for every healthcare player.

Trust is a vital determinant of health behaviors and outcomes, but COVID-19 has dramatically influenced how the public makes healthcare decisions, according to the February online survey of more than 10,000 people in 10 countries worldwide.

According to the report:

1ne: More than half of respondents say the pandemic reduced their confidence in the healthcare system, and only 61% say they are confident in their ability to find answers about healthcare and make informed decisions for themselves and their families, a 10-point decline over five years.

2wo: Trust in the healthcare sector directly impacts personal health behaviors and a person’s likelihood to change their health decisions based on how they affect others.

3hree: Those with higher levels of trust in healthcare are more likely to be proactive about their general health, vaccinated against COVID-19, supportive of public health measures over personal freedom, and accepting of changing recommendations from healthcare officials than are low-trusting respondents.

The divide stems from a mixture of economic, geographic, cultural and political factors. Of those surveyed, 71% of high income earners were more likely to trust healthcare compared to 55% of low income earners, while 62% of white people had high trust compared to 55% of Black.

While this is an excellent general overview, it does not apply to all healthcare. Trust, for example, in physicians is still relatively high. Most patients completely trusted their physicians “to put their needs above all other considerations” (69%). Patients who reported having enough choice of physician (p < .05), a longer relationship with the physician (p < .001), and who trusted their managed care organization (p < .001) were more likely to trust their physician. 

But do doctors trust the system? Physician trust in the U.S. healthcare system significantly declined during the pandemic, along with their confidence in the leaders and executives at the healthcare organizations employing them, according to a report from the nonpartisan research group NORC at the University of Chicago commissioned by the ABIM Foundation. A poll found that 30% of physicians do not trust their healthcare organizations’ leadership and even fewer trust industry executives in general.

U.S. consumers’ trust in pharma is low, despite the industry’s contributions to ending the pandemic: Only 15% of U.S. consumers say they trust pharma companies more than they did before the COVID-19 pandemic, according to Accenture’s 2021 survey.

According to Accenture, “the pharma industry has ‘earned’ some modest gains in trust from patients due to vaccine development. Yet along with those gains, patients’ expectations have now been elevated even further”.

The pharma industry has ‘earned’ some modest gains in trust from patients due to vaccine development. Yet along with those gains, patients’ expectations have now been elevated even further.  Patients in the US want to see a broader sense of urgency in the development of new medicines for non-COVID conditions relevant to their own lives.


What does this mean for DTC and HCP marketing?

Anyone who believes that nothing has changed is living in an alternate reality, yet pharma continues their DTC campaigns like the pandemic were only a minor inconvenience. Trust is not given; it has to be earned every day.

It’s hard to earn trust when the public reads about price increases and pharma companies blocking competitors from releasing generic/biosimilar products. However, the public is aware that they may need prescription drugs to manage chronic health conditions.

As I have written before, DTC needs to go through a transformation from “marketing” to “helping” patients and caregivers navigate an environment low on trust and full of misinformation. Even patients will still line up if a prescription drug shows promise.

Wegovy, for example, has been approved by the FDA to treat obesity and excess weight – conditions that can lead to type 2 diabetes and prediabetes. This new treatment has led to significant weight loss in clinical trials and is in short supply because of high demand. But will patients take this medication without modifications in diet and lifestyle? If so, they are going to ve disappointed.

With insurers requiring more preapprovals for medications and PBMs taking a more significant chunk of Rx dollars, there is a lot of mistrust in a system that is less than truthful about the actual costs of treatments.