Episode 4: Closing the Last Mile in Healthcare, with Melissa Dragic Swoope

Final transcript, lightly edited for readability. Timestamps match the published episode. The views expressed by guests are their own.

00:06 Patrick R. Coyle: I’m Patrick R. Coyle, and this is Patients + Profitability. Patient access and healthcare economics are usually managed as separate problems. I believe they’re one conversation. When patients struggle, the business struggles too. Every episode, I sit down with one person who has lived both halves of it. Let me introduce you to Melissa Swoope. Melissa, tell my audience about you because you’ll do a better job. Thank you.

00:35 Melissa Dragic Swoope: Hi, good afternoon, Patrick. Thanks so much for having me. I’m Melissa Dragic Swoope. I’m a certified specialty pharmacist and healthcare executive and founder and managing principal of TROJE Health Strategies. My work is direct-to-consumer health strategy from the molecule to the patient. At Walmart, I led specialty clinical services and field programs, then serving as founder of the Walmart Healthcare Research Institute. At Lilly, I led global community engagement strategy across the therapeutic areas in R&D. Patrick, across these roles, I’ve stayed curious about the same question. What does it take for someone to actually receive the care or research opportunity that you and I’ve built? Across these roles, I help teams connect the science, the patient experience, and the business to make that happen.

01:31 Patrick R. Coyle: So most people who talk about the patient journey have never actually stood at the end of it, but you have. So what’s what’s interested me the most about you is that only a few weeks ago we discovered we spent our careers looking at healthcare from almost opposite directions. And somehow we’re in the same place at the same time. I came to it from the CFO suite, and you came to it from the pharmacy. And You started talking about repeatability and sustainability and profitability. So let’s start at the counter. Before we talk about anything you’ve built, take me back to the third day as a pharmacist in Hawaii. Tell me about the man who walked up to your counter.

02:18 Melissa Dragic Swoope: Yeah. Patrick, thank you. We didn’t share a language, but I was still responsible for his care. I was early in my pharmacy career in Maui, and that encounter stayed with me. It made me think about how much we assume when we explain something to another person. Have they understood us? Have we understood them? What do they need to take the next step? That’s where my curiosity comes from. The person in front of you can tell you something about your process that you’ve missed, only if we’re willing to pay attention.

02:54 Patrick R. Coyle: And you just hit on something that I hadn’t thought about, but and you’re you’re first generation yourself. And even though you didn’t speak the language, did that have an impact on your discussion, how you approached that conversation with him?

03:11 Melissa Dragic Swoope: Yeah, Patrick. My parents came here with a baby in a suitcase. There were three of us, girls, and we all went into science. I grew up understanding how much opportunity can mean to a family and the responsibility that comes with it. That shapes how I listen. I wanna understand what someone is bringing to the conversation because it may be different than what I assumed.

03:36 Patrick R. Coyle: And there’s a huge assumption in there, right? In America, that everyone speaks the same language. And we know that’s not reality. And I remember at different times in brand launches, and you’re trying to figure out how many different languages are you going to syndicate the reports in or the communications. And I just think in 2026, are we really ready to say how many, you know, hundreds of different Dialects and languages we need at at the pharmacy to effectively communicate with a patient, but then also from a manufacturer to be able to make sure that those communications, the messaging comes through. I don’t know. What are your thoughts on?

04:22 Melissa Dragic Swoope: Yeah, I think that’s right. I I think that’s really where patients and profitability come hand in hand. And that’s really what intrigued me about coming to have a conversation with you. That nuance in how we deliver the communications to the people who bear the burden of disease and the levers that we pull to meet them exactly where they are. That’s really where what I call the magic and the rubber hits the road, where strategy and operations come together, and ensuring that the language that we use together is both meaningful, not only in the language and the material, but also in the how.

05:10 Patrick R. Coyle: And and in that interaction with that patient, which was going to have such a huge impact on your outcome, you found the bridge in not having the language, but you had the empathy and you could explain it and connect with him. And I I think there’s so much of that that’s needed. It may be even taken for granted at the pharmacy because everyone else has done their job. And then all of a sudden the patient shows up and the patient may. Speak a totally different language. The patient may have different a different comprehension level of what that care and that that course of treatment that’s been prescribed is going look like. It’s fascinating. I don’t think I’ve thought about it as deeply as as you just helped me to to get there.

05:57 Melissa Dragic Swoope: Yeah, and I I think when you think about it, Patrick, that patient experience in the business economics in the same moment. I had another example when I had a prescription for hepatitis C hit my P&L. The patient was glad the prescription went through. I wanted to understand everything it had taken to actually get there to my pharmacy and what would it help for that patient to complete treatment. That took me deeper into specialty pharmacy, the science, the education, the access and support around the medicine. As responsibilities continue to grow, the question became how do we make that good care repeatable? What does the team need? How do we staff it and know whether it’s working? That’s really where I hear you saying thinking about it more deeply began for me. And the love for specialty grew. In the field with another patient at another pharmacy counter.

07:01 Patrick R. Coyle: And you and you taught yourself specialty pharmacy from the inside out. And I’m speaking from that manufacturer perspective at that time to just say that, you know, one of those decisions, if you pick the wrong language, right, if you’re not expressing that properly in the communications, that one patient that shows up could could fall off, may not understand. Right. And and so I just I think that’s so critical. But as you were going through You know, the specialty pharmacy embedding this in into the operations, it sounds like almost an MSL role where you’re pointed toward a patient rather than toward a prescriber, a medical science liaison. What what problem were you trying to solve there?

07:48 Melissa Dragic Swoope: Yeah, I was really trying to solve how do we close the last mile coming from background retail executive, that last mile delivery not only is on the retail side of the business, but on a healthcare, especially as patients become consumers, that direct to patient or direct to consumer health strategy. Was born during that specialty time. That is exactly right, Patrick. I loved how you talked about that MSL role. I had a role and it was a pharmacy clinical services manager. We had responsibility for multiple states, multiple stores, hundreds of millions in P&L and what we needed to build was the last mile. Injection training is a really good example that I built Getting the medicine to someone that doesn’t tell you whether they feel confident using it. Our work identified gaps in that experience, and that helped turn them into a clinical service. And so the MSL role now was patient-facing and with thought leaders and the specialists and the providers that really connected that care continuum and that care coordination. We brought the clinical education, as you alluded to. The technology and the workflow together so that really support could be delivered consistently. Something you’ll hear me talk about is that consistently scalable, sustainable, without that, there’s really no mission and there’s no patients and ultimately there’s no business. And so we published on those work on addressing those training gaps. That’s the connection between listening, leadership, you hear a problem, Decide what needs to change, bring the right people together, and ultimately the follow through. That’s really closing the last mile.

09:48 Patrick R. Coyle: We when we connected, we talked about an auto injector, which was the same one on both sides, but that’s just one brand, right? And then there’s one administrative method of administration. But what do you do when you have to create all this operational model for all of these different brands? And with the subtleties of the labels and administration and how do you scale that up and and go to Your patient base on that side.

10:20 Melissa Dragic Swoope: Yeah, Patrick, when we I think about how do you scale the details and the nuances and what I call shared decisioning and really ultimately listening to the patient needs to be able to persist, start on therapy, continue on therapy. There’s a really a framework of how do you look at this globally. And how do you design for it across therapeutic areas, across different sponsors, across different mechanisms of action and deliveries and getting the nuances right? This is when asking open-ended questions, staying curious with the provider and the patient to really understand how did we choose that therapy? How much was the patient involved in that? And how are the other people around that patient going to support them? In that therapy to persist on. It really brings me to one of the other programs that my team and I created was community healthcare workers. And so thinking about those details and those nuances, Patrick, it may be cold chain, how do we make sure that that patient at that department is going to pick up their package within the allotted timeframe of that cold chain to stay in the package insert, right? And we had an interdisciplinary team within the specialty care model that I developed with the team because patients’ practical circumstances affect whether those care happens. So whether it be an auto injector, whether it be an oral oncolytic or whether that be coordinating the care to the infusion center. This team needed a way to understand those barriers, respond to them. And that required a clear role, relationships, and a process for getting those concerns, both from the manufacturer, the healthcare provider or specialist, and the patient to the right person. And so I’m really proud of that. Something that we built, the people that were behind that work, the team that helped me scale that. And that really turned what patients were experiencing into something that we As sponsors and in the industry can act on and study to improve the process for the next innovation.

12:47 Patrick R. Coyle: That’s amazing. Yeah. Operational excellence means something different to everybody in all different industries. But in in regards to cold chain, I think whether it’s patients assume that that project product shows up refrigerated throughout the process of getting it to them or a manufacturer has to do a lot of things. And then the pharmacy has to make sure operationally that that’s maintained. Otherwise, the product goes bad. So I think there’s a huge part of the process and operations just in cold chain alone, which are probably misunderstood, underappreciated. So I think it’s fascinating. when you went to the Disney Institute, some of what you learned there, you turned into moments of care. Can you share that with us?

13:37 Melissa Dragic Swoope: Yeah, Patrick, as your my scope continued to grow. My work had to be deliberate and I had to stay close to the people and the work that they were doing. I had the opportunity to serve as one of the founders within Moments of Care, where we went to the Disney Institute and trained from best in class experience almost 10 years ago, nine years ago, where We knew that putting the patient at the center and ensuring their their experience was equally as important as getting to deliver on adherence or getting to deliver on revenue growth. And we really looked at moments of care for patients, for everyone, everywhere, creating a framework that would allow Over 16,000 pharmacists, 5,000 stores, 45,000 technicians to operate with that patient experience and the excellence as a Disney Institute created. Patrick, I loved that work for a couple of reasons. It allowed us to highlight the people that were in our stores doing the work every day. And Really being able to scale that moment. It only takes a moment for you and I to have connected to realize how many threads we intersect across our careers. And it only takes a moment for someone that is field-facing on the front lines to connect with that patient, to help them to persist, to identify those barriers and ultimately create joy. And that’s what we learned at the Disney Institute.

15:38 Patrick R. Coyle: I think it’s fascinating because we’re, you know, all these views you share are just yours and yours alone and not your prior or current organizations. That should be stated. But at the same time, companies that you think of primarily as profit focused, forget about which industry, they are really process focused, right? And the and the customer experience that Disney maintains throughout the park, a lot of parks, a lot of that is not well understood. It’s taken for granted and probably similar similarly with the pharmacies, the large-scale pharmacies, where you think, okay, it’s profits first. No, you’re throwing in patients amidst all the other consumers that are buying books. They’re also buying medicines. And and how how do you have that same customer experience, but now point it at a patient? I think it’s it’s fascinating.

16:35 Melissa Dragic Swoope: Yeah, no, Patrick, and really when I think about a net promoter score on how do we as industry and the people who serve industry and ultimately are collaborating to the last mile, that patient experience NPS net promoter score is often undervalued metric that tells you a lot about. Where those operational failures can be uncovered, accelerated, and ultimately patients receive their medication faster, more affordable, and we can continue to grow that access. And that innovation actually lands after we’ve spent all those years really perfecting the science.

17:26 Patrick R. Coyle: And the patients and profitability exist at the same time and they’re interdependent on each other. I I love it. So before COVID, and you know, I think many of us didn’t even realize that the last pandemic had been 1918 until we’re living in one, you had already built live injection training. and I think the pandemic just created that opportunity to make that virtual care much more normalized. what were you seeing? That made you believe patients needed that before everyone else knew that they had have it.

18:01 Melissa Dragic Swoope: I was seeing that our patients everything had lined up. The innovation had received approval. That FDA approved drug had now received formulary placement. That prescriber had utilized that shared decision with the patient and the caregiver, and that prescription was actually at the pharmacy. And after speaking with my clinicians and my team, understanding why was it now now being shipped out the door? And we really looked at our assessments to understand, were we asking questions that allow the patient and the vulnerabilities of injection to come through? What were the other things that kept them up at night? A lot of that would really surprise you, Patrick. I know it surprised me, and I had been caring for patients now for over a decade. And what we learned were things like, if I start now, will I be able to afford it in six months? If I don’t have any support system, what if I can’t do the injection by myself? What if I don’t get the right needle size? And now I’m scared. And when we put those barriers really as the end in mind, we were able to design backwards. And that’s where CareLive and Live Injection Training really came from, was listening deeply, staying curious with the patient, and then making sure that that feedback loop met with the prescriber and the manufacturer and the patient to ultimately get to better outcomes. And better experience, which we published with the National Association of Specialty Pharmacy.

20:02 Patrick R. Coyle: And I think that comes right back to it has to be repeatable, sustainable, and profitable. Otherwise there’s no mission and there’s no patients. Right. So when you said that, those three terms really stuck out to me. And I said, okay, there it is. So do you want to explain that and your passion behind those three words?

20:24 Melissa Dragic Swoope: Yeah, when we think about a service, Patrick, it really has to be clinically useful. It has to be economically sustainable if we want people to keep receiving it. I wanted to really understand that deeply from both sides. Are appropriate patients starting? Are they completing treatment or receiving the support they need to continue? What does the service have to deliver? And where are we creating avoidable work? When we think about better care, how can that create business value? We have to measure where that happens and make the investment case honestly. That’s why your finance perspective belongs in the conversation early.

21:10 Patrick R. Coyle: Yeah, if you don’t bring in the profitability piece and the sustainability early, then unfortunately none of it follows. And so I think it’s such a critical piece that when I was a CFO, you realize that so many people had done so many things and so many patients are waiting for you. Right. And those advocates, some of which we’ve heard from on the show, are are doing everything they can to just. Get ready for launch. And then sometimes, you know, those little decisions you talked about having to make on the other side of the house, if if manufacturers don’t make those decisions the right way or with the right, you know, with the right financial support in mind, the whole mission fails. And those patients that have been waiting with hope, and hope is such a strong word, right? Hope outweighs fear. But it you have to complete the mission. You have to make it available. You have to think of all those details. It has to be sustainable. When you when it does, you’ve seen some of those things worked. And right, maybe you tell us what’s happened to the numbers. When you do those well for the patient, what happens to time to first fill? Adherence, persistence? What did you see in the numbers and measuring the outcomes?

22:35 Melissa Dragic Swoope: Yeah, Patrick, the biggest learning over my career was to partner with finance early. Because at the end of the day, patients are waiting, and we as leaders have a responsibility to not bring to market programs that are not sustainable. And as a healthcare provider and a healthcare executive, one of the things coming to industry to really understand. What are the outcomes that that manufacturer also had in mind? When we can understand our two of our missions together and really design those programs that are financially responsible, that are outcomes focused. We deliver time to starts that are 20-30% lower than the industry. Get prior authorizations that move from weeks to days. We have patients persist or complete therapy to greater than 95%. And we really bring in those quality standards that our payers, part of the equation, are really looking at. Because at the end of the day, Patrick, it’s all of our responsibility to lower the total cost of care. To ensure that the care is coordinated across the teams. And when we can look at it from a financial standpoint with the patient at the center, bringing the right stakeholders across, that’s really the framework and the people that are needed together to bring this. And what I like to call as a multiplier, the effect of bringing the right stakeholders, the voices. And the admissions together to align it for financial success for all parties.

24:33 Patrick R. Coyle: And I think now in 2026, with all this reform that’s going on and the impact that’s still being properly understood from the IRA, the profitability is under fire for many manufacturers. And what to continue investing in and supporting, especially in areas like we’re talking about, where you can’t measure return on investment. but it’s really an outcome. It’s a return on the outcome. And why are we doing any of this if we’re not going to have the right outcome for that patient? So you talked about something in there that was really fascinating to me. I talk about it all the time. I think just the general lack of awareness of what I call the silent leak. When you were talking about in the past prior authorizations, and I know you you did one from the side of a highway. And I’d love to hear more about it because if that prior authorization doesn’t get done. The silent leak is that you’re not even measuring the the patient and the prescription the right way. And certainly without that understanding, the profitability is definitely going to come under fire. So maybe tell us a little bit about that experience.

25:50 Melissa Dragic Swoope: Yeah, Patrick, what you’re talking about is an extreme ownership and accountability matrix that I had the opportunity to serve under when we think about that leakage of every moment that a patient, a healthcare provider, a specialist waits is moments that we will never get back. And One could argue that even it becomes a trust when people feel cared for and there is a sense of urgency that you would apply to reporting to the street, that you would apply to a prior authorization. That’s where what I describe as a second clock of the patient actually starting therapy, people feel the gap and they also feel the urgency and so Recognizing when I was in the field how much the prior authorization mattered not only to the prescriber, the MA, the patient, the caregiver, my team within the pharmacy to ensure that everything we could do brought the best experience around that collaborative healthcare team to ultimately deliver to the patient. Is what you’re describing. And I have many memories of prior authorizations in my what you’ve described as an MSL role, which I love. I always make that comparator as a pharmacy clinical service manager to deliver on the promises that we to get them the care at the right time for the right patient so that they can lead better lives, healthier lives with their families and friends. And so the side of the car and prior authorizations and learning different managed care organizations and the different lab values and ensuring that we had the right little platform to accelerate those prior authorizations and really making the business case of the ones that we wanted to scale and the ones that we wanted to promote to customer were really some of the most fondest memories. And it ultimately was to deliver to the patient.

28:11 Patrick R. Coyle: That extreme ownership and accountability made the difference of whether that patient and countless patients ever get on therapy. And I think that’s one of the most misunderstood parts of the process of how manual it still is today and how difficult in a lot of practices, not the ones you’re a part of, obviously, because you made the difference, but that I see out there with other channels. It’s a step that is time consuming. And if it’s time consuming, those companies make profitability decisions that affect patient outcomes. So everybody could be doing the right thing. And then all of a sudden it winds up with a pharmacy that may be the economics of under reimbursement or a very expensive process to get that PA authorized falls by the wayside and it becomes a switch. And maybe this switch is what was intended, maybe it wasn’t. And most people don’t understand that those rules in each state are very different. And so every pharmacy and their approach is very different. So I don’t know if you have any thoughts on that.

29:28 Melissa Dragic Swoope: I just love you’ve really drawn out the every state and every payer in those states have a different approach. Oftentimes, Patrick, what I becomes lost on us is that we live in a republic. And so when we kind of circle back to designing those programs at a global stage, that really is how we think about each individual state as a country. And how do you apply those principles to be able to work for the people that they’re serving in those states? And as we move into the next five, ten years, this is really where technology, AI, agents, the rural health transformation, these grants, and ensuring the Appropriateness to deliver on these outcomes with this financial model is critical to the people that we’re serving. And so prior authorizations is one component of that story, and landing on the right tool to serve that particular pharmacy in that particular state for those conditions of the community that bears those. Disease is incredibly important. And those leakage cannot be underestimated to really improve that time to start, that persistency. And ultimately understanding the timing of that prior authorization even to have to be renewed so that people don’t lose hope and receive their medication without a disruption of care.

31:26 Patrick R. Coyle: I think it’s so widely variable the level of knowledge of emerging pharma companies doing their first launch. Someone said something to me one time and it stuck out. And we were talking about pharmacy selection. I said, Well, it’s okay. We’ll we’ll pick one pharmacy for distribution. It doesn’t really matter. And that really stuck out to me. And I think it’s indicative of there’s so many different people doing so many different jobs. I hope that everybody listening and hearing the difference that you made and your organizations have made, the pharmacy matters tremendously and who’s going to be carrying your product. When you built the Walmart Healthcare Research Institute, what problem were you actually trying to solve?

32:17 Melissa Dragic Swoope: Yeah, when I thought about my time at specialty and I thought about really understanding deeply the people that needed to be represented to bear the burden of disease, the one thing came to mind that comes to mind no matter if you’re on the research or commercial is access. And so ensuring that all people had an understanding of clinical research. Were engaged and understood how to access that was really the mission and the responsibility that we had in over 4,000 medically underserved areas. And so engaging people, allowing them to have a seat at the table, to have a voice in that conversation was really the mission and how we went from an ideation to a go to market and scaling.

33:17 Patrick R. Coyle: And you hit on something before with all the rural healthcare grants that are coming out and bringing bringing that care to the community, the rural community. What happens when you stop expecting the patient to find the research infrastructure and instead you bring that to places where the patients already trust or the patients are underserved? That’s gotta make you feel great.

33:44 Melissa Dragic Swoope: Yes, it was really great, Patrick. So it was what we knew all the all along. When you can build within the healthcare infrastructure, that’s really where that patients and profitability becomes. What I had seen in the industry was building outside of that healthcare infrastructure. And what we Once would say our community was asked, are they hard to reach or are they hardly reached? And when we just started asking, it was amazing the engagement, the expertise that was within our communities, within our teams, and the desire to learn more. And so that was the joy. And the outcomes that we were able to produce were three times the referral rate in communities across the industry, across therapeutic areas, where many times you wouldn’t have thought to do that within a pharmacy. Those will be the joyous memories, not only for employees, which we served over 1.9 million. But also those communities of 190 million people walking through doors every day and patients seeing their pharmacists three to four times a week versus three to four times a year.

35:16 Patrick R. Coyle: So it begs the question. And I think a lot of pharma manufacturers are always being confronted with patient recruitment. And is that a marketing or awareness problem? Or is it really just a patient pathway problem?

35:36 Melissa Dragic Swoope: Yeah, I like to think about it as a pathway, thinking about a patient every all the way as early as the molecule. So in early phase planning, really before it gets to phase two, three, understanding that journey and that pathway and the inflection points along that where we can really plug in. That not only leads to better understanding, better access, but ultimately, should that molecule become an approved drug, better launch. And so thinking that as a pathway and as a what I like to call flywheel of the patient at the center, that’s really where that direct to consumer, direct to patient strategy comes to life because you’ve operationalized it as early as a molecule.

36:34 Patrick R. Coyle: Fulfilling the promise of hope. Right. I I’ve been asked when I do some of the patient journey mapping. And sometimes I’m asked, okay, where are we going to start? How are we going to segment it? And I guess the the question I always come back with is which patient? Yeah. Right. Which which patient patient do you want to start with? What their journey looks like. Find the worst one you possibly can and work yourself back. It’s probably still not the worst one. But it’ll give you a good indication of what’s broken upstream or or what has changed in the ecosystem that everybody has not had time to catch up with. So I I think like you said, it’s it’s amazing. It’s a it’s a pathway problem, much more often than than not.

37:23 Melissa Dragic Swoope: And the when is really important, right? That patient. I love a good journey mapping. And some of the things I love the team to think about is when in time is when are we matching this patient? I was recently among an industry leader and they had shared about understanding that patient journey and not trying to make the patient journey fit the perspective. That we as an industry partner were trying to do. And I thought that was really thought-provoking for someone to share that had been in the industry for decades and was an esteemed colleague to recognize coming to that patient journey mapping with the when, the where, but really ultimately to not fit the one that you had in mind. Is the curiosity that we’ll need to bring into these next few years to really handle these profitability and revenue streams that you’ve shared here and the other dynamics in the environment to really shape what it looks like to say access in the future.

38:40 Patrick R. Coyle: I think we’re we’re gonna have to be much more vulnerable, every one of us in the system and the process, that it’s complicated. And nobody knows everything. And by the way, it’s changes every day. And and every patient’s different, and every product is different, every skew is different, every indication is different. And so, like earlier you said, and we we touched on with the with the states. How can you really think about creating a homogenous experience for every type of patient and every type of plan and every type of state? It’s hard. Right. So it’s okay to admit it’s hard and that we’re all learning still, and just despite however much we know already. and so, you know, bringing that to really interesting topic you brought up when we first met, but you told me about a clinical trial. And about a loop that never got closed. And I want you to tell that story here in whatever way you you feel like sharing it with us and and what the learning is for this audience because this is that’s what we’re here for.

39:55 Melissa Dragic Swoope: Yeah, I think about that research experience and that example, what really comes to mind is the follow through. How can we focus on the follow through for me? The operating lessons really matter. The patient experience, a protocol criteria, site understanding, and what information was available across the system were disconnected, Patrick. And so when we think about the commercial or that research experience patient, different people held different parts of that picture. The question was really who owns bringing the information together, getting the concern to the right person, and confirming it had been resolved. And so what I like to say is inspect what you expect. I can’t tell you. That a particular call would have changed the clinical outcome for this patient. But what I can say is that the process needed clearer, more ownership in an escalation pathway that was transparent for all the parties involved. It truly that experience, understanding when a patient has the hope, has found the trial, has gotten to the site. And then ultimately is not eligible for enrollment and potentially randomization due to two months within a five-year criteria. That really strengthened my conviction that those responsibilities matter. They need to be designed into the work from the beginning with finance to understand. That if we don’t do this, these are the outcomes that both we and our patients and the people who are serving to bring these outcomes to bear will face. That comes with that humbleness, that curiosity, and that transparency, Patrick. I really appreciate you bringing the thoughtfulness into the conversation and ensuring that lived experience. And real examples matter, that they’re not anomalies, and we all can really rally around that.

42:31 Patrick R. Coyle: I think the more that leadership appreciates that and sees things differently and accepts that vulnerability, that it’s not nothing’s perfect, right? But we’re all doing our part along the way. Then I keep hearing design and operations and process and also learning and building that back into the redesign. I think is so critical for every product that it’s different. All the different stages. Throughout commercialization of a product. And I think your perspective is just amazing because you’ve seen the patient journey from so many different and unusual types of seats. You’re building some great things today. And what have you learned now in this different stage of all this building, applying all that experience?

43:23 Melissa Dragic Swoope: Yeah. Patrick, I really where I really see the future and the work that I’m building within TROJE is really to understand what we’ve talked about with the nuances of that direct-to-consumer strategy or what our industry knows as a patient. I’m particular here because our strategy has to be before a patient. Has to be proactive to really ensure preventive health, to ensure we meet people that are uninsured, underinsured, and are of the different cultures and the countries that we wish to be in from an access standpoint. And so I’m helping organizations understand what happens between that first interest, that treatment or trial participation, and then ultimately, Patrick, to build that Clear pathway through it. So what does that really mean? I want to be able to connect the science, those clinical teams, the commercial strategy, access the pharmacy, patient support with clear ownerships of the next step. Direct consumer health is a strategy, but ultimately, Patrick, you and I both know the start is really the proof of our success. And so the work that I am continuing Really is after that start, how do we engage people with the support that they need to stay engaged and the teams that need to learn? What actually happens when people start?

45:05 Patrick R. Coyle: And when you put the patient first, what part of that journey is doesn’t have a functional involvement? It’s almost none. Right. And throughout my career, I’ve always, I think finance people have always said I feel disconnected from that part of the journey. Well, it starts with funding. So you you talked about CROs and and early stage research. It starts with funding. So, you know, the the process continues and like you said, gets measured on those starts, but also on the fills and and the and the positive outcomes. So I know someone asked you who your ideal client was and you said anybody. And they said that was too broad. Well, what do you think they were really asking in probably the wrong question there?

46:00 Melissa Dragic Swoope: Yeah, it was really what are what will I what will be the return on outcomes? What will be the return on investment? And so really thinking deeply and unpacking that question and then understanding the word anybody really where thinking about the person. I loved how you just described about finance and Anyone in that journey who’s responsible about putting the patient. This is where the organizational change management or the OCM is critical, Patrick. And so not only is it a top-down, but a bottoms-up approach. And so everyone in that organization needs to understand the why and how it impacts the return on the outcome. And that’s really where education Learning these functions across organizations matter and anybody really means what is the problem that you’re trying to solve and how do we think about the important decisions that are still needed to be made. And so reframing the anybody to what what in your strategy or your pipeline or your company and goals. What has a scientific potential, right? What molecule has it? What protocol has a right defining participation? How does that commercial strategy come to life and actually reach the market? And ultimately clinicians, pharmacies and support teams make it usable in someone’s life to help them get better.

47:45 Patrick R. Coyle: And I love that. The ideal client is anybody where the bottleneck is going to impede that patient journey. And it’s never known because it it could be one little step in that flywheel you talked about, one cog in the wheel throws it all off. And that what gets thrown off is a patient who is needs that medicine. To enjoy a better quality of life or even just to keep maintaining life itself. And back to the finest part, if if somebody doesn’t understand enough about where the handoffs break or the funding that’s required to keep it going can’t be elucidated properly in the story, then maybe a stakeholder doesn’t buy in. And if a stakeholder doesn’t buy in, maybe that becomes the bottleneck now. So I think you hit on the education piece there. That’s such a huge part of everything I’m doing and advocating these days is just a shared education and knowledge base. Everybody’s going to have a different perspective on it. But I think if we have one common book to kind of sing from that hymnal, then I think we we will all understand the patient journey better.

49:10 Melissa Dragic Swoope: Yeah, Patrick, and that’s why I was so drawn to your work. in that education, that understanding from our side, the industry, the sponsor side of it. it really was how I envisioned the Healthcare Research Institute of a shared understanding because ultimately that workplace is a community and with different stakeholders. And the same beliefs, values that drive us in the community that we serve in are also internally. And so that shared learning, that shared understanding, that shared lexicon, singing from the same hymn is critical to business success. And that’s why the importance of your education platform is crucial to ensuring that we have a shared language. Both from an industry perspective and the people that we’re ultimately serving.

50:15 Patrick R. Coyle: I couldn’t agree more. I noticed last time when we first met, like I started at the intro, we spent our careers looking at healthcare from almost completely opposite ends. And here we are now, you were standing at the pharmacy counter, I was sitting in the CFO suite, and somehow CFO seat, and somehow we ended up saying almost exactly the same thing. And I say Patients + Profitability, you say repeatable, sustainable, profitable. What do you think? Two people like us looking at healthcare from opposite ends, landing in the same place, what do we do next?

50:57 Melissa Dragic Swoope: Yeah, Patrick, so I loved it. I continue to love the dialogue and the conversation. We’re looking at the same system from different places. Gather those questions really give us a stronger basis for making more decisions. And so bringing the different perspectives together to examine the economics more closely. Mine brings the patient experience into that discussion, and yours brings the financial expertise. When I think about What’s the one thing we could leave and do differently here is start with that one patient pathway. Listen to patients and the people doing the work. Find where the progress stops, bring the right functions together, give the next step an accountable owner, and measure what changes and ultimately what fails. Because we all have extraordinary science. We have talented people in our organizations. And there is a real opportunity that if we can connect their work more effectively and our people, that we can ultimately reach our patients who can benefit. And so I want us to be more about how can people, how can we think about people and the benefit from the science we have and how can we have an informed voice about what comes next. I want teams to feel like they’ve been listened to. I want the work to be made clearer. And I want them helped to really understand that what they’re building is something they should be really proud of. And those capabilities are the leaders and the leadership that we need in these organizations to help bring this last mile closed and ultimately. The outcomes that both industry and the patients really will help to achieve a more broader purpose.

53:04 Patrick R. Coyle: The whole journey is so important, but like you kept talking about the last mile is the most critical. And so thank you for all that you’ve done to make that last mile happen for patients and also for profitability and sustainability. As we have always talked about, patients and profitability are not competing priorities. They rise and fall together. The patient journey and the economic journey aren’t two different journeys, they’re the same journey viewed from opposite sides. And Melissa, I think you and I somehow managed to prove that by arriving here from completely different directions. So thank you for joining me.

53:42 Melissa Dragic Swoope: Thank you, Patrick. Thanks for exploring this with me. I really enjoyed the conversation.

53:49 Patrick R. Coyle: Thank you. Have a great day.

53:51 Melissa Dragic Swoope: You too.