Last month, for World Lung Cancer Day, Johnson & Johnson launched ‘The 3rd Opinion’ — an initiative designed to shift the treatment conversation toward the patient’s own voice. According to research published in Future Oncology, up to 77% of lung cancer patients in the Asia Pacific leave treatment decisions entirely to their physicians, despite 69% of doctors encouraging shared decision-making.
“Cultural norms around stigma, not questioning authority, and limited understanding of the disease can often be major barriers causing patients not to voice concerns or ask questions, even when healthcare professionals actively encourage their input,” said Johnson & Johnson when announcing the initiative.
This is especially significant in Asia Pacific, which accounts for 63% of the global lung cancer burden.
By naming and defining a “third opinion,” the patient’s perspective, Johnson & Johnson seeks to empower individuals, amplify their voices, and make collaborative care the standard across the region.
The initiative is being launched across multiple markets with educational resources, including a Lung Cancer Book of Answers in China, patient empowerment videos, and shared decision-making tools designed to help patients confidently articulate their treatment goals.
To learn more, we spoke with Anthony Elgamal, Vice President of Oncology, Johnson & Johnson Innovative Medicine Asia Pacific, about why elevating the patient’s voice is central to improving outcomes — and how ‘The 3rd Opinion’ aims to redefine the treatment journey across Asia Pacific.
What inspired the creation of the ‘3rd Opinion’ concept, and how does it address gaps you’ve observed in lung cancer care across the Asia Pacific?
The inspiration for ‘The 3rd Opinion’ emerged directly from a critical gap we identified through research and engagement with patients and healthcare professionals across Asia Pacific. While significant scientific advancements have revolutionized lung cancer treatment, we observed a persistent disconnect: 77% of patients in the region, despite physicians encouraging shared decision-making, often remained passive in their treatment journey.
Balancing scientific accuracy with an empathetic, patient-centric narrative was a deliberate and critical creative choice for Johnson & Johnson when creating ‘The 3rd Opinion.’
This is highly significant in Asia Pacific, which bears 63% of the global lung cancer burden and has a higher prevalence of specific genetic mutations like EGFR. The clinical consequence of this passivity is often subpar treatment alignment, reduced adherence, and missed opportunities for truly personalized care.
‘The 3rd Opinion’ directly addresses this by providing a framework – a clear, actionable concept – that empowers patients to speak up about their personal values and goals, thereby integrating their unique perspective into the clinical decision-making process. It’s about elevating the patient’s voice from a silent participant to an active, informed partner in their care.
In the campaign, emotion plays a central role in communicating a complex medical message. What creative choices did you make to achieve this balance between scientific accuracy and an empathetic, patient-centric narrative?
Balancing scientific accuracy with an empathetic, patient-centric narrative was a deliberate and critical creative choice for Johnson & Johnson when creating ‘The 3rd Opinion.’ We understood that while the medical facts are crucial, the emotional journey of a lung cancer patient is profound. Our approach was to humanize the complex medical message by focusing on the patient’s lived experience and their aspirations.
Instead of just explaining the disease, we emphasized why a patient’s voice matters – connecting it to their desire for more time with loved ones, to witness life’s milestones and moments that matter to patients.
From walking their daughter down the aisle, to meeting their grandchild for the first time – moments that matter to our patients will be presented alongside the message that these are possible if they seek to shape their own treatment plans.
It is critically important to empower patients to recognize their role in the treatment journey. It’s a call to go beyond traditional consultations, starting with asking the right questions to clearly understand their disease and expressing their needs and priorities so that doctors understand not just the clinical picture, but the human one too.
Our approach was to humanize the complex medical message by focusing on the patient’s lived experience and their aspirations.
Hence, we made a deliberate choice to include patient empowerment videos and depict relatable scenarios where patients articulate their goals in our campaign materials.
Data shows that while 69% of physicians in the Asia Pacific encourage shared decision-making, 77% of patients still prefer to let their doctors decide for them. What factors drive this gap, and how does the ‘3rd Opinion’ initiative seek to change it?
The data you pointed out highlights a critical challenge: a disconnect between physician intent and patient behavior. The gap is driven by several factors, including deeply ingrained cultural respect for authority figures, which often leads to patient passivity where they may perceive it as inappropriate to ask questions.
In certain countries in Asia Pacific, cancer also carries significant stigma, discouraging open discussion, and a sense of fatalism can also lead patients to simply accept their prognosis without active engagement. Furthermore, patients often lack the vocabulary or a clear understanding to articulate their personal preferences and goals effectively, even when encouraged.
Patients often lack the vocabulary or a clear understanding to articulate their personal preferences and goals effectively, even when encouraged.
‘The 3rd Opinion’ directly addresses this by normalizing patient input; by coining a specific term, we create a cultural permission slip for patients to voice their questions and preferences for treatments, giving them a recognized concept to embrace. It provides a structured framework for patients to identify and articulate their personal goals, moving beyond vague feelings to concrete preferences.
Resources like the Lung Cancer Book of Answers (available in China only) then equip patients with the knowledge and confidence to engage in these critical conversations. Crucially, we aim to shift the perception that shared decision-making is about “questioning” the doctor to providing vital, personalized information that enables the physician and patient to make a decision tailored to one’s needs and preferences.
This subtle but powerful reframing is essential for cultural acceptance and adoption.
Asia Pacific is a highly diverse region, with wide variations in culture, language, and healthcare systems. How has the ‘3rd Opinion’ campaign been adapted for these differences, and are there plans for further tailoring in the future?
Recognizing Asia Pacific’s immense diversity was central to the campaign’s strategic design. While ‘The 3rd Opinion’ is a unifying concept, its implementation and communication are rigorously localized.
Our adaptation strategy is built on deep insights from our multi-market Lung Cancer Patient Engagement Program, involving healthcare professionals and patient advocates across key markets like Australia, China, Japan, Korea, and Taiwan.
By coining a specific term, we create a cultural permission slip for patients to voice their questions and preferences for treatments, giving them a recognized concept to embrace.
Campaign materials are also culturally and linguistically localized, which ensures all campaign materials are adapted with culturally appropriate imagery, scenarios, and communication styles that resonate with local audiences.
Looking ahead, our commitment to tailoring ‘The 3rd Opinion’ and advocacy for shared decision-making will continue. True integration requires ongoing effort and adaptation, and our continued efforts will focus on ensuring ‘The 3rd Opinion’ remains culturally relevant and impactful across this incredibly diverse region.
The campaign includes tools such as the Lung Cancer Book of Answers and patient empowerment videos. How were these resources developed to be both culturally relevant and practically useful?
The development of these practical resources was a meticulous, dual-focused process, prioritizing both clinical utility and cultural authenticity.
For clinical relevance, the content is drawing upon the latest scientific evidence in lung cancer. We collaborated with leading oncologists and patient advocates to ensure the information is accurate and directly addresses the most critical questions patients and their families face regarding diagnosis and treatment. These tools are designed to empower informed discussion, not to replace professional medical advice.
For cultural relevance and practical usefulness, our approach was deeply collaborative and iterative. We leveraged insights from our multi-market Lung Cancer Patient Engagement Program, which informed how information is best received, common misconceptions, and communication dynamics within different cultural contexts.
We carefully framed content to respect local cultural norms; for instance, in cultures where direct questioning of authority is less common, resources help patients articulate preferences in a way that supports the physician’s decision-making, rather than challenging it. With resources such as the Lung Cancer Book of Answers, patients are provided with key topics and questions to ask their doctors during consultation. These practical tools can facilitate meaningful joint discussions that ultimately lead to an optimized treatment plan that respects the patient’s preferences.
Drafts were also rigorously reviewed and validated by local patient groups and healthcare professionals to ensure authentic resonance and practical utility in facilitating shared decision-making. These tools are strategically designed to bridge complex medical information with the patient’s personal journey, in a manner that is both empowering and culturally appropriate.
How do you measure success for a campaign like this—beyond awareness metrics—when the ultimate goal is to change patient behavior and engagement?
Measuring the success of a campaign like ‘The 3rd Opinion’ involved a multi-faceted approach, starting with traditional awareness metrics that demonstrate the campaign’s reach and resonance, which has been a remarkable success.
Media buzz surrounding ‘The 3rd Opinion’ was picked up and amplified across 27 markets globally, including the USA, Europe, and Africa. This widespread international recognition is a powerful indicator of the campaign’s ability to cut through the noise and capture attention.
I hope that there will be a significant increase in proactive patient engagement where patients will arrive not just seeking answers, but prepared to articulate their personal goals and preferences.
Beyond these traditional awareness metrics, success to me would be hearing more discussions around “What does success look like for you?” – whether that’s maintaining specific functions, managing pain, or achieving particular life milestones.
I hope that there will be a significant increase in proactive patient engagement where patients will arrive not just seeking answers, but prepared to articulate their personal goals and preferences, transforming the consultation from a physician-led monologue into a truly collaborative dialogue.
Ideally, conversations will stray away from solely discussing survival statistics and become more focused on patient-defined outcomes.
What role do partnerships with clinicians, advocacy groups, and patient organizations play in embedding the ‘3rd Opinion’ into everyday clinical practice?
Changing behaviors of people in the region requires the collaboration of many parties, making partnerships an absolute fundamental.
With clinicians at the frontline, we partner with leading oncologists and healthcare providers (HCPs) to ensure ‘The 3rd Opinion’ is clinically relevant and practically implementable within their busy practices. Their endorsement and active participation are crucial for validating the concept and championing its adoption among their peers.
Meanwhile, collaboration with patient advocacy groups (PAGs) such as Lung Foundation Australia, patient platforms such as Dongdong Oncology in China are invaluable. They are trusted voices within the patient community, providing direct access and credibility, ensuring our resources and strategies are truly patient-centric and address real-world challenges.
These partnerships create a virtuous cycle: HCPs validate the medical necessity while PAGs ensure relevance and reach. Together, they form the bedrock for integrating ‘The 3rd Opinion’ into the fabric of lung cancer care.
As treatments become more complex, how do you envision the shared decision-making model evolving over the next five years for oncology in the Asia Pacific?
With various partners that target the root cause of issues, such as “The 3rd Opinion”, I hope to see shared decision-making models in oncology as well as in other disease areas applied actively across Asia Pacific.
Technology will likely play a vital role, with digital health tools, AI-powered information platforms, and virtual consultations facilitating shared decision-making. These technologies can provide personalized information, help patients prepare for consultations, and track patient-reported outcomes to inform ongoing treatment adjustments.
Furthermore, shared decision-making could be standardized faster if it’s also driven beyond the oncologist to involve the entire multidisciplinary team – nurses, pharmacists, palliative care specialists, and even financial counselors – ensuring a holistic approach addressing all facets of a patient’s journey.
