Ashish Rishi on The Patients Clinical Trials Leave Out — and the Evidence That Counts Them In | Pharma Prescribed
Ashish Rishi is Founder and CEO of Unwritten Health, the Manchester-based patient experience data platform working to make life science's evidence reflect the people it's meant to serve.
His mission is unsentimental — and it starts with his father. At 17, Ash watched his dad spend three years fighting for a GP referral for worsening back and bone pain. The eventual diagnosis was terminal prostate cancer, delivered to an 18-year-old and his mother — for whom English is a fourth language — in a two-minute conversation and a flyer, with no family network to turn to. His father lived six more years and passed away three months before Ash's graduation.
That experience became a company. In this episode Ash explains "inclusion debt" — his term for how bias compounds at every stage of drug development: unmet need defined without the real patient voice, multi-billion-pound programmes built on focus groups of eight to ten patient experts, recruitment budgets thrown at social ads that reach the already-reachable, and value dossiers that carry only the majority narrative. By market access, it's too late to fix.
The Patients Clinical Trials Leave Out — and the Evidence That Counts Them In
His answer is Equity Engine: a 6,000-strong UK participant panel profiled across the social determinants of health, built through gurdwaras, mosques, temples, churches and community groups, generating longitudinal lived-experience data at a scale focus groups never could — and turning it into submission-ready evidence.
Honest about being a "failed scientist," about burnout and anger, and about the trust he has to earn in every room. A powerful conversation about fixing inequity as an evidence and design problem, not just a moral one.
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Full transcript and episode notes: https://pharmaprescribed.com/episodes
⏱️ CHAPTERS
0:00 Intro
0:35 Meet Ashish Rishi
1:00 A father's diagnosis
3:00 From neuroscience to comms
4:00 The clinical trial wake-up call
7:00 The Demand Diversity movement
9:00 Building Equity Engine
12:00 Inclusion debt explained
15:00 UK data fragmentation
17:00 Barriers and misinformation
19:00 AI-powered patient insights
26:00 Neurodivergent-friendly trials
28:00 Quickfire round
30:00 Golden rule and wrap up
👤 ABOUT ASHISH RISHI
Founder and CEO of Unwritten Health and creator of the Equity Engine platform. Neuroscience MSc and former health communications specialist. Sits on the scientific advisory board of IHI READ-Y (an EU Innovative Health Initiative / Horizon Europe programme advancing inclusive clinical research) and the equity committee of the US Prader-Willi Syndrome Association. Advocate for re-engineering health inequity as an evidence and design problem.
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🌐 https://www.unwrittenhealth.com
🎙️ ABOUT PHARMA PRESCRIBED
Pharma Prescribed is the podcast where leaders, innovators and hidden voices in healthcare open up. No soundbites, no spin. Just raw insight, one prescription at a time. Hosted by biometrics consultant Adam Walker.
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#AshishRishi #UnwrittenHealth #InclusionDebt #HealthEquity #ClinicalTrials #ClinicalTrialDiversity #PharmaPrescribed #PatientExperience #SocialDeterminantsOfHealth #RWE #HealthInequality
