Digital-Health Pharma Pillars

Posted by Dr. Yossi Bahagon, October 06, 2015

Innovative digital-health solutions, which are patient-centered, are a vital component in future delivery of healthcare. These innovative solutions, which empower people to play an active role in managing their own healthcare, will improve clinical outcomes, reduce costs, enhance patient-physician relationships and enrich patient experience.

The pharmaceutical industry is in early stages of adapting to this new environment. In the pharma industry, the upcoming era of technology-enabled participatory medicine is named the Pharma 3.0 era. Where Pharma 1.0 was focused on blockbuster drugs, and Pharma 2.0 around increasing operational efficiencies, Pharma 3.0 will develop multiple and new business models with new skills around analytics, customer segmentation and the new “blockbuster drug" ‒ patient engagement (referenced by Leonard Kish).                                

Major healthcare trends that are reshaping the pharmaceutical market place:

1.Health consumerism – informed and demanding patients are now partners in their own healthcare. The rising knowledge on diseases and treatments among nonprofessional population derives the need to shift from current product centric and product efficacy approach to a more consumer experience and solution centric approach. At all points along the patient pathway, pharma can engage and connect to the ultimate benefit of the patient. Patients search online pre- and post-diagnosis, they influence government strategy, they can choose whether to take a specific intervention or not, and their engagement massively influence outcomes. Patients trust becomes more important than ever, and an explosion of new opportunities will abound for those who put patient outcomes and customer experiences front and center.

2.Pay for outcomes is on the rise – measurement of economic outcomes, alongside clinical ones, will be the determinants of whether a medicine is used or not. The on-going collection and interpretation of real world data will be the norm for all interventions, and reimbursement will be based on real market measured effectiveness.

3.The bigger agenda is shifting to prevention – many governments are beginning to focus on prevention rather than cure. The change of emphasis will enable pharma to enter the realms of health management.

4.Digital natives – Generation Y – are becoming active healthcare recipients – Millennials are used to handle most, is not all, of their interactions using online tools. This population expects healthcare to be no different. When it comes to managing their health, Millennials have more access to information, connectivity, and technology than any other generation. Yet, competing financial pressures and government policies mean tradeoffs between healthcare spending and other purchases, leading them outside the traditional system of care in an attempt to live in the moment and save money. For healthcare players this means accepting the new reality – control in healthcare has shifted from providers to consumers.

Summarizing these trends – about half of U.S. adults take prescription drugs. Those drugs are only part of what consumers today expect pharmaceutical companies to provide. According to various surveys, about three-fourths of prescription-taking consumers say pharma companies should offer services that complement the products they sell, providing an holistic solution to their patient's needs.

Moreover, the pharmaceutical industry is struggling with a turbulent business landscape, as there are fewer blockbuster drugs. In response to this shifting environment, Pharmas are looking to move to a range of value-added services under the moniker of Beyond-the-Pill, and most of those new services are digital.

Major Digital-Health developments that are reshaping the pharmaceutical market place:

1.Big Data – applying machine learning predictive analytics methodologies and platforms on large clinical, genomic, biomic and physiological biomarkers datasets will enable –

Precision medicine – personalizing treatment appropriateness through better patient segmentation and individualized patient pathways

Improve efficacy of clinical trials through improved identification of patients that would be more likely to benefit from the drug under development

Identification of predictors of efficacy and lack of efficacy

Identification of new predictors for disease states of interest

Improve marketing through segmentation of patient tracking pathways, personalization of messaging, social media communications, and medical reps activity

2.The rise of Connected Health (or the Quantified Self era) – The Internet of Things (IoT) is getting personal. Wearables, ingestables and even implantables, will not only help people with their fitness, but will also monitor longitudinal bio-physiological measures and through that help manage disease and its treatment. In the next few years, wearables will be part of the day-to-day experience of many consumers (just like smartphones today). Monitoring capabilities are embedded in fashion, watches, smartphones etc., and shape consumer's quality of life and clinician/patient partnership. The last will be based on improved awareness, self-management, and prevention strategies.  Monitoring will be seamless, and, yet, be able to provide real-time, personalized, medical insights.

Extensive use of wearable sensors and data analysis will allow tracking of quality of life, not just efficacy and safety Connecting the visions of Digital-Health and Beyond-the-Pill will enable Pharmas to re-boot the value proposition their customers seek. For example – a patient taking a Beta-Blocker will see medication's effect on slowing his heart rate in real-time on his watch. This will enable his physician to personalize dosing accordingly.

3.Mobile Prescription Therapy (MPT) – most Pharma companies have already launched apps for medication tracking and beyond, yet the vast majority of them have failed to create a change in patient's long-term behavior.

MPT is born from the confluence of mobile and web technologies, clinical and behavioral science and data science.

Some Pharma companies are already combining a pharmaceutical therapy and a companion digital tool – whether that be a tracking app, a wearable sensor, a smartphone-enabled personal health device, or all three. These integrated pharma-digital therapies are prescribed by physicians to their patients.

At its core, MPT represents a healthcare solution that supports patients in their daily self-care, while offering healthcare players additional data for decision-making. In addition, this solution can generate validated, more cost-effective clinical outcomes.

4.Tele-Care – the aging population, the soaring burden of chronic disease, and the shortage of professional human resources creates significant gaps between available healthcare and the desired accessibility, quality of care and quality of service. These gaps cannot be solved with current face-to-face based workflows.

Tele-care is already on the rise in the U.S. and in the few next years it is expected that healthcare will no longer be confined to clinicians in the clinic or hospital. The ubiquity of digital communication means that many doctor-patient communications will be virtual and will take place at patient's home. These digital visits will include digital diagnostic tools that facilitates physical examination at a distance.

Healthcare productivity will be revolutionized through reduced travelling time, waiting time and the reduced inconvenience of routine contacts. Moreover, there will be a differentiation between medical encounters that requires a face-to-face interaction and most other interactions that can be handled remotely. This will enable physicians to spend more time with the more complicates patients who need more guidance, support and care.

In close collaboration with health providers, Pharma companies will be able to provide distinctTele-Care support, like clinical pharmacists consultation, for patients already on prescribed medications. 

Summarizing these trends – generally speaking, Pharma companies do not currently poses Information Technology and digital user-experience expertise. According to a recently published report(Pharma App Market Benchmarking 2014), a typical big pharma firm has, on average, a portfolio of 65 mobile applications. Yet, since 2008, the top 11 largest drug companies have clocked up only 6.6m downloads. The report suggests drug makers seeking greater mobile-health engagement should ditch the product-focused model and seek expert help. As digital technologies are moving forward very fast, it is not realistic to assume Pharmas will be able to keep up with the pace of advances in these fields. In order to encompass the full exponential potential of the Pharma 3.0 era, Pharmas will have to open themselves to new business models and new business collaboration models. Much like current approach to achieving inorganic growth is through new product innovation, mergers and acquisitions, near future will be leveraged through business model innovation and the creation of partnerships with and acquisitions of Digital-Health companies.

Out of all the digital health stakeholders, pharmaceutical companies have both one of the biggest opportunities and some of the most significant challenges to make the most of mobile and digital technologies. As such, while providers, payers and other consumer colleagues have dived into the digital health world with gusto, pharma is still a long way behind the curve.

Loads of consumer and technology companies are entering into the space that should be owned by pharma. As healthcare business models evolve, if pharma does not quickly adapt, they will be left as a commoditized pill provider. 

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