September 28, 2022 PAO-08-022-CL-05
As patient numbers are set to double in the coming decades, one of the consequences is that lead times in hospitals will need to be reduced by 50% just to maintain current levels of care. And even this feels impossible, given a predicted lack of healthcare workers and the rate at which burnt-out personnel are leaving the profession. To address this huge challenge, smarter diagnostic tools and a growing role for remote care — especially for conditions that can be self-diagnosed and self-treated, or for which treatment can be self-administered with remote guidance — will be of huge importance in the new paradigm. That’s as long as any advances are seen to deliver excellent outcomes and a better patient experience.
The pharma industry, which is already growing its role in delivering hybrid solutions combining therapies with diagnostic and smart solutions and devices, could play a significant role here — not just as creators and providers of the medication but also as providers of smart solutions and data-related tools.
Secondary prevention (slowing the progress of already-diagnosed conditions or avoiding relapse) and certain chronic diseases present a particular opportunity for pharma to add new value out in the real world. Diabetes management is already well established as an example of digital health in remote care, but smart monitoring and targeted interventions are also making inroads into the management of autoimmune disorders like inflammatory bowel disease, cardiovascular health issues, and cancer — both in monitoring the progression of those conditions and in predicting and averting the chance of flare-ups.
As well as doing more to proactively support healthcare providers and patients, digital health opportunities provide a chance for pharma companies to capture (and become a trusted source of) important real-world data about patients’ behavior/trends and their wider well-being.
So, let’s break down the opportunity.
There are two main dimensions through which digital health solutions can have a significant impact. One is at a healthcare provider (physician and hospital) level, where the latest advances in genetic testing and biomarker measurement have the potential to boost early detection of conditions and hone decision-making around the most effective treatments. The second is at a patient level once an individual has entered treatment. Applications here include tele-consultations, remote monitoring of chronic conditions, and chronic disease self-management, including associated education, reminders, and prompts to modify and maintain desired behavior.
At a hospital/specialty care level, digital health can transform early and even incidental detection of serious diseases like cancer. Teams managing targeted screening programs, such as checks for lung cancer in high-risk populations, may already use artificial intelligence and machine learning to ‘read’ high volumes of medical images efficiently, and detect even minute traces of the disease that may be invisible to the human eye.
Take Cosmo Pharmaceuticals’ GI Genius AI-enhanced endoscopy aid device, which detects colorectal lesions during a colonoscopy and is now approved for use in Europe, the United States, and Canada. The device, which provides endoscopists with a “virtual second observer” to assist in endoscopy exams, is marketed worldwide via a partnership with Medtronic. It works in real time, as an adjunct to the gastroenterologist, highlighting regions with visual characteristics consistent with different types of mucosal abnormalities, such as colorectal polyps of all shapes, sizes, and morphologies.
If the future of pharma no longer involves straightforward drug sales, it is clear that the industry must think laterally and work harder to be indispensable across a greater range of touchpoints and to maximize the scope for reimbursement. Leveraging digital solutions to move innovative medicines up from third-line treatment options to second or even first line would be an important strategic win for pharma.
To date, it is the treatment of chronic conditions that has been the most transformed by digital health and is attracting strong investment. Solutions linked to diabetes have the greatest traction and highest profile up to now, as the parameters are relatively straightforward to measure and react to. But other disease areas are also seeing success now too, including multiple sclerosis (MS), a complex chronic inflammatory and degenerative disorder of the central nervous system. Targeted digital solutions in this area are helping both with the monitoring of patients’ physical symptoms and in maintaining good mental health.
Sanofi’s partnership with mental health app provider Happify Health is a good example of the latter, extending support to patients to help them cope with depression and anxiety, which are among the many distressing symptoms of the disease (people with MS can be up to five times more likely to develop severe depression than the general population, studies suggest). Working together, the two companies have developed a promising proof of concept for an app that uses cognitive behavioral therapy to help improve mental health through education and other activities.
Merck’s SmartPatient/adveva multi-channel patient support system, meanwhile, connects MS patients all over the world with a range of support services, including round-the-clock access to instructional videos on how to safely handle medication, tips for living with MS, personalized reminders to keep patients on track, and a built-in diary to facilitate discussions about their treatment.
Tools for maintaining a close connection with patients affected by broader mental health conditions are also attracting a lot of interest, currently. During the pandemic, Boehringer Ingelheim and Click Therapeutics announced the collaborative development of a prescription-based digital therapeutic tool for use in the treatment of schizophrenia, filling a gap in support for patients — while treatment guidelines recommend tailored psychosocial intervention therapies, it isn’t always easy for patients to access these interventions.
Although respecting patient confidentiality is paramount, companies providing digital solutions will automatically be capturing a wealth of real-world data which, as anonymized trend insights, could inform their own development and commercial strategies.
These findings will also hold interest for clinicians as pharma organizations work toward more of a trusted partnership with physicians and hospitals.
If, via digital channels and tools (even if applied in the third line of care), pharma is able to identify when an initial/alternative treatment is failing to deliver the intended benefits, the benefits for the patient, healthcare provider, and pharma could be considerable. That’s if those insights could help trigger new, targeted intervention, so that the affected patients are redirected in a timely fashion to a more effective therapy. A good example is in the case of autoimmune diseases like Crohn’s, where it is relatively common for resistance to therapies to build — close monitoring could help identify the point of drop-off or decline at an earlier stage, to everyone’s advantage.
Pharma companies should be evaluating current care pathways to identify untapped opportunities — aligned to their products and brand strategy — to improve patient outcomes. This is not something they can do in isolation. Innovative delivery and partnership models are emerging, involving partnerships among care providers, digital technology providers, and pharma companies. In partnership, trailblazing pharma companies will be able to carve out value propositions for a new era of smart healthcare.
Gérard Klop is a partner at Vintura, a Dutch consultancy firm that provides strategy consultancy to pharma and healthcare providers embracing transformation. Gérard has been a strategy consultant to the pharma and medical devices sectors for two decades and is a published expert on value-based and value-managed healthcare.