Pfizer is winning praise this week for its quicker-than-usual U.S. launch of a heart drug. The medicine, Vyndaqel (tafamidis), treats a rare and potentially fatal heart disease that’s also underdiagnosed.
It came on the market in May and posted nearly $80 million in sales in the July-September quarter, despite competition from multiple rivals. One way the company is working to further improve the launch is by leveraging data to speed diagnosis.
“We worked with a payer to create an AI algorithm to identify patients who have this condition,” reported Pfizer’s Lidia Fonseca, chief digital and technology officer and EVP, during a panel discussion at this week’s HLTH event in Las Vegas. While the algorithm hasn’t been deployed yet, since May thousands have received the medication, which treats wild-type or hereditary transthyretin amyloid cardiomyopathy, or ATTR-CM.
According to the American Heart Association, ATTR-CM is characterized by a stiffening of the walls of the left ventricle, hampering the heart’s blood-pumping ability. While symptoms often start as early as age 20, the disease may not be noticed until after age 65, the AHA points out.
“We are working with a number of IDNs to actually integrate [the ATTR-CM algorithm] into their EHRs so that it can be available at the point of care,” said Fonseca. “That’s impactful. You’re saving peoples’ lives.”
In the last couple of years, a number of big pharma companies have appointed chief digital officers, often from non-healthcare or otherwise unique settings, to lead transformation efforts spanning R&D and supply chain to manufacturing and marketing. They’re tasked with initiatives like unlocking the value of data, furthering patient-centricity and transitioning the old sales model of “carrying the bag” into non-personal connections with HCPs, in the midst of legal and regulatory barriers that often complicate those goals.
They bring to their jobs skills in digital transformation, management and steering multi-million-dollar budgets. “What you’re seeing is us being brought in—and we’ve been there, done that—to harness digital,” said Fonseca, who joined Pfizer after CIO roles in the diagnostics sector.
The question of how these efforts are panning out is a matter of debate. The panel at HLTH, which also included CDOs Karenann Terrell and Bertrand Bodson from GlaxoSmithKline and Novartis, respectively, presented an opportunity to gauge progress.
Terrell, whose previous experience included executive stints at Walmart and DaimlerChrysler, talked up GSK’s partnership with 23andMe for drug discovery and other machine-learning and AI deals, as Bodson touted Novartis’ AI pact with Microsoft as well as its launch of innovation hub Biome in San Francisco and plans to open similar hubs in France and Spain to engage with startups. Pfizer, said Fonseca, is also working with Verily to develop a new clinical-trial platform that has so far shaved months off the firm’s cycle times.
However, these were tempered with the humbling fact that pharma itself is often an obstacle to progress. “The biggest barrier we face is often ourselves,” said Bodson, an Amazon vet. “50% of my job is often cultural…How do we get out of the way when we need to unboss the organization?
“It’s not just what we do but how we go about it,” he added. For instance, the idea behind the Biome’s series of open-innovation labs is to make it easier for startups or other partners to work with the drug giant. “Let’s be frank; we’re not easy to work with… We’re not always organized the way we should be.”
Under Bodson’s watch, Novartis has worked to assemble more of what he calls “bilinguals,” those who can talk tech, patients and data and who understand the underlying science. “We mobilized 1,500 people over the last year-and-a-half, [including] 700 in data science.” In marketing, though, he said there’s a need for more brand leaders “who really understand tech and who can make sense of the data.”
To that point, Terrell said that what makes its 23andMe and other discovery pacts different is the way they operate as ecosystem plays. “We don’t think of it as a bilateral relationship that GSK is managing at the center. We look at those companies solving together with speed and much better probabilities of success.”
Another “major gap,” Bodson said, is the building of platforms that allow for scale, rather than one-off digital initiatives.
Terrell recounted one such GSK initiative that didn’t necessarily pan out so well. “We don’t like to talk about failure,” she acknowledged, sharing that “GSK had a ‘myasthma’ app that went so far as to say, ‘Could we actually help with adherence?’ What we learned was it helped but not enough. It was not relevant,” and has since been shuttered.
But, she quickly added, “That failure, that experiment helps us move forward in our understanding of how in the real world patients are using the medicines and how most effectively they can stay in care. [This kind of learning] is going to be enormously important as we head toward personalization of medicine.”
It’s also a good reminder of the need to ensure that “in our own organizations we use a similar risk profile to the way that the emerging, pure digital health companies think about risk,” she added.
To be fair, pharma isn’t the only vertical struggling with these kinds of challenges. An oft-cited 2018 Mckinsey survey on digital transformation showed that many companies have undertaken such efforts, but that it’s very hard for more traditional or conservative sectors such as pharma. Among respondents from firms in high tech, media and telecom, 27% characterized their efforts as successful. Success rates in pharma ranged between 4% and 11%.
What’s led them to redouble efforts is the realization that “patients are consumers who got sick,” said Terrell. “The digital world that’s influencing them in media, commerce, social media—all that they’re immersed in—is influencing their opportunities for care.
“And you can’t separate the digital and digitizing of the consumer behavior from the healthcare and life-science challenges that we have,” she said.
Asked how they will harness tech to get pharma closer to the patient, Fonseca and Terrell said they foresee providing digital companions for each of their medicines. “That, to me, is the next step in terms of providing this ecosystem,” said Fonseca. “These are information resources, tools that help a patient manage a chronic condition and their health.”
Terrell described these as “computational companions that go along with the medicines we put forth, whether it’s connected inhalers in the respiratory space, or diagnostics for rare diseases that we open-source into the medical community and on into the FDA. These …are incredibly important to be approved with the medicines. It’s the direction life science is moving in general, because it speaks to the effectiveness of medicines for the right patients, [and] it helps payers, providers and life science work together in one ecosystem.”
While as a whole, pharma’s transformation remains a work in progress, the CDOs seem unbowed. “Pharma has leveraged digital for efficiency gains with some modest results,” said Fonseca. “But what we’re trying to do now is really transform and disrupt the model, disrupt ourselves. And I would challenge that it’s not going to be a startup necessarily that should shake us up; it’s going to be us. By bringing experienced CDOs who can really make it happen and transform the landscape.”
This article has been updated in response to a call from the company clarifying that the ATTR-CM algorithm has not yet been deployed and has not influenced the launch of Vyndaqel.
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