How drugmakers are facing the entrance of consumer giants into healthcare

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Celgene's Nancy Powell (speaking) along with Amy West of Novo Nordisk during an MM&M panel in March that was sponsored by Deloitte Digital
Photo credit Ali Smith

The wave of consumer companies deepening their forays into healthcare, coupled with broader health system change and questions about advertising effectiveness, has spawned a bracing set of conditions for drugmakers. On one hand, they're expanding beyond a traditional reliance on pharmaceuticals as a sole value proposition. 

“Diabetes has become an epidemic, even though we have all these amazing innovations from a molecule and device standpoint. Which says to me that it's much more than taking a pill or an injection,” said Amy West, senior director of patient centric marketing and digital health innovation for Novo Nordisk, the world's largest producer of insulin.

Indeed, some manufacturers are forging product-plus partnerships, finding kindred spirits in consumer-facing digital startups whose tech offers to meet customer needs in ways that complement traditional therapies. Startups can realize the drugmaker's marketing and scale benefits. 

See also: 'Less about the product and more about the patient' Soundbites from Transforming Healthcare 2018

Novo, for instance, last year partnered with Glooko to offer patients the startup's diabetes management app, and a recently-announced tie-up with Sempre Health leverages that outfit's text-based reminder program to secure lower costs on Novo drugs if patients refill prescriptions on time.

West, speaking at an MM&M panel discussion sponsored by Deloitte Digital earlier this year, cited “a lot of pressure to move on that [meeting patient expectations for a consumer-friendly experience] because of the new entrants we're seeing in this space.”

But as drugmakers reinvigorate their approach in ways partly inspired by the encroachment of firms like Amazon and Apple, and partly by the health system's slow shift from value to volume, industry suffers from what one pharma executive called "an ill-defined perception of what its role is in patient care," other than discovering, making, and marketing medicines. 

See also: The big driver of investment in tech isn't Silicon Valley; It's the patient

"Pharma has to get over itself as, 'We're here to take care of the total patient.' I don't think that's a credible statement that they can make," said Joe Shields, senior director, global strategy and innovation, AstraZeneca. "The intention is good. I just think pharma is a part of the ecosystem. And [it's] trying to assume more roles in the ecosystem without permission."

For one, the industry's reputation is such that the public may not feel comfortable with a manufacturer owning patient data. "If you are a person with COPD, would you want your pharma company knowing how many times you inhale? You may or may not," said Shields at the MM&M Transforming Healthcare Conference this month, one of his last speaking engagements before he starts a new role with a consulting startup.

Another fly in the ointment to its beyond-the-pill aspirations: pharma doesn't typically assign product managers to digital programs. "The business development function has to get serious about digital health in pharma, so we can actually have professionals doing contracts and putting together deals that are longer-term than six-month pilots," Shields added.

See also: AstraZeneca's Joe Shields to launch Health Accelerators with Think Patients

As some manufacturers look outside, others are placing more focus internally. Celgene, for instance, hasn't demonstrated quite the same preference to go the digital health collaboration route as some of its biopharma brethren, at least not in public.

“We're...trying to build competency in the organization,” said Nancy Powell, director, digital health IKU for Celgene, “because the world is changing around us and the skill sets of marketers are going to have to evolve from that traditional marketer.”

The big biotech formed IKU (which stands for information, knowledge, utilization) as an organizational capability to manage healthcare data as a core asset and harness insights. “Although we have a lot of data, we don't have as much data on our own customers as an Amazon or an Apple,” acknowledged Powell, also at the Deloitte event. 

See also: Pharma adopts data-science culture in move toward AI

Questions on the effectiveness of traditional consumer engagement are also driving them to find new ways of enhancing consumer appeal.

"Traditional DTC solutions are...becoming less effective because people don't watch TV or read newspapers [as much anymore], and consequently a lot of pharmaceutical companies are looking at digital," said Amir Kishon, CEO and co-founder of RMDY Health, which offers cloud-based digital therapeutics programs and personalized guidance designed for drugmakers to offer along with their therapies.

Digital therapeutics are non-pharmacological interventions, like coaching apps or online modules built on behavioral health concepts, that can boost outcomes. These range from hybrid approaches -- the drug plus some form of digital support -- to digital as monotherapy -- like Pear Therapeutics' reSET app, which was approved last year by the FDA to treat substance abuse disorder and is being marketed by Novartis' Sandoz unit


"Given the complexity of such solutions, we will see pharmaceutical companies adopting global digital therapeutics platforms that are already approved by their legal [departments]...so brand teams can have all those capabilities pre-approved out of the box," Kishon predicted.

To be sure, pharma has created customized patient-support platforms before, but the home-grown programs aren't the same. West's team, for instance, built the Cornerstones4Care diabetes health coach and SaxendaCare in obesity. “What we hear back is, ‘I don't want to be reminded to take my medication, that tells me I'm sick, or that there's something wrong with me,'” she noted.

Moreover, drugmakers' heightened search for digital partners with synergistic benefits is born of a realization that patients “are not defined by their chronic disease situation or whatever they're dealing with,” West said.

See also: Amazon's ability to attract other employers makes its healthcare coalition very formidable, experts say


By contrast, the big tech and e-commerce companies are good at understanding “who I am as an individual,” before seeking to address their health problems. “It's very intimidating to see Amazon and Google stepping in, because they do have a lot of information about what the person really wants to be focused on,” said West. “We're focused on what the person doesn't want to be focused on.”

One way the tech giants are moving into healthcare is through voice assistants, such as Amazon Echo and Google Home. Merck was probably the first drugmaker to go big on demonstrating the potential in healthcare, issuing a challenge for companies to come up with an Amazon Alexa-assisted service for diabetes patients to find – and fund – innovative technology partners.

In April Amazon, which had reportedly been considering a foray into the pharma space, said its Amazon Business division won't sell pharma products, focusing instead on medical supplies. Share prices of drug distributors and drugstore chains improved on that news.

See also: Wellpepper wins Alexa Diabetes Challenge

Going forward, finding an appropriate way to leverage day-to-day data around what patients/consumers want to be doing, with a savvier approach to health and wellness, may form a roadmap.

Powell, of Celgene, did speak about partnering to add digital therapeutics or, potentially, new transformational ideas like preventing disease. “We're starting to see the socialization and sharing economy taking place,” she said. “How do we as an industry start approaching and learning from other companies in regards to appropriate partners to really move in that direction around looking at a more holistic approach that goes beyond just the molecule?”

As for the latter, it's important to look for “wrap-around health and wellness support,” West added. That is, services providing “the contextual relevance to the patient that explains why they need to take the medicine,” and showing how other aspects like sleep, nutrition, and exercise impact their day-to-day health.

“That's a huge opportunity,” she said, “and we're just scratching the surface.”
To be sure, her team has built customized patient-support platforms for diabetes, like the Cornerstones4Care diabetes health coach and SaxendaCare in obesity. 


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