UK: Pharma And The Connected Patient: How Digital Technology Is Enabling Patient Centricity

This week we launched our report Pharma and the connected patient: How digital technology is enabling patient centricity. Our report focusses on pharma's efforts to utilise smartphone apps, wearables and other digital technologies in an effort to put patients at the centre of new business and operating models. This transformation, from a provider-driven marketplace to a patient-centric health ecosystem, is being driven by the need to demonstrate value to payers and patients and respond to a variety of powerful forces that are transforming healthcare. These forces are requiring pharma to become more agile and to do more for patients than deliver safe and effective drugs.

Pharma's traditional business model is facing escalating cost and pricing pressures, increasing competition, shorter time in the market, expiring patents, declining profitability and mounting regulatory scrutiny. Thus far, pharma has attempted to address these challenges using traditional business strategies such as mergers, acquisitions and reorganisations, and many companies are also focusing on fewer therapy areas. However, increasingly, pharma companies are realising that a new transformational business model is needed to effectively address their challenges – with a general acknowledgement that they need to engage more effectively with patients and place them at the centre of each part of the pharma value chain. This transition towards a more patient centric approach has the potential to revitalise the industry so that it remains relevant and profitable.

We identify the use of innovative digital technology as a key enabler of this transformation and examine how pharma is beginning to develop more patient-centric strategies, by making effective use of these digital technologies. Our research involved extensive literature reviews, supplemented by primary research that analysed the number and popularity of smartphone apps produced by the top 12 pharma companies. We also surveyed 190 patient groups for their views on how health apps are being used, particularly apps that are produced by the pharma industry.

Our primary research into pharma-produced apps showed that pharma can do more to engage with patients, particularly through the smartphone. While the number of apps produced by the top 12 pharma companies more than tripled between 2013 and 2016 from 305 to 988, the growth rate of these downloads has slowed considerably in the same time frame. In addition, the five most popular of these apps make up just over 50 per cent of these downloads, meaning many of these apps are rarely used. Overall, these pharma-produced apps were downloaded over 5.6 million times in 2016 – a number dwarfed by the 3.2 billion downloads of the 260,000 or so Health apps available in 2016.

Our survey results elucidated some of the reasons behind why pharma-produced apps are less popular than they could be. The patient groups who responded to our survey viewed apps produced by pharma to be less trustworthy than those produced by healthcare professionals, other industries and individuals. Similarly, patient groups were much less willing to share their personal health data with pharma companies than healthcare professionals.

Based on the results of our primary research and our review of the literature, we identified six main challenges the pharma industry is currently facing in becoming more patient-centric:

• the traditional product-based pharma culture can be at odds with the move to a more agile and responsive patient centric culture – engaging differently with patients' needs requires collaboration and co-ordination among cross-functional teams
• regulatory uncertainty with regard to digital technology and patient centricity – despite some guidance, the rapid pace of technological advancement is adding to the already complex regulatory landscape, creating uncertainty amongst pharma as to regulators'  expectations and requirements
• data safety and privacy in the face of the proliferation of medical apps and other digital technologies – in moving from randomised controlled trials and anonymised data collection to collecting identifiable data as part of a more patient-centric approach, pharma needs to ensure the highest levels of data safety, privacy and user consent are maintained
• corporate reputation can undermine patient engagement with pharma – largely due to past publicity about excessive pricing and a lack of transparency, public confidence has been eroded, reducing patients' willingness to engage with pharma
• attracting talent with the skills to support a patient-centric ecosystem – pharma's traditional risk averse corporate culture and perceived a lack of agility and 'fail-forward mentality' that normally governs entrepreneurial endeavour can impact recruitment and retention of  digital skills
• low levels of health and digital literacy impacts patients' ability to engage effectively – with between a third and a half of people having low health literacy, this can undermine patient engagement with mobile health technologies.

We identified five strategies that pharma are adopting to respond to the above challenges, including:

• change corporate cultures and structures, based on shared values and cross-functional working to promote agility, foster innovation and attract and retain appropriate talent
• develop partnerships to support the deployment of digital technology, including patient portals and engagement platforms, to help deliver a more patient-centric experience
• automate processes supporting patient facing activities and optimise use of digital talent – automation can benefit clinical trial management, drug launch monitoring and marketing content approval. The use of digital hubs can optimise deployment of digital talent
• create new contracting and pricing models, underpinned by patient information and insights, and generated through the use of digital health technology and big data analytics
• build collaborative relationships with patients, payers, healthcare professionals and regulators to improve health and digital literacy, and predict and manage new risks, including data security and privacy risks. 

We also identified seven actions pharma companies can take to utilise future enablers of patient centricity:

• embed blockchain technology to improve efficiency, safety and traceability – blockchain's highly secure, decentralised framework for data sharing has the potential to overcome the limitations of large-scale sharing of health data
• adopt gamification to enhance patient engagement, health literacy and medication adherence – gamification's built-in reward mechanisms can stimulate further play and greater understanding of health conditions
• use 3D printing to transform all stages of the pharma value chain – more personalised medicine, made possible by 3D printing, can be more cost-effective, can increase productivity and enhance collaboration
• optimise the potential of the connected patient to develop new outcome-based propositions – pharma companies could become a central player in a learning health ecosystem
• make patients true partners in managing their own care – pharma will need to embrace patients' increased control of their data and their ability to own, operate and drive their own healthcare
• utilise non-traditional players' experience of disruptive technologies and customer engagement – pharma will need to engage with technology giants, start-ups and players from other industries to maximise their patient-centric strategies
• adopt distributed research networks and web-enabled virtual trials – a transformed clinical trial ecosystem will rely on consortia, public-private partnerships and crowdsourcing platforms that will drive new business and research models.

As pharma moves from simply engaging with patients to becoming more patient-centric, pharma will need to listen to the voice of the patient at every stage of the company's business, from drug discovery to winning regulatory approval to post-market disease management. This will help pharma companies improve recruitment and retention in clinical trials, thereby bringing drugs to market that better reflect patient needs; it should also improve medication adherence, resulting in better outcomes, and improved safety monitoring, all of which should help maintain pharma's relevance and sustainability.

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