Imagine an inhaler that tracks dosages and reminds patients to stick to the regime. By providing information on the times and frequency of usage, and on the barriers to adherence, such a device would help both doctors and patients manage illness.
This “smart inhaler” is already being developed by pharmaceutical giant GlaxoSmithKline in partnership with digital health solution provider, Propeller Health, as they seek to improve their offerings – and, in turn, patient well-being.
Products developed through partnerships like these are likely to become increasingly significant as pharmaceutical companies begin to diversify and expand their scope in the healthcare market from developing only therapeutic products to healthcare solutions.
On the surface, the healthcare industry looks promising. In Asia, the market is predicted to grow by 12.8% between 2014 and 2018, and spending is expected to rise to US$2.2 trillion. A 2012 report from Bain & Company also forecasted a global total profit pool of the total healthcare industry to rise at a CAGR of 4%, from $520 billion in 2010 to $740 billion by 2020.
But delving deeper, the report revealed that growth would not be evenly distributed across the different healthcare sectors. Areas to do with the delivery of care would be expected to contribute most to growth and profit but in contrast, pharmaceutical companies would likely decline in profitability, with brand-name drugs only growing at around 1%.
These changes are in part because of the pressures of ageing populations and a rise in chronic diseases, as well as the rising healthcare costs. The result is pressure from payers for pharmaceutical companies’ to go beyond simply “selling a drug”. Rather, the way forward is for companies provide holistic solutions that go beyond the pill – solutions that may require collaborations to achieve.
Pharmaceutical companies today are no strangers to collaboration. For years, they have worked with smaller start-ups and biotech firms, combining their financial muscle and knowledge of stringent regulatory processes with the versatility and innovativeness of small firms.
With the rapid explosion of knowledge over the last ten years, they have also begun to increase their outreach to academia, embracing open innovation models, while keeping their core competencies in-house. This enables them to tap on the knowledge of research institutes’ insights into key areas.
To date, these types of collaborations have been product-, rather than solutions- focused. Firms have focused on creating products that pass the tests for safety and efficacy – key hurdles for regulatory approval. In part due to the rudimentary technologies of the past, less resources have been channeled into tracking real-world evidence and understanding if desired health outcomes are eventually achieved outside the clinical trial setting, where confounding factors like patients’ lifestyle choices and medication adherence come into play.
With a paradigm shift towards creating more holistic solutions, pharmaceutical companies have begun to recognize that they need to take collaboration a step further, tapping on the expertise of traditionally unconventional partners like tech powerhouses and digital health start-ups. Such collaborations are essential for the longevity of the pharmaceuticals business as patients increasingly seek products that support their needs from diagnosis all the way to rehabilitation, or even prevention if possible.
Creating holistic solutions
There are many advantages to such collaborations: with tech or digital health companies, the expertise in collecting and making sense of vast amounts of data may help pharmaceutical companies access the right information needed to locate biomarkers and improve diagnostics. This may mean that they will be then better able to stratify the population and create more targeted medication. They may also be able to use this data to speed up the currently long-drawn clinical testing phases in order to bring more products to market.
But very importantly, these partnerships can enable pharmaceutical companies to leverage the benefits of big data to develop patient-monitoring gadgets, helping them move “beyond the pill” to create solutions that manage a broader spectrum of medical conditions.
Like GlaxoSmithKline and its “smart inhalers”, diabetes drugmaker Sanofi has begun looking into methods to augment drug prescriptions with insulin dosing and glucose monitoring devices through a partnership with tech firm Verily, in hopes of tapping its expertise in consumer software and miniaturized electronics.
Similarly, Takeda, together with Vanderbilt University and Texas Digestive Disease Consultants (TDDC), have begun trials for iBData, a wearable device that collects data on symptoms, triggers and aggravating factors of inflammatory bowel disease. The goal is for this information to help doctors to better customize patient treatment plans.
Through these partnerships, drugmakers have also sought fresh avenues to engage their patients – more directly in home or step-down care settings. Merck, for example, ha partnered with electronic health record provider Practsice Fusion to track if patients are up-to-date with their vaccines and to notify those who need treatment, and Novo Nordisk has paired up with IBM Watson Health to create a “virtual doctor” who can provide diabetes patients with treatment advice.
Companies like Abbott have also stepped in to educate diabetic patients directly on taking ownership of their health, going beyond pharmacological benefits of medication, to include nutrition advice.
In Singapore, opportunities for similar partnerships are tremendous. EDB has been working to bring together unconventional industry partners, government stakeholders and healthcare providers – both solutions providers and demand-drivers in the market – to roundtable discussions with the specific intent of driving collaborative solutions that can subsequently be scaled and exported.
The process will no doubt be challenging, as partnerships require that all stakeholders benefit. Drugmakers will need to be able to determine the value of benefit to each stakeholder, and in turn, convince the relevant parties to share the costs of development.
But more pressing, perhaps, will be to overcome the challenges to do with patient privacy. While it is useful from a data aggregation perspective to have access to patient data, we will need to ensure the right frameworks are put in place so that right information can be released without comprising the patient privacy.
All the key stakeholders – companies, government, patients – will need to tread a delicate balance between security and innovation to achieve the desired outcomes.
Preparing for this paradigm shift, EDB, together with the Ministry of Health and Duke-NUS Medical School, has set up the Centre of Regulatory Excellence (CoRE). As a neutral party, CoRE can potentially serve as a regulatory think tank that can explore some of these landscape shifts and bring together relevant stakeholders to brainstorm on these complex issues.
Moving ahead, change is inevitable and with digital technology as a key enabler, the possibilities are endless. The question the pharmaceutical industry needs to answer is how it can fill current gaps in the landscape, riding the wave of the digital revolution to innovate and deliver solutions the market needs.
This article was written by the director of Biomedical Sciences at the Singapore Economic Development Board (EDB). The views expressed are her own.