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Pharma challenges - Patient Centricity and Digital Capabilities

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Pharma challenges - Patient Centricity and Digital Capabilities

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Today pharma's business model is being challenged. The industry needs to rethink how it creates value. In particular, it needs to connect to patients and caregivers in a meaningful way. It many cases this connection can be guaranteed through digital tools and strategies. This presentation focuses on these challenges and showcases some best practices that are already available in the marketplace.

Today pharma's business model is being challenged. The industry needs to rethink how it creates value. In particular, it needs to connect to patients and caregivers in a meaningful way. It many cases this connection can be guaranteed through digital tools and strategies. This presentation focuses on these challenges and showcases some best practices that are already available in the marketplace.

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Pharma challenges - Patient Centricity and Digital Capabilities

  1. 1. P h a r m a C h a l l e n g e s M A K I N G S E N S E O F A D I G I T A L W O R L D Moving fast is not the same as going somewhere.
  2. 2. “ ” Innovation needs to be part of your culture. Consumers are transforming faster than we are, And if we don’t catch up, we’re in trouble. Ian Schafer
  3. 3. D R A M A T I C C H A N G E S Pressure for Pharma The next wave in pharma innovation. Operating Environment: - Globalization - Heightened transparency expectations - Increased exposure to innovative technologies - Social and Economic Pressures (wider health ecosystem) Consequences: - Escalating costs and pricing pressures - Increasing competition - Shorter time in market - Expiring patents and declining profitability - Mounting regulatory scrutiny
  4. 4. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Digital is Enabling Patient Centricity Forces that are changing a provider-driven marketplace to a patient-centric health ecosystem. - Ageing population (↑chronic disease) - Unrelenting pressures on capacity and financial viability - Policy and payers seeking to control costs and requiring evidence of value and effectiveness - Health technology, genomics, connected devices, big data analytics and AI - Blurring of provider boundaries: new entrants, partnerships and collaboration as part of the new health ecosystem
  5. 5. G R O W I N G R E A L I S A T I O N S Pressure for Pharma The need for a new business model – beyond the hype. New patient-centric business model - Connected devices - Big Data Analytics - Personalized drugs - Smaller patient groups - Monitoring and Managing Patient adherence - Health Outcomes New Ecosystem Regulatory Bodies Patient Advocate Groups Healthcare Providers Healthcare Payers Pharma
  6. 6. T H E R O A D T O P A T I E N T - C E N T R I C I T Y Challenges for Patient-Centricity The ambition to become truly patient-centric. 1 2 3 4 ↑ Agility and responsiveness to become patient-centric Regulatory uncertainty with regard to digital technology Data safety, privacy and user consent Corporate reputation can undermine patient engagement with pharma. 5 Attracting the talent with the skills to support patient-centric ecosystem 6 Low levels of health and digital literacy (patients)
  7. 7. T H E R O A D T O P A T I E N T - C E N T R I C I T Y Challenges for Patient-Centricity The ambition to become truly patient-centric. 1 ↑ Agility and responsiveness to become patient-centric Margins in digital health are small compared to pharma’s margins Hard to make a commercial case Requirement for constant upgrades is at odds with an industry that takes a decade from “bench to bedside”
  8. 8. T H E R O A D T O P A T I E N T - C E N T R I C I T Y Challenges for Patient-Centricity The ambition to become truly patient-centric. 2 Regulatory uncertainty with regard to digital technology Rapid pace of technological advancement is adding complexity to regulatory landscape. FDA: Apps are devices only if they are used in diagnosis, treatment or prevention of disease (Digital Health Innovation Plan) EU MDR: all medical software apps as medical devices, most standalone apps will fall under Class I.
  9. 9. T H E R O A D T O P A T I E N T - C E N T R I C I T Y Challenges for Patient-Centricity The ambition to become truly patient-centric. 3 Data safety, privacy and user consent Only 76% of mHealth Apps had a privacy policy that was readily accessible to users ↑Health data volumes/year 48%
  10. 10. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Pharma and Patient Data Feedback loops are the key to great results. ↑Health data volumes/year 48% Example Oncology Combination of data sets Age, Gender, Diagnosis History, Medication and Treatment History, Laboratory Values and Hospital Encounters Automated-Feature-Discovery (AFD) machine learning engine Model insights: - 200 lab values, chronic comorbidities - Abnormalities in lab results (ie. Liver function marker, increased the likelihood of a patient transitioning to the next line of therapy in 140% of cases) - Patients on maintenance therapy were 20% less likely to transition to the next line of therapy
  11. 11. T H E R O A D T O P A T I E N T - C E N T R I C I T Y Challenges for Patient-Centricity The ambition to become truly patient-centric. 4 Negative reputation Factors such as failing to serve the needs of neglected patient groups, excessive pricing and a lack of transparency Eroded public confidence in pharma PatientView: UK-based research company, specialize in obtaining perspectives from patients groups Corporate reputation can undermine patient engagement with pharma.
  12. 12. T H E R O A D T O P A T I E N T - C E N T R I C I T Y Challenges for Patient-Centricity The ambition to become truly patient-centric. 76% “High” or “Some” trust in health apps developed by patient groups 32% “High” or “Some” trust in health apps developed by pharma 83% “Willing” or “Somewhat willing” to share personal data from health App with primary or specialist doctor 30%“Willing” or “Somewhat willing” to share personal data from health App with pharma
  13. 13. T H E R O A D T O P A T I E N T - C E N T R I C I T Y Challenges for Patient-Centricity The European Health Literacy Project 6 Low levels of health and digital literacy (patients) Health Literacy can correlate with low levels of engagement with health technology 2016: Study 4974 American adults 25,7% Low Health Literacy level had used a patient portal 42% Adequate Health Literacy Level had used a Patient Portal
  14. 14. D I G I T A L P H A R M A Benefits of engaging with Pharma Collaboration across Patients, Payers, HCPs and Regulators. Improve Patient’s Digital and Health Literacy - Information clear, simple language and understandable at basic levels - Foster meaningful with patients and healthcare professionals - Provide consistent customer experience to improve health outcomes
  15. 15. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Medical Accuracy Improving Bedside Education Online search engine results related to health 1300 Websites 43,5% In line with AAP recommendations 28,1% Contained inaccurate information 28,4% Were not medically relevant in ScientificAmerican
  16. 16. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Patient Education Improving Bedside Education: Multimedia Content http://patientnexus.visualhealthsolutions.com/
  17. 17. T H E R O A D T O P A T I E N T - C E N T R I C I T Y From Patient to Consumer The ambition to become truly patient-centric. Source: 5 elements of a successful patient engagement strategy,AthenaHealth, 2014 Health Literacy Patient Activation: Patients become more involved in decision-making
  18. 18. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Connected Patients Challenge: Bring drugs to market that reflect patients needs - More informed - ↑ Expectations - Personalized services - Active role in their own health
  19. 19. T H E R O A D T O P A T I E N T - C E N T R I C I T Y Customer-Centered Digital Ecosystem Need to shift to a more direct, personal relationship. Source: Defining patient centricity with patients for patients and caregivers: a collaborativeandeavour, BMJ Innovations,2017
  20. 20. “ ” The biggest innovations of the 21st century will be at the intersection of Sun-Tzu biology and technology. Steve Jobs
  21. 21. P H A R M A A N D T H E C O N N E C T E D P A T I E N T To Err is Human Technical advancements, Standardizing Procedures, High reliability organizing 1999: US Institute of Medicine 44000 – 98000 people die in hospitals each year due to medical error Today: Still at 3%-5% deaths
  22. 22. D I G I T A L P H A R M A Electronic Patient reported Outcomes Moovcare (Israel) – commercial version for lung cancer patients Doctors and nurses miss many symptoms people experience during chemotherapy Patients requested to report 12 symptoms (ex. Sleeping & breathing difficulties, etc) System proactively monitored symptoms, care team was able to intervene earlier and identify problems before they become more severe Patients using the app were able to stay on chemotherapy longer than others because they were less likely to deteriorate Less likely to be admitted to hospital Survived 31 months vs. 26 months
  23. 23. D I G I T A L P H A R M A Patient Managed Healthacre The use of digital platforms for patients to own, operate and drive their own healthcare Use social media and other platforms to review symptoms, disease states, potential treatments Data-collection Frameworks – Apple’s ResearchKit or platforms like PatientsKnowBest
  24. 24. P H A R M A A N D T H E C O N N E C T E D P A T I E N T AI Applications in Health Care Technical advancements, Standardizing Procedures, High reliability organizing Mazor Robotics Pre-op medical records in orthopedic surgery to physically guide the surgeon’s instrument in real-time 5X reduction in surgical complications ↓ 21% in patients’ post op hospital stay $40B savings annually
  25. 25. P H A R M A A N D T H E C O N N E C T E D P A T I E N T AI Applications in Health Care Technical advancements, Standardizing Procedures, High reliability organizing Dosing Errors Represent 37% of all preventable medical errors Potential $16B in savings University of California Correctly determined the dose of immunosuppressant drugs to administer to organ patients MIT (08/2018) Correct drug dosage for glioblastoma Objective: Dosage regimens less toxic but still effective Simulated patients Reinforced Learning technique (RL) – receives an award or penalty depending on whether the action works toward the outcome Precision medicine-based treatments
  26. 26. P H A R M A A N D T H E C O N N E C T E D P A T I E N T AI Applications in Health Care Meet Molly: UCSF and NHS Molly is a nurse avatar developed by Sense.ly – an empathy-first engagement platform Leverages Mayo Clinic Symptom triage algorithms to deliver care advice through voice (no typing required) and chat functions. Developed 10+ years ago by Mayo Clinic physicians and nurses. Focused on specific chronic conditions like heart failure, diabetes or COPD. It’s human-like. It talks to patients naturally, and they talk to the nurse as they would a real nurse or doctor. Potential to save $20B annually and 20% of time nurses spend on patient maintenance tasks
  27. 27. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Alice Cares Technology with human care to support seniors
  28. 28. P H A R M A A N D T H E C O N N E C T E D P A T I E N T AI for Back-Office Increasing Efficiency Of nurses’ workload 51% 16% Of physicians’ workload Solutions: Voice-to-text transcription ↑ Administrative workflows Eliminate time-consuming non-patient activities Potential savings: $18B /year Other areas: Insurance Fraud No shows or lapse on treatment Data breaches (WannaCry or Petya) Non patient-care:
  29. 29. “ ” We want to know what consumers are looking for, what their values are, and how we can meet their needs. Gayle Fuguitt
  30. 30. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Better Patient Communication Being more in touch with patients Typical patient journey is ripe for digital disruption Patient portals, apps and online communities can help
  31. 31. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Better Patient Communication Blue is a digital touchpoint
  32. 32. P H A R M A D I G I T A L T O O L S Mobile Health Apps and Wearables. Sources. Mobi Health 2018 86% 76% 72% 61% HCPs believe mobile Apps will increase their knowledge of patient conditions HCPs believe apps and trackers will help patients with chronic diseases. Of HCPs believe apps will encourage patients to take responsibility for their health Believe that apps will help those that are at risk of developing preventable disease
  33. 33. P H A R M A D I G I T A L T O O L S Mobile Health Apps and Wearables. Sources. Mobi Health 55% 50% 48% 46% HCPs believe can help patients who are healthy maintain their health Mobile technology increases the efficiency of patient treatment Can help patients that are discharged from the hospital The potential to improve their relationships with their patients
  34. 34. P H A R M A D I G I T A L T O O L S mHealth Apps Mobile is the most ubiquitous healthcare technology. Sources. Deloitte Research, Reasearch2Guidance, 2017 260k 3,2B 5,6M 1000 mHealth Apps on the market Downloads of mHealth Apps Downloads are pharma mHealth Apps Total number of mHealth Apps developed by top 12 Pharma
  35. 35. P H A R M A D I G I T A L T O O L S mHealth Apps Mobile is the most ubiquitous healthcare technology. Sources. Deloitte Research, Reasearch2Guidance, 2017
  36. 36. P H A R M A D I G I T A L T O O L S mHealth Apps Patient Groups views on health apps used by their members . Sources. Deloitte Research 2017
  37. 37. P H A R M A D I G I T A L T O O L S mHealth Apps Patient Groups views on health apps used by their members . Sources. Deloitte Research 2017
  38. 38. P H A R M A D I G I T A L T O O L S Pharma Apps Capitalizing on patient familiarity and use of smartphone apps. Sources.Reasearch2Guidance,2017 Create new relationships with healthcare professionals Learn how patients use and respond to medication Support patients to achieve better outcomes Target marketing strategies more effectively Improve productivity and profitability Differentiate products from competition Benefit from smartphone reach
  39. 39. P H A R M A D I G I T A L T O O L S Wearables Smartwatch and fitness bands continue to dominate the space. Real-Time Data Collection ↑ Self-Awareness ↑ Personal Safety Motivational tool (eat better, lose weight, fitness) Set goals, reminders and incentives for healthier living $40B Wearable Market Total Value in 2018
  40. 40. P H A R M A D I G I T A L T O O L S Patient Portals Patient portals that access medical records and communicating with clinicians dominate. Interest andUse Age Ethnicity Education Level Health Literacy Health Status Role as a caregiver Healthcare provider endorsement Patient Portal Usability
  41. 41. “ ” The best marketing doesn’t feel like marketing. Tom Fishburne
  42. 42. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Beyond the Pill AstraZeneca’s Day-by-Day Coaching Service for patients recovering from a heart attack After a heart attack, many people don’t change their lifestyles or refill their medication. In the US, 200,000 people a year go on to have a second heart attack. 75 heart attack patients and caregivers to find out their real needs. Developed unique content, training a team of dedicated heart-health coaches, and using the latest technology. RESULTS: 64% of patients started a new exercise routine. 17,1% improvement in the clinically recognised Patient Activation Measure (PAM) score. 40 health coach interactions per week.
  43. 43. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Beyond the Pill Novartis: Social Network (P2P) for Heart Failure Partnered with the American Heart Association and actress/singer Queen Latifah to be a part of their Rise Above Heart Failure initiative. They collaborate with American Association of Heart Failure Nurses, Association of Black Cardiologists, American College of Cardiology and WomenHeart. Together in HF aims to connect those affected by heart failure, provide heart failure resources and offer content from medical experts. The social network features dedicated sections for heart failure patients to share their stories and discuss how they live with heart failure. There is also a section for caregivers to interact with each other. Open only to individuals located in the United States, content is private and only available to other members. HCPs are not permitted to sign up in their capacity as healthcare practitioners; they can register in the capacity of a patient or caregiver.
  44. 44. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Patient Education iTbra A revolutionary wearable that detects breast cancer earlier than mammograms—to bring early detection to the masses and save millions of lives worldwide.
  45. 45. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Self-Logging KardiaMobile FDA-cleared, clinical grade personal EKG monitor. KardiaMobile captures a medical-grade EKG in 30 seconds anywhere, anytime. Detect Atrial Fibrillation, Bradycardia, Tachycardia or Normal heart rhythm. More than 50 Million EKGs recorded. https://vimeo.com/251698484
  46. 46. D I G I T A L P H A R M A Gamification for Patient Engagement Reward mechanism, stimulating further play and greater understanding of health conditions. Gamification can have a positive impact on patient engagement, health literacy and adherence. Pediatric Clinical research Trials Incentivization, challenge and reward can be applied using digital technologies Provide a platform for direct communication that is accessible, familiar, motivating and can help educate future generations about health The Hospital for Sick Children Team created the Pain Squad App for cancer patients aged 8-18 to track their pain before, during and after procedures or treatment.
  47. 47. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Pharma and Patient Data Secure, digital communication with providers accelerates issue resolution. ZappRx® is a digital health company offering a prescription & prior authorization platform. ZappRx® can improve communication with healthcare providers, deliver cleaner and more complete orders to specialty pharmacies, and provide transparency into the prescription status across all stakeholders. As a result, specialty pharmacies can focus more on delivering medications and improving the patient experience. Ability to focus more on patient support
  48. 48. P H A R M A A N D T H E C O N N E C T E D P A T I E N T Pharma and CX Phph.ideo.com Phantasy Pharmacy is a design exercise that comes out of IDEO Boston/Cambridge. Designers were set loose to reimagine these types of maladies with the lens of childhood optimism and wonder. Their final design outcome? A faux-pharmacy and radical conceptual products for common childhood ailments like eczema, earaches, pinkeye and lice. How embarrassing moments can be transformed into badges of honor, empowering kids to celebrate the awkwardness of childhood.
  49. 49. “ ” Take a risk and keep testing, because what works today won’t work tomorrow, but what worked yesterday may work again. Amrita Sahasrabudhe
  50. 50. D I G I T A L P H A R M A Strategies to improve Patient Centricity Top-Down Approach that puts patient agenda at the heart of the company. Sources.Adapted from Eye for Pharma
  51. 51. D I G I T A L P H A R M A Strategies to improve Patient Centricity Top-Down Approach that puts patient agenda at the heart of the company. Patient Value Units Strategy and Change in Corporate Culture and Structure Teams in all major UCB therapeutic areas Responsible for “Patient Value Practices, Operations and Functions Objective: Reframe Business Development around the patients’ needs Cross-functional Cooperation
  52. 52. D I G I T A L P H A R M A Strategies to improve Patient Centricity Patient Communities, Patient-centric journey and collaboration with research. 500k+ Online portal and mobile application People with Health Conditions can share information and data relating to health and clinical trials with other patients and researches Approach to map customer journeys Objective: Improve patient outcomes and involvement in research Collaborated with pharma companies Ex. UCB – epilepsy community Shire – Track and share experiences for patients and caregivers living with rare diseases 40M Patients Points of Data about Disease
  53. 53. D I G I T A L P H A R M A Strategies to improve Patient Centricity Patient-Centric Development for Clinical Trials 18000 Collection of tools, including an easy to use mobile app and an online platform that has been validated for clinical trials Enables patients, healthcare providers and life science companies capture and analyze data Development with IDEO Example: In 2016, Clinical trial to assess the impact of using smartphone-based Parkinson’s tracker App to promote patient self-management, enhance treatment adherence and the quality of clinical consultation. After 16 weeks – 72% participants continued to use the App 2017 – Partnership with AstraZeneca 64M Patients Points of Data about Disease
  54. 54. D I G I T A L P H A R M A Strategies to improve Patient Centricity Patient-Centric Development for Clinical Trials Technology developer that has created a range of EC and FDA- approved mobile apps in collaboration with Big Pharma Diabeo (Sanofi): Mobile App for patients with Type 1 and Type 2 Diabetes Provides patients with decision-making support through algorithms that can help calculate personalized doses of insulin and remote management of conditions Connections via telemedicine with healthcare providers Helps improve hBA1c in poorly controlled Type 1 patients Roche: Developing an app for women affected with breast cancer Patient will manually enter their symptoms which are then analyzed and relayed to medical team for personalized follow-up Will facilitate tailored notifications and treatments
  55. 55. D I G I T A L P H A R M A Strategies to improve Patient Centricity Move toward digital CRO. Digital Patient Unit 3M Patients Database to provide patients with information to better manage their personal health Provide opportunities to participate in clinical research, observational studies and programs to better their condition Objective: create technology solutions that tackle some of healthcare’s biggest challenges (ex. Integrating digital technology within clinical trials) Solution Design Studio
  56. 56. D I G I T A L P H A R M A Strategies to improve Patient Centricity Eliminate the risk of late-stage complications in diabetes. Open Innovation & Crowdsourcing Platform Increase R&D capabilities and cuts down the risk and costs associated with research failure Pay for solutions 370 000 registered solvers 59 000 solutions submitted $48 000 000 Awards Posted 2000+ Challenges Outsourced for Crowdsourcing 2000+ winning solutions https://www.innocentive.com/ar/challenge/browse Seekers Solvers
  57. 57. P H A R M A D I G I T A L T O O L S Transforming the Art of the Possible Blockchain and Data protection and transparency. Blockchain can record irrefutable evidence on the performance of a medicine and demonstrate adherence to the prescribed regimes. Overcome the limitations of large-scale sharing of health data, namely date security and patient privacy concerns.
  58. 58. D I G I T A L P H A R M A Strategies to improve Patient Centricity Blokchain, Data and Health. Blockchain startup that links the physical and digital worlds with cryptographic identity chips and blockchain technology. Partnered with LinkLab Lifesciences supply chain consultancy Serialized “track and trace” pilot for pharma Compliance protocol that will satisfy Drug Supply Chain Security Act (DSCSA) which passed into law in 2013 By 2023 pharma companies should be able to track the production of drugs from raw materials all the way to dispensing in an inoperable and electronic way
  59. 59. D I G I T A L P H A R M A Improved Patient Monitoring Case use: GSK – form the basis of important clinical trials and studies Apply technologies, design and techniques developed in motorsport to other highly regulated, data rich and safety critical industries Digital Therapeutics Biotelemetry: use real time data from F1- derived modelling and simulation software Real time decisions (machines) Right Time decisions (informed human decisions/interventions) Design Time decisions (Long term interventions/process change)
  60. 60. Thank You

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