Digital: Teaching An Old Dog New Tricks?

Car maker Tesla has a few lessons for pharma on truly putting digital first

This year’s eyeforpharma Barcelona conference made me feel old.

Firstly, while chatting with [eyeforpharma Chairman] Paul Simms, I realized I have attended all but one or two since their inception. Secondly, there was a lot of discussion about digital topics and I can’t even use Facebook correctly.

Ironically, I was asked to chair the last day’s discussion – on digital transformation. An old dog leading a discussion about new tricks.

Recognizing my own ineptitude, I turned to someone who really knows about digital transformation – my son. My older son joined Tesla last year, working as a digital security expert at its Palo Alto headquarters, so I asked him what lessons about digital transformation the pharmaceutical industry can draw from Tesla.

After expressing no small degree of mirth that I had been chosen to contribute to the topic, he pointed out that I was looking at it the wrong way. “You don’t transform things,” he said, “you have to rebuild them. You start with digital, then think about the rest of the business.”

When we spoke he was attending a security conference in Vancouver where many of the computer experts (dare I say ‘geeks’?) had expressed their wonder at how tech-oriented Tesla is – for a car company. “But we’re not a car company,” he said. “I think Tesla is a digital company that makes cars.”

This seemed an interesting tack. Instead of thinking about ‘digitizing pharma’, what would a ‘digital company that makes drugs’ look like? Let’s think like Elon Musk; if you’re a digital company that just happens to make cars, you start with the digital part not the wheels and motors.

Consequently, I propose four imperatives for a digital product, whether a spreadsheet, car or drug:

  1. It must be connected. Once, you bought software in a box and installed it in isolation on a single computer. Now, you buy it on the web and share it across devices

  2. It must be easily and regularly updated by the manufacturer, usually for free

  3. It cooperates with other digital offers, even its competitors; at present, we don’t even think about cutting and pasting content created in one piece of software into another competing piece

  4. It incorporates Artificial Intelligence, probably in a rudimentary way right now, but ready for more sophisticated levels of intelligence.

There are undoubtedly many more characteristics that are necessary for digital success (I’m sure my son would add security, for example) but let’s keep this simple for now, given my problems with Facebook, let alone anything more complicated.

You may be thinking that the above imperatives can’t apply to drugs, but ten years ago we wouldn’t have thought they applied to cars. So how does Tesla do it?

  1. Tesla cars are connected. Period. This can be deactivated if you’re really worried about big brother, but they are designed always to be online

  2. Tesla cars regularly update their software automatically; I have to go to a dealer and pay a hefty amount just to update the mapping function of my car

  3. Tesla cars seamlessly fold leading functionalities from other digital companies into their operating systems

  4. Tesla cars can pretty much drive themselves.

Other car companies, from BMW to Renault, have made some excellent electric cars, and many have made enormous strides in connectivity, AI, etc. But Tesla stands alone; while their competitors have adapted their cars to the digital technology, Tesla builds cars around the technology.

What would this look like in pharma?
Can a drug be connected? We would have said that about a car a while ago. Pharma’s products aren’t just drugs; they are more than that. We talk about patient support programs – and you might spend hundreds of thousands or even (gasp) millions of dollars on them – but with a Tesla approach they become central. And they must be connected; forget about ‘an app’ or, even worse, a website, or people on the phone to support patients and prescribers. A truly digital approach is fully connected, multichannel (or omnichannel, another new idea), tying patients and prescribers together and which happens to incorporate some drugs.

If you’re serious about digital transformation, this is what you will sell, and this is what will be created in R&D. Do you have a digital R&D team folded into your clinical R&D team? I’m not talking about adding digital elements to what comes out of R&D, rather approaching a pathology with a joint innovation team including both clinical and digital developers to build blended approaches from the start. Eventually, the clinical elements might be secondary or incorporate off-patent products but the real innovation would come from the digital side through connected platforms.

Once you have a truly digital product, it can be regularly updated. Pharma comes out with products that never change over their patent life, then they are replaced with some other patented product. What if your fully branded diabetes, Parkinson’s or oncology offer was a connected digital platform that was constantly refined and updated for free with new digital functionality (software) and occasional new physical elements, including chemical compounds (which would effectively become firmware)? Some international support platforms – like Abbvie Care or J&J’s Care For Today, which have built established reputations with brand equity – could easily remain in place even if the underlying drugs were replaced.

There was talk at eyeforpharma about cooperation, yet pharma is a very competitive industry, but this new kind of patient-centered support platform doesn’t have to be competitive. MS patients that are better off and more adherent won’t hurt your MS product at all, and there’s no earthly reason to restrict efforts to just your drugs except for the marginal cost of supporting each patient.

However, the more digital we are, the more marginal cost goes down, which brings us to the inevitable – artificial intelligence. The degree to which it will be truly intelligent and when this will occur is a point of debate, but we talked a lot during the conference about the impact of AI on R&D – and it is coming to patient and HCP support as well.

Chatbots abound, while truly impressive virtual health assistants (VHAs) are beginning to see the light of day as well – Teva’s Claire for Copaxone in the United States was a groundbreaking application and more are coming. VHAs are focused on patients, not only helping them to adhere to medication but accompanying them in their general health behavior as well. Consider NextIT’s Alme demo.

Of course, I’m biased. At Observia, we are focused entirely on patient support, and there are many aspects of the ‘digital-first’ approach that are well outside the patient support sphere, but I would start here. Patients are pharma’s real clients, after all, they are the users of any product, physical or digital, and that’s where pharma must start thinking.

A final thought. I asked my son if he had advice for pharma execs facing digital transformation. He said to tell them that “the skills and knowledge that made them successful will become useless. It will be a different ball game, but it’s not like they’ll be out of a job. Computers still need humans to assist them, at least for a while.”

He meant the last part to be comforting, but the first part is undoubtedly true. Just as Elon Musk has shaken the automobile industry to its core, what will happen when Google, Microsoft or Amazon decide to approach pharma with a digital-first philosophy? It is simply not possible to gradually move into the digital world, building little adjuncts to existing business. Someone is going to look at it the other way around, starting with a connected, updatable, cooperative intelligent digital offer to patients that includes drugs and if pharma doesn’t do it, pharma will simply become a link in the supply chain for whoever is innovative enough to shake things up.

Kevin Dolgin is President and co-founder of Observia, a French company specializing in patient support and adherence programs.

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