The Time is Now to Move Far Beyond the Pill

Companies must change their mindset and embrace digital technologies if they are developing beyond-the-pill solutions that deliver real value

There has been a lot of talk about ‘beyond the pill' strategies for many years, as companies create services and solutions that are complementary to their drugs. More recently, with the many changes affecting healthcare, pharma companies are adjusting their business models and looking at strategies to improve patient outcomes and diversify revenue sources that go far beyond the pill.

Wellness programs and chronic disease management are common approaches, offering opportunities for companies to increase customer engagement leading to improved outcomes. For example, Biogen has used Fitbits to monitor the walking activity of patients with multiple sclerosis, previously only measured during visits to the doctor’s office.

This is a good example of an integrated solution that help patients achieve better health outcomes by engaging them with the process. Tracking their own progress – and seeing what other patients are doing – can build community and encouragement. Such communication is especially important in chronic long-term conditions where patient engagement is critical for improved outcomes.

Wearables, ingestables, and implantables offer many new opportunities for pharma companies to become involved in the overall health of their customers, as well as to know how well their medicines are working. As technology becomes a bigger part of pharma, it's likely that medications will have an accompanying mobile app, with devices to track a drug's outcome.

Leadership and regulation

Despite many attempts by companies to create beyond-the-pill strategies, many have failed to meet the objectives set and subsequently been pulled. While such failures have a variety of causes, there are some common challenges. The first is leadership, which, oftentimes, is chosen from existing teams and lacks the relevant experience in building typically digital, beyond-the-pill solutions.

A second challenge is a regulatory environment, where anti-kickback regulations require pharma to document and charge fair market value for services. Start-ups outside pharma, including the many digital health start-ups, are not required to comply with such regulations, putting pharma companies at a disadvantage. Adding complexity, some customers such as payers also sell these kinds of healthcare solutions meaning that pharma can become a competitor to its biggest customers.

Each of these challenges lends an opportunity for pharma leadership to think strategically. The most efficient approach is to integrate new services and solutions fully into the core business model, rather than trying to add it on in a stand-alone manner. Biogen did this successfully in the FitBit example above.

Creating a circuit of information that feeds itself, improves patient outcomes and obtains valuable data about the success of a medicine. Additionally, wrapping pills in useful services and solutions adds value for customers, enhancing the primary business.

Big data and AI

The trillions of data points delivered by big data and AI are critical factors in the creation, improvement and delivery of beyond-the-pill strategies.

As more patients participate in their healthcare through wearables, ingestables, and implantables, opportunities arise to understand customers in a holistic way. This allows us to analyze, understand and predict what would offer real value to customers, and deliver more comprehensive healthcare solutions.

A generics company launching a premium-priced drug with no real differentiation to generics used artificial intelligence to identify what components were needed in a program to ensure it offered enough value-add for the brand to launch successfully despite the high price tag. The project involved both a patient and physician program, and saw the drug become the largest in the class within six months of launch. The company is now taking this further by adding this data to other data – wearable sensors, social media, CRM, doctor prescribing data – to further refine and tweak the program.

Another example is the Novartis-Qualcomm $100m partnership. Compliance to medication is critical in organ transplants so Novartis used the Proteus chip-in-a-pill technology to track patients on Diovan, increasing compliance from 30% to 80% within six months. “If we can save one patient from needing another transplant, we’ve saved a life and at least a half-million dollars,” said Dr Tamir Miloh, Assistant Professor of Pediatrics and Surgery at Mount Sinai Hospital in New York. “The investment is relatively little and the benefit enormous.”

Novartis also working with Google on glucose-sensing contact lens technology for people with diabetes, and for people with presbyopia who need can no longer read without glasses. The smart lens will correct vision and help restore the eyes natural autofocus on near objects. Another $100m investment focuses on mobile-enabled clinical trials, firstly monitoring patients with chronic lung conditions. The trial is observational and does not involve any Novartis drugs but collects biometric sensor data and transmits it to a cloud-based big data platform, which securely sends the data to the study coordinator.

Mind the gap

Most of the beyond-the-pill strategies Eularis has been involved with to date have been around patient engagement, sensors, patient and physician services, and big data and AI – ancillary services, not completely new business models.

There is a transformation waiting to happen in the pharma business model, a space that is slowly evolving as we focus on better clinical outcomes and value. The current gap lies between the theoretical understanding of the need and the execution of a plan for it. Real change must come from the business focus; currently, we are still focused on medicines when we should focus on our customers as people, not as physicians or patients.

To do that, we need to transform ourselves into a data-driven industry focused on our customers’ needs rather than only medical breakthroughs. You'll want to start by asking the right strategic questions and to prioritize – big data and AI can help you get started, but a real transformation in thinking needs to take place.

Dr Andrée Bates is the Founder and President of Eularis

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