Patients’ Week 2011: How Health 2.0 helps patients put a doctor in their pocket

In the run up to eyeforpharma’s second annual Patients’ Week in September, Andrew Tolve looks at how pharma can participate in the burgeoning Health 2.0 movement, to the benefit of both patients and the pharma industry itself

Despite enormous advances in medicine over the past 50 years, a lot of us are still unhealthy.

Rates of obesity have skyrocketed, while diseases like hypertension and diabetes are more prevalent now than ever before.

This may be good news for pharma’s bottom line, but it’s bad news for our overall wellbeing.

Health 2.0, a movement that includes dozens of technologies that empower individuals to stay healthy, preempt disease, and better manage chronic conditions, can help turn this trend around.

“If you always had a doctor walking around with you, you could gather more data about yourself and keep yourself healthier,” says Artem Petakov, co-founder of WorkSmart Labs, a Health 2.0 start-up. “Health 2.0 is helping to put that in your pocket.”

Pull out your smartphone and inside you’ll find dozens of apps and sites that make it possible to track your workouts, your diet, your medicines, your diseases, and your genetics.

While the age of personalized medicine may still be some way off, these technologies are empowering patients with personalized healthcare now. (For more on personalized medicine, see ‘Personalized medicine: A kick-start for innovation?’.)

Pharma has an opportunity to embrace and cultivate this movement, to the benefit of both patients and the pharma industry itself.

As Esther Dyson, an angel investor in several Health 2.0 companies, points out, “Pharma can harness Health 2.0 to match drugs more effectively to the appropriate market of individuals. Ultimately, they can help lead the charge or they can get left behind.”

Health goes mobile

Over the past five years, the Internet has become a dynamic, personalized platform for information and interaction.

At the same, society as a whole has become increasingly health conscious—not necessarily healthier, but more willing to consume healthier products, as the growth of organics attests.

Plus, next-generation mobile phones and tablets can now search the Web and run apps wherever users go.

The confluence of these three trends has made Health 2.0 possible.

“Social media is important, but mobile really changes the game,” says Petakov, “because it’s a device you have with you all the time. You have to have that for exercise and wellbeing, whether it be at the gym or to track foods and medicines.”

A wide range of companies has cropped up to capitalize on Health 2.0.

WorkSmart Labs, for instance, has released CardioTrainer, a virtual training partner that tracks workouts and helps store information to illuminate individual patterns and motivations.

MedRewards offers the equivalent of a frequent flyer program for healthy behavior; patients earn points for going to the gym more than five times a week or for taking their medicines regularly.

Then there’s Keas, founded by the former head of Google Health, which offers step-by-step Care Plans designed by wellness experts to get individuals engaged with their own medical data and on a path toward positive health outcomes.

On the chronic disease side, there’s Hemolog, an app that allows hemophiliacs to manage their infusions and open up personal data to doctors. (For more on Hemolog, see ‘Collaborative care: Improving information exchange and adherence’.)

And on the genetic front, there’s 23andMe, a service that lets individuals test their DNA for predisposition to diseases and then engage in online communities and clinical research to help develop treatments in areas of personal interest.

“This is all starting to happen,” says Dyson. “It’s happening with a small number of companies, but their number is growing.”

Getting healthy, making money

Most Health 2.0 companies are still in serious start-up mode.

Some have established concrete products and communities; more are developing them.

WorkSmart Labs, for example, has a few apps like CardioTrainer on the market but its larger vision—that of a platform that lets individuals manage their health and wellbeing the way allows them to manage their finances—is still in the works.

The same goes for Keas, whose website is in beta, and for MedRewards, whose website doesn’t even exist yet.

Even the more established Health 2.0 companies, like 23andMe, are yet to shed their start-up status.

23andMe has more than 60,000 community members and numerous investors, including some from big pharma.

“Until we have millions and millions of people in every disease area, we are going to have a startup mentality, because each disease area requires a lot of innovation,” says 23andMe’s co-founder, Anne Wojcicki.

Dyson thinks it won’t be long before many of these companies find traction, however—first with fitness fanatics, then with employers eager for lower insurance costs, and finally with governments saddled with billions of dollars in debt caused by poor health management.

“There didn’t used to be money in telling and motivating people to be healthy,” she says.

“Now there is. Like it or not, commerce makes the world go round.”

Convincing consumers

Not everyone is convinced that Health 2.0 is about to explode, though.

Around the world, some 1.3 billion adults and more than 40 million children are overweight or obese.

While governments and economies feel this burden, the obese, by and large, are unaware of the medical risks and costs associated with their own weight.

“I’m profoundly skeptical” of the Health 2.0 movement, says Lisa Suennen, co-founder and managing member of Psilos Group, which provides venture and growth capital to companies that improve the quality of healthcare while reducing its cost.

“Not because I don’t think it’s a good idea, but because actual real-life patients don’t get that engaged in their health. The vast majority of people don’t tend to get serious about health until they don’t have it.”

From Suennen’s point of view, the notion of people paying for products that will help preempt disease is not a compelling one for the majority of patients.

In order for Health 2.0 to take off, public education needs a boost.

People need to know about the importance of staying healthy and, more importantly, how much unhealthy behavior costs.

Plenty of people know that McDonald’s isn’t a healthy food option, but lack of money or incentives often leads them right back under the golden arches.

It’s thus imperative to illuminate the costs of obesity, not just in some ambiguous government debt figure but in these individual patient’s pockets.

“I do think that if our healthcare system starts to change in a way that more people become connected to the cost of healthcare, through health insurance products that make them become aware, it can turn things around,” says Suennen.

“I think it’s inevitable that some of this Health 2.0 will come to be. I’m just not sure how much.”

Stacey Chang, strategic lead for consumer health and medical products in global design firm IDEO’s health and wellness practice, agrees.

“I’m thrilled with this idea of having [the Health 2.0] toolset to increase engagement, but we have to recognize that it is a toolset and not necessarily the spark,” Chang says.

The spark will come from the consumerization of healthcare, he argues, as more products like the Wii Fit, shows like the Biggest Loser, and stores like Whole Foods prove the commercial value of health.

“These technologies and toolsets will help fulfill the promise, but we need something else to draw them in initially from the consumer side to the health side,” Chang says.

How pharma can become a partner in health

It would be easy for pharma to view this burgeoning Health 2.0 movement as a threat.

After all, pharma makes drugs to help patients manage and overcome diseases.

Health 2.0 is about engaging patients to stop those very diseases from happening in the first place.

There are several counterpoints to this argument.

For one, in the past pharma has not done a good job aligning itself with patient needs and their broader sense of wellbeing.

“People have a different set of needs when it comes to medicine,” Chang says.

“When individuals talk about their health, that means a lot of things beyond what drugs they’re on. They talk about their health and fitness, their emotional wellness, all those other things that tie into their sense of wellbeing. They never feel like pharma is a partner in that.”

Health 2.0 gives pharma a new opportunity.

Companies can actively embrace patient wellbeing, knowing full well that drugs will still work their way into individual’s lives.

For instance, the vast majority of patients with diabetes or hypertension end up on drugs, so why not create a feeling of goodwill and alignment with their broader wellbeing before they do.

“It’s a little of the Miracle on 34th Street moment, where [patients] say, ‘Oh, these companies actually have a greater good in mind and, by the way, they’re now providing me with the tools by way of drug therapy to achieve that greater good,’” according to Chang.

Secondly, as patients become more involved in their own health, it opens up new markets for pharma companies to pursue.

One obvious field is that of preemptive treatments.

If a large chunk of the population knows that they’re genetically predisposed to, say, Alzheimer’s or Parkinson’s disease, they’re going to be much more likely to seek treatments before the disease has set in.

“I think that almost every pharma executive would agree that the best way to develop successful treatments is with people early onset or pre-symptomatic,” says Wojcicki of 23andMe.

“Once you start to have damage in the body, it’s harder to reverse. Moving forward, treatments are going to help earlier and earlier, and that will lead to some really interesting partnerships for the pharmaceutical industry.”

Wojcicki points out the pharma industry can (and already has started to) partner with communities like her own to expedite drug discovery. (For more on drug discovery, see ‘The patient’s view: Patients with a (re)purpose’ and ‘Patent expiration: Innovate or die’.)

If you’ve got a vibrant community filled with individuals enthusiastic about their health and aware of diseases they’re genetically predisposed to, that’s an ideal pool for drug research and development. (For more on drug research and development, see ‘The patient’s view: How patients can add value to—and influence—pharma’ and ‘Pharma R&D: Where will the new drugs come from?’.)

J&J, Genentech, Roche, and a host of undisclosed pharma companies are already partnering with 23andMe.

There are dozens of other Health 2.0 companies out there, though, that are collecting data, community members, and app users—waiting to be tapped for drug discovery.

“Everyone recognizes that pharma needs to experiment with ways to make drug discovery more efficient,” Wojcicki says.

“Our hope is we can take on some of that for them and get consumers excited about research. We want people to walk away from a clinical study and say, ‘I feel so good that I did that, that I helped move the needle forward.’” (For more on clinical recruitment, see ‘Social media: A tool for clinical trial recruitment?’.)

For all of our Patients’ Week 2011 stories, check out eyeforpharma’s website in September.

For everything patient-related, join the sector’s key players at Patient Adherence USA on October 24-25 in Philadelphia and Mobile Innovation for Pharma on December 1-2 in London.

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