Out of all the digital health stakeholders, pharmaceutical companies have both one of the biggest opportunities and some of the most significant challenges to make the most of mobile and digital technologies. As such, while providers and payors have dived into the digital health world with gusto, moves from pharma have often been tentative. They are just now starting to take off. [Download this in-depth report as an eBook (PDF) right here.]
Challenges for pharma
Pharma is fighting an uphill battle in many ways. One is that, as technologies like mobile devices, social media, and video communications bring healthcare into patients’ homes, patient trust becomes more important than ever. And pharmaceutical companies generally aren’t as trusted as physicians or even insurers.
A Deloitte survey last year found that although people trust doctors and academic centers most, the next most trusted entities are companies like WebMD, then Google search results. At the bottom of the list is pharma and payor companies.
“So the worst part about that is those groups are the ones providing the largest amount of health information and consumers don’t trust them at all,” Deloitte physician Harry Greenspun told MobiHealthNews at the time. “So one of the most interesting things we’re seeing in health is partnerships with pharma and payors and with other organizations to get that info, and get those apps in a method they can believe in, and trust.”
A more recent study, by Makovsky Health, found that only around 35 percent of consumers would trust a disease website sponsored by a pharmaceutical company, and 16 percent said they would never visit a disease website sponsored by a pharma company. Paulo Machado, a healthcare consultant whose past credits include marketing and innovation roles at AstraZeneca and Bristol-Meyers Squibb, summed up the situation.
“If I’m a consumer do I want to talk to pharma companies or do I want to talk to my doctor? Who am I going to believe more?” he said. “The biggest competitors to pharma are not other pharma companies, it’s other healthcare organizations.”
Another challenge is that pharma is historically extremely risk-averse, which Pharmica consultant Matt Hendricks said could contribute to the fact that so few pharma companies have groups like J&J’s Janssen or Merck’s M2i2.
“So, why isn’t it happening? Why doesn’t every major pharmaceutical company have a group like Janssen?” Hendricks asked at a panel discussion last December during HIMSS’ mHealth Summit. “Why doesn’t every pharmaceutical company have a booth downstairs? There are some very big impediments that are worthwhile to address. One, is when you look at the development of a drug program, it is really all about managing risk and being able to cross off all the risks associated with developing a drug. When you introduce a new factor, it inherently increases risk. In a business that is focused on reducing risk, then those are things that life sciences companies are going to stay away from.”
Since the digital health opportunity is so new, Hendricks argues pharma companies are more comfortable sticking to what they know and what is proven.
“Even though the economics of developing new drugs are becoming increasingly difficult, at the end of the day it is still a well understood process that the finances are easy to figure out,” Hendricks continued. “When comparing an opportunity with so many risks and lack of clarity around regulatory approval and business models to something that has been around and been well-trodden for many decades now and has well-trodden business models, when a company is looking at where to put its resources, it’s going to go to where it believes it can get the highest return. Many of these companies still see the biggest opportunity for their resources is in developing drugs and not in developing other therapies that improve health outcomes but may be riskier.”
Looking Beyond the Pill
Outside of the use of mobile devices by pharma sales reps, pharma’s movements in digital health over the past few years have fallen broadly under a few basic umbrellas: patient engagement tools, including medication adherence, prescribable digital therapies, new kinds of sensors, and big data initiatives. Like payers, though, pharma companies aren’t limiting themselves to areas that relate directly to their core business of selling drugs and therapies.
“We think that there’s a transformation that’s waiting to happen,” Aman Bhandari, director of Merck innovation group M2i2 recently told MobiHealthNews. “Some people say the work that you’re doing, population health, that seems like the work of delivery systems. That seems like the work of payers or plans. You know, ultimately, we see a major convergence happening in terms of goals and outcomes and we see a real systemwide refocusing on values and outcomes measurement as kind of the central theme that’s driving everyone across the industry. We think there’s an extraordinary opportunity for pharma to have a seat at the table that it hasn’t had before and we’re hoping to give it that.”
Merck’s innovation group is supporting a wide variety of research partnerships in the areas of capturing the patient voice, clinician-facing technologies, and innovative uses of data. Similarly, Johnson & Johnson’s Janssen Healthcare Innovation group is working on some things related to pharma — like medication adherence app Care4Today and mobile-enabled clinical trials — bit is also working on integrated care business offerings for healthcare, using software to improve rates of cardiac rehabilitation.
As M2i2’s Chief Medical Information and Innovation Officer Sachin Jain puts it “the ultimate incentive is that we as a company are gradually finding our way into the outcomes improvement business, as opposed to the pill and vaccine business, and as we do that, I think we realize that data and technology and HIT is going to be a critical enabler.”
Jain thinks that as the healthcare system as a whole moves toward outcomes-based medicine, pharma companies are no exception.