Psychotherapy for Pharma

What can pharma learn from its digital past?



For several years now pharma and their industry partners have been trying to deliver on the promise of digital health without much success. Even worse, now upstarts like Welldoc and Omada and even consumer technology giants Google and Apple are coming to the game. This has many in the industry concerned and looking over their shoulders. In other words, a good time for pharma to become the patient and undergo a bit of Psychotherapy.

In this article, we’ll help the Patient understand a little about themselves, their situation and give them a platform to make some positive changes going forward!

Case History

Several years ago genomics, the internet, diagnosis tools and empowered patients were going to change the world of healthcare. There would be more active patients, better diagnoses and the right pill to the right patient, all this leading to better outcomes.  What’s more, today’s Patient (Pharma), was going to help make it happen. They were well funded, knowledgeable, well connected and ready to help deliver on services and outcomes.  A bright new future was in store!

The reality is that things haven’t quite worked out as hoped. When we look back we can see that for all their bluster and bravado our Patient was;

  • Ready for products, not solutions and services
  • Afraid of letting human behavior confound results
  • Unclear how to organize itself
  • Unable to define the business case
  • Intimidated by a challenging new field

No wonder things haven’t turned out as expected!

Products not Solutions and Services

Pharma is a development and commercialization machine built around an unchanging asset, the molecule.  They have honed and optimized every step of this process from discovery and development to regulation, launch and sales.  Solutions, however, required a lot of new things they weren’t ready for; unfamiliar technology, iteration of a solution during and after the pilot, evidence generation in the real world, cultural adaptation, user engagement and that was just the start.   

Human Behavior

Traditional clinical trials focus on engineering human behavior out of the equation so the drug action is the sole focus. The inclusion of the unpredictable behavior of humans in the real world was a new challenge that might jeopardize these expensive assets! Influencing behavior, as is often the case with digital health also requires regulating the solution or underlying algorithm as a medical device. This drew pharma, especially the commercial organization, further outside their comfort zone.

Organization

Serviced-based solutions look like commercial programs but act more like development ones. They cost up to 3-5 times the launch budget of a blockbuster drug and aren’t guaranteed to succeed. Yes, pharma does spend hundreds of millions of dollars marketing and selling drugs but most of this spend is at the country level. The global budgets where the extra spend, needed to finalize the early digital health solutions, was to be found, are relatively meager. This meant that there was no strong owner to bring the solutions to market with the budget and support needed.

Business Case

The new model required user-centricity, iterative development, new kinds of evidence generation, and since no one had done it before there was no template to follow. No wonder it was a challenge to define a business case or even predict how the solutions were going to deliver a return on investment".

The traditional pharma business model follows a predictable formula. It involves getting the molecule to market and scaling quickly whilst filling the label full of claims and then getting paid based on every pill or injection prescribed by doctors, people with whom pharma knew how to communicate. The new model required user-centricity, iterative development, new kinds of evidence generation, and since no one had done it before there was no template to follow. No wonder it was a challenge to define a business case or even predict how the solutions were going to deliver a return on investment. Most pharma companies didn’t have a governance structure that could accept the risk, even if the amounts in dollars were far less than the cost of drug development.

New Technology is Difficult

The new way of going to market was challenging but the underlying technology for the services or outcome support was also often new, untested and changing.  Solutions developed pre-mobile apps look positively ancient even if they were cutting edge 5-6 years ago. The skills of traditional pharma IT were also not prepared for building customer-facing products in this rapidly changing environment; they were instead good at inward focused business support. Adding to the IT challenge, the personalized medicine revolution has been slower than anticipated and who thought putting a chip in a pill would be easy?

Unfortunately in a time-limited world, we’ve come to the end of our session. Like all good group therapy, it makes sense to get others involved so feel free to leave your comments below and help the session along. What aspects of our Patient’s problems haven’t we covered? Regulation, payers, interaction with Health Care Professionals?

We’ll be looking ahead next month at what pharma can do to avoid ending up on the therapists couch again in our article - When Pharma Shouldn’t Build Digital Health Solutions.


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