PharmaVoice: Seeing the Potential in mHealth

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An interesting free mHealth paper is published in the latest issue of PharmaVoice magazine including ‘executive viewpoints’ from Gavin Birchnall, Senior Product Manager, ERT,  Chris Watson,  Director of Product Strategy, ERT,  Paul Greene, Senior VP, Clinical Development — CNS, INC Research,  Dara Liguori, Digital Engagement Strategist,
Ogilvy CommonHealth Worldwide, part of WPP Health & Wellness  and  Brandie Linfante, VP, Digital Strategy, Ogilvy CommonHealth Worldwide (part of WPP Health & Wellness).

mHealth Insights

“More pharmaceutical companies are recognizing the potential mobile applications present for improving outcomes”

I think this is accurate and should come as a reality check. In 2017 most Pharmaceutical companies haven’t yet even woke up to the potential of mHealth.

“A core principle in the collection of scientific data is that data about an event are always better if collected in temporal proximity. Put simply, if there is health information you want for a clinical study, it is best to collect it when it happens instead of waiting for a study visit. This might include the collection of adverse events or patient reported outcomes; it might also include the collection of sleep parameters or vital signs. In essence, this is real-time data collection and is the foundation of quality and precise data”

I think this is a key reason why Apple’s ResearchKit is completely transforming the global $100B/pa Clinical Trial Industry.

“What’s in it for Pharma? A growing number of pharmaceutical companies are tapping into the opportuni- ties mHealth presents. For example, GSK is committed to increasing use of mHealth data in its clinical trials as one way to try to reduce the cost of developing drugs. Daiichi Sankyo developed a mobile app to help pa- tients with atrial fibrillation by providing tai- lored reminders to adhere to their medication. Boehringer Ingelheim has also been at the forefront with its commitment to apps to im- prove adherence, including a partnership with Propeller Health for a sensor that monitors adherence of COPD and asthma patients. Lilly has developed a mobile app to help patients remember to take their once-a-week diabetes medication Trulicity at the right time and how to use the injection mechanism correctly. And Takeda’s iBData program helps patients with inflammatory bowel disease track their symptoms through a smartwatch app”

A nice summary of apps that Pharma companies are making but when you realise the scale of these companies operate at (eg. GSK has revenues of £28B and employs 100k staff) isn’t it clear that these companies are ripe for disruption by Mobile First competitors e.g. GSK can reduce the cost of their trials but that’s not what it’s going to take to actually compete with Apple who have a 100% commitment to Mobile First Clinical Trials. Pharma brands using mHealth to make their Clinical Trials cheaper is equivalent to dead Music brands using the internet to make manufacture of their CDs cheaper when the real change was coming from iTunes and MP3 playing mobile phones.

“Advancements in technology over the past five years have led to increased interest around the topic of mHealth — the monitoring and delivery of healthcare through mobile devices. Approximately 93% of us now own a mobile phone and, with an increased desire from the pharmaceutical industry to use electronic data capture over traditional paper methods, it’s no surprise that the use of mo- bile phones has become commonplace within healthcare”

The Pharma industry urgently needs to consult those with better understanding of the mobile market. This 93% stat is pretty much irrelevant because the reality is every customer of the Pharma industry has a mobile phone and the importance of this becomes obvious when you realise that the 7% who don’t own a mobile phone largely consists of babies and children who aren’t yet old enough to have a mobile (but do have Parents/Carers who have a mobile).

“The use of mobile devices as a method of data capture has opened the door to an easier, and more effective, way of generating real-world data (RWD). This creates a larger base of real-world evidence (RWE) for pharma to inform decisions about the cost-effective- ness and patient value of a new product to the healthcare system”

Imagine how out of touch you have become when you are in an industry that feels the need to use acronyms for “real world” data/evidence?

“Until recently, sponsors tended to view paper assessments as the most economical means of collecting data directly from patients. Paper questionnaires, it seemed, were much less expensive than the alternative of providing patients with electronic devices loaded with applications for reporting. However, paper involves heavy back-end costs as responses must be manually checked and entered into a database — a time-consuming, labor-intensive chore. Plus, data quality suffers from a combination of waning compliance and data-entry errors”

If even there was an industry that could benefit from being completely redesigned by the Born Mobile Generation.

“In today’s digital world multiple market forces have also converged to create a rising demand for patient-collected data. Firstly, the pharmaceutical industry is making a concerted effort to understand the patient experience over time, recognizing that treatment is not just about epidemiology or biology. To fully serve patients and improve their care, pharmaceutical companies are eager to understand how patients are feeling, how they make decisions, how their lives are impacted by their condition/disease, and what challenges they face functionally and emotionally. Secondly, payers are demanding evidence of a product’s value for cost, and RWD collected from patients can bolster evidence that a product adds value beyond the standard of care. This information may become crucial in an increasingly competitive marketplace. Thirdly, regulators are moving toward a more patient-centered focus, this is particularly true in some therapeutic areas — notably oncology — where regulators are requesting assessments of patient symptomatology that can only be derived from patients themselves”

I continues to surprise me how little appreciation there is in the Pharmaceutical industry for the interest that Patients have for using their data to improve their own care and advance science. How about even just treating me like a statistic?

“Patient-focused RWD programs can be designed to elicit subjective feedback on their symptoms and side effects, response duration, treatment adherence, treatment satisfaction, activity levels, emotional state, lifestyle, quality of life, and any other relevant contextual elements”

I think this is one of the fundamental reasons Pharma brands aren’t able to make the shift and properly embrace the mHealth opportunities. Their share holders don’t want them to be in the actual business of care because that needs you to prioritise trust and the focus needed to build trust would rule out all those profitable tricks they do with pricing and politics.

“Combining data collected directly from patients with other RWD sources provides a more holistic view of the patient’s treatment experience and changing health status. These data enable sponsors to fine-tune their estimations of a drug’s overall value and its impact on efficacy and safety. The most appropriate combination of data sources will likely be different for each given research need, but patient-collected RWD enriches RWE analysis. Hughes et al. estimate that RWE can potentially generate $1 billion for a top-10 pharmaceutical product when it is applied collectively in six major areas”

It amazes me the way the Pharma press ignores the elephant in the room. Surely the availability of this data is going to reduce the imprecision of evidence based medicine and this could just as easily result in a fall in sales of top drugs?

“The tool can be set to accept only data within specified parameters, preventing the entry of outlying data. A patient, for example, would not be able to enter a body temperature of 88° Fahrenheit”

I think it’s hilarious how Healthcare Executives always imply that Patients are the incompetent fools. I see far more mistakes made by medical professionals (who are busy and inundated with the demands of administrivia) entering data than by Patients (who have got the most to lose from it being inaccurate). If you have a tools that accept physically impossible medical data perhaps you should hire someone to build your app who has a clue what they’re doing…

“It is likely that patient engagement and participation in the real world will become more entwined across the entire product lifecycle, from development through to post-approval. Exactly how this will be optimized remains unclear. Yet, what is clear is that electronic data capture solutions and developments to enhance their affordability, rapid implementation, and ease-of-use have made great strides in recent years. Furthermore, the ability of patients to use their own devices”

There are actually people who talk like this.

About David Doherty
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