Industry Trend Analysis - Drugmakers To Push Patient And Physician Communications Through Apps - DEC 2017

BMI View : Advances in technology, a global focus on improved healthcare efficiency and increasing patient participation in the healthcare decision - making process will result in greater healthcare personalisation. Individual-specific disease diagnoses and personalised healthcare regimens will increasingly become the standard practice of care in health sectors globally. Ultimately, healthcare will be led by the consumer and following this, by healthcare professionals, instead of by government mandates or industry initiatives. This will result in the development of mobile phone -based tools that focus on disease management - for both patients and physicians .

It is our view that consumer-driven initiatives will reform healthcare systems around the world to provide real-time, focused and more personalised medicines and healthcare services. As patients put a premium on convenience and the ability to manage their own medical care, healthcare providers including drugmakers - will be forced to be more proactive, providing services that aid the holistic prevention and management of disease.

Mobile applications (apps) and the trend towards gamification and 'nudging' in order to gently change an individual's behaviour provide the healthcare sector with new ways to sustainably alter patient behaviour and improve health outcomes. A search for medical apps on the Google Android and Apple iO S platforms shows the sheer size of this industry, with hits reaching in the hundred thousands. Highlighting drugmakers' recognition of ways in which smartphone apps can be instrumental to their businesses - multinationals Pfizer, Merck & Co, GlaxoSmithKline (GSK), AstraZeneca, Sanofi, Roche, Novartis, Johnson & Johnson, Bayer and Abbott Laboratories have all produced apps for use by patients and healthcare professionals. The apps include disease calculators, educational packages, patient diaries and information on drugs.

Examples Of Drugmaker Investment Into Apps

  • In August 2017, GSK announced that it was expanding its digital healthcare programme for asthma. The company expanded its relationship with Propeller Health, which develops mobile health sensors and apps that can be incorporated into medical devices that treat respiratory conditions, such as inhalers. The companies are moving ahead with a new initiative for researching and launching the commercial use of Propeller's clip-on mobile sensor and software platform for use with GSK's Ellipta inhaler.

  • In June 2017, Roche bought Vienna-based diabetes management platform mySugr for an undisclosed price. Privately held mySugr offers a logbook for mobile devices to help people track their blood sugar, medications and activity levels. It has been working with Roche since 2014 and previously got funding from Roche's Venture Fund.

  • In January 2017, Novo Nordisk signed a product and services development deal with Glooko, a developer of mobile health tools and apps for diabetes care. Under the deal, Novo Nordisk and Glooko will develop personalised digital services, including apps, to better support people with diabetes in areas including treatment adherence and blood glucose management. The new digital services that Novo Nordisk and Glooko develop will also eventually be integrated into a broader digital healthcare platform that the Danish-based drug and device manufacturer is building with IBM Watson Healthcare. In July 2017, the first product from Novo Nordisk's partnership with Glooko was launched - an app called Cornerstones4Care Powered by Glooko, or the C4C app for short, which allows people with diabetes to measure and track blood glucose, activities and meals.

Apps For Patients

Pfizer - NeP Diary: This app supports patients with neuropathic pain and encourages adherence to their medication. The purpose-built app is free and has been developed for patients who have been prescribed Lyrica (pregabalin) for neuropathic pain. The app can also be used for appointment reminders and diary entries.

GlaxoSmithKline - MyAsthma: This app uses the Asthma Control Test (ACT), a validated questionnaire developed by GSK, to allow patients to measure their asthma control and provide motivation for them to change current behaviour.

Novartis - SymTrac: This app is directed at people with multiple sclerosis (MS) and helps them in tracking their general wellbeing and symptoms over time. The data recorded is displayed in easy-to-read charts and can be shared with healthcare providers to enhance consultation and support decision making.

Roche - myStudyCompanion: This app assists patients on clinical trials by providing relevant information and schedule details. Access is provided to patients currently enrolled in specific clinical trials.

Sanofi - GoMeals: This app was developed to help people make healthy lifestyle choices at home or on the go. GoMeals includes tools for eating healthier, staying active, and tracking blood glucose levels.

Apps For Healthcare Professionals

AstraZeneca - Inside Gout: This app is an interactive educational tool that offers healthcare professionals useful and engaging information about the systemic and chronic nature of gout.

Roche - Onco App: This app contains an extensive database on Roche oncology products: Avastin (bevacizumab), Herceptin (trastuzumab), Mabthera (rituximab), Xeloda (capecitabine), Tarceva (erlotinib), Zelboraf (vemurafenib), Perjeta (pertuzumab) and Kadcyla (trastuzumab emtansine). The app is an updated reference and serves as a medical resource used by physicians, residents, pharmacists and other healthcare professionals for clinical information.

Pfizer - SPIRE Clinical Trial Screening: This app is designed to aid site coordinators and investigators in determining subject suitability for participation in Pfizer's SPIRE clinical trial during the pre-screening and screening stages. The Spire clinical trial involves the study of an in-development drug and its effects on bad cholesterol (LDL-C) and cardiovascular events such as heart attack or stroke.

Merck & Co - The Merck Manual Home/Professional Editions: These two apps are medical references for both general public and professional use, respectively. The two versions differ in the degree of detail they provide but both reference the company's medical textbook and reference - the Merck Manual.

Bayer - Gadovist Breast MRI App: This app is aimed at medical professionals in the field of radiology. The app includes a collection of 32 cases and illustrates the diagnostic competence of dynamic contrast-enhanced breast magnetic resonance imaging (MRI) utilising Gadovist.

A Digital Business Strategy

It is our view that the development of smartphone applications by drugmakers is an advisable business strategy.

Innovative Marketing - Smartphone Use To Increase

BMI's Telecommunications team calculates that global 3G subscription rates reached a figure of 3.9bn in 2016, and that by 2021 this figure will reach 5.6bn subscribers. We note that while not all subscribers will be using a smartphone, we can assume that falling smartphone prices will allow more customers to acquire smart devices.

Facilitate Improved Patient Outcomes

The potential for apps to improve adherence to medication and the management of disease makes their development an almost compulsory investment. In addition to improving compliance to prescriptions, drug companies can use apps to differentiate their products from those offered by the competition and to recruit patients into clinical trials.

Improve Interaction With Doctors

Drugmakers can use apps to interact with doctors as well as obtain information, such as prescribing habits, without the use of a medical sales representative, aligning with our core view that sales forces will contract in developed states. The primary cause of this trend is the declining influence of US and Western European doctors on prescribing decisions, itself due to state-imposed cost-containment measures. Accordingly, drugmakers operating in traditional markets are shifting resources from mass prescriber-level detailing to vertically integrated cost-benefit promotion. This business activity involves far fewer individuals and the sizes of sales teams are being slashed.

Investment Risks

We note that while drugmakers have recognised the need for the development of mobile apps - assessing the direct return on investment of the apps will be difficult. An increase in patient and physician use of apps will not directly correlate into the increased consumption or prescription of particular products, and will therefore impact decisions for further investment into such technologies.

Additionally, while healthcare apps are being developed to increase healthcare outcomes, questions may be asked about the accuracy of the services, which will ultimately affect the success and regulation of apps. It is difficult to judge the accuracy of healthcare apps and to assess how users interpret the data. The use of apps may result in incorrect self-diagnosis - an issue that may eventually take up more healthcare resources, resulting in the increased regulation of healthcare apps.