Culture Clash = Pharma + Digital?

What better location for a meeting of old and new than St Pancras.  The old steam locomotives have been replaced by Eurostar.  Similarly how will old pharma adapt to the new digital age was the question asked at the PLG conference on 19^th May.  According to Jo Pisani, Partner Pharmaceutical and Life Sciences Strategy at PWC, the Tricorder used by Dr McCoy in Star Trek to measure a patient’s health is no longer a dream.  The ‘connected consumer’ utilised by Uber to hire taxis has led the way to the ‘connected patient’.  Apparently 27% of senior citizens are tracking some aspects of their health using digital technology but this is usually provided by digital companies like Google rather than pharma companies or the NHS which has other priorities.  There are digital touch points all along the patient pathway: diagnostics, treatment dosing, pharmacy, and long term care.  Big Pharma companies have cottoned on to this and are rapidly buying and licensing digital healthcare technology while the digital companies including start-ups are entering the fray.  Pharma has recognised it needs to learn new skills and business models and this is best done through M&A and alliances.

An example of a Big Pharma company that has embraced digital technology is Janssen. Marco Mohwinckel, Global Head of Integrated Care Business explained that digital technology provides the opportunity to modernise the pharma business model given that the blockbuster model is under severe pressure because of longer and more regulated development, market access hurdles and shorter commercial life cycles.  Digital technology provides Personalised, Predictive, Preventative and Participatory solutions for healthcare.   The growth of digital health is reflected in the investment of between $4bn and $7bn, similar to the VC investment in biotech years ago.  Health care reforms are shifting customer needs from volume to value (quality of care) which can be supported by integrated solutions of pharma and digital.  Pharma companies need to understand and invest in digital healthcare solutions across the value chain starting with human genome sequencing to clinical trials to self-diagnosis to co-ordination of care.  Although digital solutions span the whole value chain but it is difficult to get people to pay for them.  Making digital technology disease centric rather than product centric, and having partnerships with patient groups helps.  However the regulators are always struggling to keep up with the technology not least of all because there is a completely different pace of change where digital solutions are developed in months whilst pharma products take over 10 years to develop.  As such digital licensing technology is later in the development cycle and relies more on the vendor than in the traditional pharma licensing model.

One small digital company that has succeeded in licensing its technology is uMotif.  The CEO, Bruce Hellman, described how digital technology has been used with Parkinson’s patients to collect data to power treatment and measure patient performance.  The data, linked to care teams, is more frequent and lower costs than traditional methods.  The digital solutions: reduce attrition in clinical trials; provides validated clinical trial data; and improves patient awareness.  During 2016 over 3 million data points have already been captured including data for randomised clinical trials.  There are 12,000 users covering 14 clinical conditions showing how a huge amount of data can be captured.  Surprisingly there was more adherence in over 65’s than below 65’s showing the digital technology is not a barrier to older people.   uMotif makes data free to academics and sells licences on a project or annual basis to companies.

The theme of improving patient outcomes was picked up by Matt Bonham, Strategy Director of Intelligent Pharmaceuticals at AstraZeneca, who described using digital devices and technology to develop personalised support for patients.  The use of devices and digital technology, for example in respiratory medicine, provides a non-invasive personalised care plan for patients to set goals.  To achieve this requires, validation with experts, evaluation of the technology, creation of the solution with patients and analysis of the results.  In the longer term digital health is here to stay but partnerships are vital.  The challenges are in design and development, defining the benefit, scale up, compliance and regulatory (where the regulators are struggling).  Once achieved there are benefits to patients in terms of awareness and compliance and to health care professionals monitoring patients.  The benefit to payers is not yet certain.

The challenges facing a small start-up company were explained by Dale Athey, CEO of OJ-Bio.  While seeking to get around the ongoing issue of lack of funds in Europe from risk-averse investors, OJ-Bio encountered a large Japanese wireless communications company which could see the potential for incorporating specific antigens and antibodies into a standard mobile phone component to develop digital diagnostic tests. This led to the creation of a joint venture which combined OJ-Bio’s expertise in protein surface chemistry with Japan Radio’s expertise in mass manufacture for phone components. The equipment consists of a diagnostic reader of a sample of blood, etc. that transmits the results by wireless technology to a mobile telephone that transmits the data onwards to a data collection point.  The device can be used for measuring infection, HIV, etc.  The joint venture with the Japanese company hit not only the usual obstacles of differences in size of company and culture differences but also the difficulty of working across industry boundaries, namely electronics and biotechnology.

In summary, this was an extremely interesting conference that summarised the state of play of digital health.  It is undoubtedly here to stay and is expected to grow rapidly.  There remains a question about what will be a successful business model.  However the most significant theme to emerge from the conference is the major differences in culture at all levels in successfully combining healthcare and digital technology such as the different speed of development and the small entrepreneurial digital companies doing deals with big pharma companies.  And, the big unknown is how will the giant digital companies such as Google react?