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CHRONIC DISEASE MANAGEMENT APPS: FILLING A VOID IN THE INDIAN HEALTHCARE ECOSYSTEM
STRATEGY
Chronic disease management apps: Filling a void in the Indian healthcare ecosystem
Parijat Ghosh
and Arunava Saha Dalal, Partners,Bain & Company’s New Delhi office and
Sujay
Subramnayan, Associate Partner,Bain & Company’s Mumbai office highlights that as digital technologies are transforming healthcare in the country,there is significant untapped potential in the chronic disease management space
Chronic diseases in India are becoming more prevalent; the country has over 55 million cardiac patients, over 20 million asthmatics, and more than 74 million diabetics. The incidence of chronic, non-communicable, and lifestyle diseases has increased notably over the past few years. Bain analysis suggests that the number of diabetics alone are expected to increase by almost 30 per cent to reach 100 million by 2030, making India the country with the second-highest diabetes burden in the world. Almost 50 per cent of diabetes cases go undetected in India, an even smaller
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STRATEGY
percentage of patients seek proper treatment, and barely 10 per cent–30 per cent of patients diligently adhere to the clinical and lifestyle protocols to manage the disease.
Pain points for patients
Our research with patients and focus groups showed that multiple challenges exist for patients in their diabetes journeys—from dealing with stress from initial diagnosis, to clinical and lifestyle decision making, and then to ongoing disease management.
The pain points at the diagnosis stage include acceptance of the longevity of the diseases and stress due to transitions in everyday habits, like switching to a low-sugar diet, consuming meals frequently to avoid sugar fluctuations, and exercising regularly to ensure physical and mental wellness. The patient also faces dilemmas like having to choose from several doctors or clinics for long-term treatment and making decisions about their diet and exercise regime, which becomes difficult due to lack of comprehensive, personalised advice and absence of a single source of truth for information. The challenges related to ongoing management primarily relate to acclimatisation and adherence to the treatment plan, monitoring and managing health records with limited clarity on interpretations of recorded vitals, and following up with doctors for treatment modifications and ordering medical supplies while dealing with the stress of the disease worsening over time.
Addressing patient needs
Essentially, the healthcare ecosystem—pharma companies, hospital chains, and doctors—does not currently fully address the major needs of chronic disease patients and a huge gap exists that can be potentially bridged via chronic disease management (CDM) applications. An effective, tech-based solution would be one that guides and enables the patient through the entire disease management journey—from finding the right doctor for proper diagnosis and suggesting changes in daily routines to setting up a personalised workout, medication, and diet plan and maintaining a tracker for vitals, right down to supporting the patient in stocking medicine supplies and follow-up visits to the doctor. CDM apps not only help to address patient pain points vis-à-vis the current system and fill a critical gap, but they also provide proper ongoing care, support, knowledge, and resources. Moreover, CDM apps strive to address concerns by providing access to health coaches, community support, a repository of verified doctors, personalised plans, reminders, easy tracking, continuous connect with doctors, and quick support in emergency situations, making them invaluable for chronic disease patients.
Parijat Ghosh Arunava Saha Dalal SujaySubramnayan
Aproven success
The new wave of tech driven CDM apps are fulfilling all these responsibilities and not only emerging as catalysts of change, but also redefining the healthcare business. For instance, a CDM app can design a personalised diet plan for a patient depending on whether the patient is vegetarian or non-vegetarian; it can also serve as a reliable source of information and guidance when the doctor may not be readily available. CDM apps provide personalised exercise planning, motivate users to continue adherence by offering benefits, and allow easy logging and storage of personal health data. They also issue reminders to re-order medicines based on past orders and adherence logs. An efficient CDM app becomes an integral part of the patient’s lifestyle, addressing patient pain points while providing the app’s promoters and partner companies direct access to the patient through their chronic disease journey over time.
Globally, companies have used the hook-monetise-differentiate-engage model to make CDM apps a huge success. These apps address critical success factors such as endorsements, effective onboarding, economic benefits for doctors, establishment of payment models, B2B partnerships, and having a robust artificial intelligence (AI)/machine learning platform. CDM apps also rely on gamification of the patient’s experience and integration of “doctor-device-patient” triage to ensure strong engagement with patients. For instance, Livongo, the poster child of CDM apps globally, achieved strong growth through a wide spectrum of initiatives—from partnerships with tech giants and a voice-enabled glucose monitor to integration with digital watches and AIdriven personalisation with real-time health signals. Offering strong, demonstrable clinical outcomes at virtually zero cost to patients, CDM platforms like Livongo that are monetised via the B2B2C model have tremendous potential for growth in the years to come.
The Indian opportunity
India is a nascent but emerging market for CDM apps. It is bustling with action, and early entrants are not only enjoying good traction among users, but also interest from investors. Phable provides select rule-based insights, continuous doctor monitoring, and discounted, value-added services and has more than 3 million users with $40 million in funding. BeatO has more than 300,000 users with $9 million in funding, providing a smooth user interface/user experience and personalised plans. International CDM player Wellthy Therapeutics, which provides clinical trialbacked AI recommendations and personalised plans with a counselling and motivationcentric approach, has signed a strategic and commercial partnership with Cipla to expand into hypertension and dyslipidemia. Similarly, Manipal Hospitals and PharmEasy have stakes in Phable and BeatO, respectively.
Healthcare players are recognising the importance of CDM apps for engagement with their patients. Leading healthcare companies are entering into strategic partnerships with healthtech companies, offering clinically validated digital disease management platforms to patients in cardio-metabolic health. The aim is to leverage digital technology in a big way and play a significant role in transforming healthcare management. Beyond investing in digital therapeutics and augmenting their analytics abilities to tap new possibilities, these organisations are deploying CDM apps to create and maintain direct connections with consumers.
CDM apps are emerging as game changers, and given the sheer number of potential users in the country, the CDM space is set to grow exponentially in the years to come. While first movers will enjoy a distinct advantage in the short-term, customer-centricity and innovation will be decisive factors in picking the leaders of this rewarding sector. For healthcare ecosystem players—including pharma, providers, medtech, and other players—the time is ripe to strike a partnership with CDM apps to enhance the quality of life of their patients while also futureproofing their business.
