SPECIAL EDITION
“The process of switching to a digital sales environment is iterative, dynamic and will constantly evolve” Page 14
HEALTH
MARCH 2020
Digitally enabled representatives AI assisted sales technology Digital pharma trends PHARMAFIELD.CO.UK
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HEAD OF CONTENT
W
Hello.
elcome to March’s Pf Special Edition, where we explore the theme of all things digital and their evolving impact on healthcare. The NHS Long Term Plan puts digital solutions at its core, but can pharma keep pace with the swift pace of digital change? It’s not simply a matter of ‘bolting on’ digital capabilities to existing models – it’s about changing thinking and making digital central to your strategy. As sales models for healthcare professional engagement continue to change at speed, Mick O’Leary writes about how there is an urgent need for digitally enabled sales representatives who are able to deliver a diverse range of activities, alongside the necessity to invest heavily in digital marketing and analytics. But is the notoriously risk-averse pharmaceutical industry responding and adapting fast enough? It’s a balance that could be hard to strike: “The pharma industry is arguably conservative in nature and invariably no one company wants to be the first to move to a new model as this is perceived as too high risk. At the same time, they also don’t want to be last,” says Mick (page 14). “Businesses cannot afford to wait until everything is perfect, as they do with many other technologies or platforms in the pharma market.” Meanwhile, Rasim Shah analyses how the marriage of technology and data is crucial to the future of pharma sales: “Those who embrace artificial intelligence will thrive and leap ahead in the intelligence race, those who don’t will fail to keep up,” he warns (page 4). We also cover the five trends of a digital pharma future; use of the cloud in healthcare; how virtual GPs and pharmacies are working together; self-care technologies, and why pharma should bet big on digital health (but tread carefully). We hope you enjoy this Pf Special Edition, if you’d like to comment on anything you’ve read, or have something to share, get in touch at hello@pharmafield.co.uk, tweet us @Pharmafield, or join us on LinkedIn.
Emma Morriss emma.morriss@pharmafield.co.uk SPECIAL EDITIONS EDITOR
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Hazel Lodge hazel@pharmafield.co.uk SALES & MARKETING EXECUTIVE
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Hannah Alderton newsdesk@pharmafield.co.uk FINANCIAL CONTROLLER
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Melanie Hamer melanie@e4h.co.uk PUBLISHER
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M AG A ZI N E S PECI A L ED IT I O N | M A RCH 2020 | 1
March HAVE YOUR SAY: If you’d like to share an idea for a feature or collaborate with us on a captivating advertorial, please get in touch. GET IN TOUCH: hello@pharmafield.co.uk
Contributors
@pharmafield
MICK O’LEARY
Mick is Regional President for Ashfield Commercial and Patient Solutions across North Europe. He is responsible for building and executing the strategy for Ashfield’s Commercial and Patient Solutions divisions across the UK, Ireland, Nordics and Benelux. From digitally naïve to native, page 14.
@pharmajobsuk
Pf Magazine
DR ZUBAIR AHMED
Zubair is the Co-founder and Chief Executive of Medicspot, known for helping independent pharmacies increase their profits through clinical services. He has been a GP for 12 years. Virtual primary care, page 10. DR AMINA ALBEYATTI
BERNARD ROSS
RICHARD GRAY
Amina is Head of Business Development for MyClinic.com. She has worked in the NHS for over a decade, working in general surgery and emergency medicine before completing her training as a family doctor. Full disclosure, page 31.
Bernard is the Chief Executive Officer and founder of Sky Medical Technology. He has 20 years of senior experience at private and public board level across multiple industries. Shock to the system, page 28.
Richard is Director, Technology Solutions UK & Ireland at IQVIA, with a focus on delivering customer value across technology solutions and using insights to fuel improved HCP engagement. In the mix, page 16
GIANPIERO CELINO
KATE GILDING
CHRIS MOORE
Gianpiero is Strategic Business Development Director at Cegedim UK. He is a pharmacist with over 20 years’ experience in delivering innovative healthcare technology solutions. Up in the Cloud, page 20.
Kate is Marketing Manager at ORCHA. With a digital background, she is applying her knowledge to the emerging field of mHealth. Complementary health, page 8.
Chris is President of Veeva Europe. A 29-year veteran of the life sciences industry, he is responsible for growing Veeva’s presence in Europe. Dynamic connection, page 26.
In this issue
MARK BREWER
Mark is Research Director, Life Sciences at finnCap. He has over 25 years’ experience as a life science analyst across small, mid and large cap companies. The time is now, page 24. HASSAN CHAUDHURY
Hassan is Digital Health Lead, Healthcare UK at the Department for International Trade. He is an expert in developing real world data solutions. Reality check, page 6. JORGE ARMANET
Jorge is co-founder and Chief Executive of HealthUnlocked. He is a technology and media entrepreneur with more than 15 years of international experience around new technology and healthcare. Unlocking continuity of care, page 22. GEORGE KOWALSKI
George is Business Development Director at ORCHA. Skilled in Healthcare IT, he’s passionate about improving health outcomes through digital innovation. Complementary health, page 8. ANDY ANDERSON
Andy is Recruitment Director at Evolve. He leads on sales, marketing and clinical recruitment for Evolve, having previously worked within medical device and pharmaceutical sales and marketing. Enhanced benefits, page 30. NEIL OSMOND
Neil is a Technologist and Founder of digital solutions agency earthware, with 20 years’ experience in the healthcare industry. Five trends of a digital pharma future, page 12. RASIM SHAH
Rasim is a Director at OKRA, connecting AI and life sciences to drive medical and commercial outcomes. The intelligence race, page 4.
INTELLIGENCE
INSIGHT
The intelligence race: AI assisted sales technology and the future for pharma
Reality check: Bet big on digital health, but tread with care
Up in the Cloud: How the NHS is utilising technology
RASIM SHAH
HASSAN CHAUDHURY
GIANPIERO CELINO
04 12
06 08
NHS
20 28
The five trends of a digital pharma future: Human and digital work together
Complementary health: Health apps, their use and effectiveness
Shock to the system: The advent of bioelectronic medical devices
NEIL OSMOND
GEORGE KOWALSKI & K ATE GILDING
BERNARD ROSS
14
10
31
From digitally naïve to native: Pharma sales models are changing
Virtual primary care: GPs and pharmacists working together digitally
Full disclosure: Blockchain could help reduce claims against the NHS
MICK O’LEARY
DR ZUBAIR AHMED
DR AMINA ALBEYATTI
16
32
22
Unlocking continuity of care: Self-care technologies
In the mix: Achieving better customer experience through digital
JORGE ARMANET
RICHARD GRAY
24
26
The time is now: The intersection between AI and pharma
Dynamic connection: Driving innovation through collaboration
MARK BREWER
CHRIS MOORE
ADVERTORIAL
30
Directory
The future of pharmaceutical sales will rely increasingly on the combination of technology and data
Enhanced benefits: The impact of technology on recruitment ANDY ANDERSON
Rasim Shah, page 4
THE INTELLIGENCE RACE AI assisted sales technology – what does the future hold for pharma?
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he future of pharmaceutical sales will rely increasingly on the combination of technology and data. Those who embrace artificial intelligence (AI) will thrive and leap ahead in the intelligence race, those who don’t will fail to keep up. The intelligence race is real; companies across all verticals are investing heavily in AI to drive sales and generate efficiencies across commercial functions. Algorithms that drive consumer purchasing decisions within the B2C environment have long proven to be successful for Netflix, Amazon and Uber. Thanks to this power to improve sales performance, McKinsey analysts in Harvard Business Review estimate that AI can create $1.4tn to $2.6tn of value in marketing and sales1. The life science analytics market is set to experience staggering growth over the next five years, reaching an estimated $33.2bn by 2024/252 . However, for those in the sales team, the growth in the power of analytics is coupled with practical challenges. The increasing difficulty for sales representatives is well documented, with up to 20% of doctors in the UK not accepting visits3 and at least 50% restricting access 4 . The question is, how does the pharma industry invest in the right AI solutions that support the process of delivering the right drug to the right patient at speed? AI TODAY
Delivering generic brand messages is no longer good enough, sales representatives must bring value to healthcare professionals (HCPs) that is personalised. Conversations need to be data-driven, based on truth rather than assumptions or just gut feel. Critical to supporting
4 | P H A R M A FI EL D.CO.U K
this personalisation is the ability to have systems that layer data, both structured and unstructured from a variety of sources – delivering powerful insights based on a granular understanding for example of patient populations, the environment and historic activity that drives outcome. Much has been said about supporting the pharma sales representatives with CRM-based suggestions termed ‘Next Best Action’. But to make sales teams more intelligent, we need systems that deliver evidence from all the data and empower individuals with a broader view of the right set of actions. What we must avoid is telling the sales representatives what to do and risk removing all human intelligence. We must focus on addressing the real problems faced by sales representatives and help them answer their burning questions: • Who is the most urgent HCP to visit and why? • Where is the best opportunity to drive sales and why? • Who is my competition in this practice and how are sales growing? • How should I contact this practice and why – phone, face-to-face or email? Successful implementation of AI systems beyond ‘Next Best Action’ will help representatives to truly support HCPs in navigating an increasingly complex and niche prescriptions market. Empowered by country-specific data, representatives must remain the vital link between innovative therapies and medications and the patients that need them most. In this increasingly competitive market it’s becoming clear that maximising the impact of each customer interaction is the best way to break through the noise and connect with HCPs 4 .
INTELLIGENCE
WHAT DOES THE FUTURE HOLD?
WORDS BY
Rasim Shah
EXPLAINABILITY
In 2020 and beyond explainability will underpin the outputs made by AI systems. However, these systems will only make sales teams intelligent if they can action the output, and they will only be empowered if they can trust the output. Why has the prediction, suggestion or recommendation been made? In an industry built on facts and evidence, AI systems must be able to explain the reasons behind the outputs or they will fail to build the trust required. This is critical if you consider the difference in data sets and data granularity across different markets in Europe. Without explainability, the representative and the system can’t learn together. EMPOWER, NOT REPLACE
Thousands of sales representatives on the road, having thousands of conversations every day across therapy areas means tens of thousands of data points. We must encourage representatives to give feedback directly into the system. This communication will use the representatives’ knowledge and create feedback mechanisms that generate a rich source of data to fuel future insights. This coupled with explainability will forge trust between the representative and the system. The best AI systems will be designed to empower representatives to take action with confidence, not replace them.
What we must avoid is telling the sales representatives what to do and risk removing all human intelligence
BE AGILE OR GET LEFT BEHIND
Sales teams can become the catalyst for life science companies to adapt quickly to change. The tools that representatives use must reflect the dynamic environment in which they work. 12-month, large scale, full country pilots that take years to implement must be a thing of the past. Validation of AI pilots for sales teams should not take longer than a few weeks. AI can and is fuelling competitive advantage within weeks and seeking out external AI vendors will help leaders of sales force teams accelerate speed of business through smarter decision-making, leading to faster execution. From the acquisition of data, system design, data modelling, feature extraction, prediction accuracy and testing, all can be done within a matter of weeks or faster, including the heavy lifting and cleaning of data. Rasim Shah is Director of OKRA. To learn more about OKRA solutions email hello@okra.ai
Top 5 takeaways 1 Conversations with HCPs must be data-driven and personalised 2 Delivering generic brand messages is no longer enough
References 1 Chui M., Henke N. & Miremadi M. (2018) Most of AI’s Business Uses Will Be in Two Areas. Harvard Business Review [online] Available at: https://hbr.org/2018/07/ most-of-ais-business-uses-will-be-in-two-areas [Accessed 11 February 2020] | 2 Markets & Markets (2019) Life Science Analytics Market by Type (Predictive, Descriptive, Prescriptive), Application (Marketing, Compliance, R&D, Pharmacovigilance, SCM), Component (Software, Service), Delivery (On Premise, Cloud), End User - Global Forecast to 2024 | 3 PricewaterhouseCoopers (2009) Pharma 2020: Marketing the future - Which path will you take? [online] Available at: https://www.pwc.com/gx/en/ pharma-life-sciences/pdf/ph2020-marketing.pdf [Accessed 11 February 2020] | 4 Khedkar P., Kalyan N. & Scott E. (2016) Sales Force Effectiveness in Pharma Is No Placebo [online] Available at: https://www.zs.com/-/media/files/ publications/public/zs-salesforce-effectiveness-in-pharmais-no-placebo.pdf?la=en [Accessed 11 February 2020]
3 Explainability must underpin AI outputs 4 Sales teams can be the catalyst for change 5 AI fuels fast competitive advantage
M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2020 | 5
TOP 5 TAKEAWAYS
1
THERE IS A PREDICTED GLOBAL SHORTFALL OF MILLIONS OF HCPS
2
A CLEAR LONG-TERM DIGITAL HEALTH STRATEGY IS ESSENTIAL
3
DIGITAL HEALTH FIRMS NEED A SUSTAINABLE COMMERCIAL MODEL
4
PHARMA MUST PROMOTE BETTER LEADERSHIP IN DIGITAL HEALTH
5
LEVERAGING EXISTING EXPERTISE IS KEY
It isn’t all rosy in digital health and it pays to be aware of some of the challenges
WORDS BY Hassan Chaudhury
6 | P H A R M A FI EL D.CO.U K
REALITY CHECK
INSIGHT
Why pharma should bet big on digital health, but tread carefully.
W
e face a global crisis in healthcare. There simply aren’t enough trained professionals to meet the growing burden to deliver care. Estimates vary but the global shortfall of healthcare professionals of all types by the end of this decade is forecast to be at least 15 million. There is no coincidence then that digital health has become such a hot ticket. Without supporting citizens to self care, better use of data for prediction, faster and more accurate diagnostics, stratifying and redirecting to more appropriate care settings, augmenting our workforce to do more and automating routine tasks, there is no version of the future where we have a sustainable model that will still be standing in 15 to 20 years’ time. Should pharma be betting on digital health as a partnership model with healthcare? Certainly. However, it isn’t all rosy in digital health and it pays to be aware of some of the challenges. CHALLENGES
For a start, digital health is not a panacea. It does not and cannot cure all. The fundamentals of a health system firstly all need to be in place for digital health initiatives to be fruitful. Infrastructure, medical education and training, regulation and governance of both people and things (drugs, devices and so on) are all examples of necessary steps.
There is also a concern that health systems which are still developing do not have enough leaders grounded in digital health to be able to exploit the potential. Instead they bring in management consultants and large tech corporations who sell them tactical solutions without having a clear and thought out long-term strategy. In more mature health systems a key challenge is revenue. There are countless digital health firms in the market but how many have a sustainable commercial model? How many are consistently generating sales, whether B2C or B2B? The overall impression is of lots of excitement, repeated fundraising and the occasional blip where a once-promising firm runs out of cash. The problem is that it is not that easy to sell to healthcare systems and I’ve never seen one as difficult to enter as the NHS. Germany has earned plaudits for its announcement in November that it would reimburse digital therapeutics but that only highlights just how many markets are still left to do the same. Each promising digital health firm is essentially trying to reinvent a wheel that pharmaceutical companies and medical device firms identified and mastered long ago. Even the very best of them could never compete with the machinery around branding, market access and sales that global life science firms view as their day-to-day. There is typically a point in the life of a digital health firm where they face a reality check. How will they overcome the barriers in front of them? Healthcare is unique and we don’t have the options available to other industries, for example offering free software to then exploit user data, of which Google and Facebook are often accused.
Each promising digital health firm is essentially trying to reinvent a wheel that pharmaceutical companies and medical device firms identified and mastered long ago
SOLUTIONS
The answer for pharma cannot just be to get involved with digital health with an incubator or a showcase. It can’t just be about having a cool, innovative digital health product to support a brand or therapy area. Instead it has to be more about supporting states to strengthen their health systems, promote better leadership in digital health and then guiding firms to be able to sell to health systems and build sustainable revenue based on decades of collective pharma sales and market access experience. Bets should be made on all types of digital health innovation. It’s just a sad truth that without support in what pharma finds relatively easy, it is likely that many of these bets will fail. Hassan Chaudhury is Digital Health Lead, Healthcare UK, Department for International Trade (DIT).
M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2020 | 7
Health apps are not intended to replace traditional methods, but to enhance them
Complementary
HEALTH
Health apps and their uptake, use and effectiveness.
8 | P H A R M A FI EL D.CO.U K
I
n recent years, the huge surge in smartphone use and increased engagement with digital health has led to people being ready to take the opportunities offered by mobile health (mHealth). Further to the hundreds of thousands of health apps on the market, five million people download a health app every day, with over 90% of health professionals believing that apps could help their patients. As such, it is clear that digital health solutions can be embedded into everyday life and health practice. The challenge remains, however, that the majority of health and care apps available on app stores are unregulated. Consequently, it is difficult for both consumers and healthcare professionals to trust the potential of digital health, without clarity in which health apps are most clinically effective. Whilst there is an app for almost any condition, the crucial factor is empowering consumers to use good, safe, trustworthy health apps. As consumers’ expectations are constantly changing, there is an onus on industry to adapt to the needs and wants of the end user, as well as to realise that one app does not fit all.
INSIGHT
The crucial factor is empowering consumers to use good, safe, trustworthy health apps INTEGRATION
Health apps are infinitely useful as education tools, allowing users to obtain medical information and monitor trends to track individual progress or manage a condition. It is important, therefore, that they are integrated into health pathways in such a way that provides the most effective and current care for patients. But, with over 365,000 health apps available to download, how can digital health be introduced safely and effectively? The Organisation for the Review of Care and Health Apps (ORCHA) addresses this challenge, and has built a unique health app review platform which improves access, trust and governance of health apps – vital for encouraging digital health adoption. Part of NHS England’s NHS Innovation Accelerator (NIA), ORCHA provides impartial advice to health bodies across the world. ORCHA works with many health and care providers and payers across England, Ireland, Holland and Estonia, and is expanding internationally to support the delivery of approved apps on a global scale. In England, ORCHA works with 25% of the NHS, helping to facilitate clarity and trust in digital healthcare delivery. Trust is the biggest barrier to the uptake of digital health, but ORCHA’s 260-point App Review process breaks through the noise of unregulated and untrustworthy apps. As of January 2020, ORCHA has reviewed almost 6000 apps and scored them according to their Data Privacy, Clinical Assurance and User Experience. It’s vital that health and care professionals are able to integrate digital health safely and effectively within everyday practice. As such, ORCHA’s extensive review engine platform, through which healthcare professionals can search for and subsequently recommend appropriate apps to their patients, helps health bodies across the world to tackle the challenge of integrating mHealth into their health and social care services. The initial idea for ORCHA came from thinking about how to improve efficiency and the quality of services to benefit more patients in the healthcare industry, as the provision of digital health solutions, such as apps, can help multiple patients at once. Working with healthcare organisations to provide a bespoke App Library is increasing access to trustworthy mHealth services, especially to patients requiring remote support. Digital health can have the best success by being used alongside traditional healthcare services and products. Health apps are not intended to replace traditional methods, but to enhance them. For instance, sometimes a drug may be most effective, sometimes an app on its own, and sometimes a combination of the two. The way forward is for pharma and digital health companies to work together, rather than being in competition. In order for digital healthcare to continue evolving, it is necessary to support clinicians in embracing digital health. By providing a range of mHealth solutions to organisations and professionals, the successful integration of digital care into patient pathways is facilitated, thereby allowing health and care services to become more patient-centred. George Kowalski is Business Development Director & Kate Gilding is Marketing Manager at ORCHA. Go to www.orcha.co.uk
WORDS BY George Kowalski & Kate Gilding
Top 5 takeaways 1
Five million people download a health app every day
2
90% of health professionals believe that apps could help their patients
3
One app does not fit all
4
Health apps don’t replace traditional methods, but enhance them
5
Clinicians need support in embracing digital health
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PRIMARY CARE How GPs and pharmacists are working together with virtual clinics, leading to more efficient patient care.
To deliver optimal care, it is vital that pharmacists and GPs join forces
WORDS BY
Dr Zubair Ahmed
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S
ince founding Medicspot four years ago, I’ve been working very closely with independent pharmacists and GPs across the UK. If you ask either whether there’s scope for a closer working relationship between the two professions, they will almost certainly say yes. To deliver optimal care, it is vital that pharmacists and GPs join forces. A stronger working relationship between the two professions is not only good for patients but also helps improve professional development for pharmacists and can help reduce the pressure on the stretched primary care system. INTEGRATION
Possibilities are emerging for pharmacists to become more integrated with general practice. A key part of the NHS Long Term Plan is the implementation of primary care networks (PCNs) that could see a typical 50,000 patient PCN employ six full-time clinical pharmacists. The evolution of PCNs is promising, laying the groundwork for a closer working relationship between the healthcare professions within the local community. However, there is still more that can be done to better integrate community pharmacy within our health system and secure its place as the first port of call in primary care. Community pharmacies often benefit from longer opening hours, with many open late at night, on weekends and even public holidays. Pharmacies also dramatically outnumber GP surgeries and are often situated in convenient high street locations, offering unparalleled access to primary care.
INSIGHT
Top 5
CAPABILITIES
For decades, the NHS has tried to convince the public to visit their local pharmacy first with limited success. As a practising GP, I understand all too well that the first step for many people is to visit their GP practice, even for minor ailments that could be swiftly remedied by a skilled pharmacist. Furthermore, a recent survey from Medicspot 1 revealed 73% of pharmacists believe that the public are generally unaware of what pharmacists are capable of. One explanation for this is that the capabilities can vary considerably from pharmacy to pharmacy. While some pharmacists can independently prescribe and are confident delivering consultations under the NHS Community Pharmacist Consultation Service (CPCS), others have limited expertise and lack confidence in managing some clinical presentations. This is a crucial hurdle to overcome in our endeavour to make community pharmacy the first point of contact within our health system. INNOVATION
While investment in a nationwide training scheme could help subdue this issue, advancements in technology have opened the door to an innovative solution that could enable every community pharmacy in the UK to deliver consistent, high-quality care. This is achieved by converting often under-utilised pharmacy consulting rooms into virtual clinics, allowing community pharmacies to level the playing field in terms of capabilities by tapping into a pool of GPs and prescribing pharmacists as and when they need to. Medicspot was the first healthcare provider to introduce this innovation to community pharmacy in 2016 and now operates in 300 independent pharmacies across the UK. It works by turning pharmacy consulting rooms into virtual clinics where patients can get seen by a clinician via video link. Within these virtual clinics, GPs and prescribing pharmacists can perform a full clinical examination with connected devices operated by the patient, including a stethoscope, blood pressure monitor, pulse oximeter, thermometer and close examination camera.
Advancements in technology have opened the door to an innovative solution that could enable every community pharmacy in the UK to deliver consistent, high-quality care
The devices have been designed in a way that makes them easy-to-use for patients and in most cases, patients are comfortable using the equipment themselves. However, in cases where a patient requires assistance with the devices, a member of the pharmacy staff is always on hand to help. After the consultation is complete, any prescriptions are sent directly to the pharmacist to dispense, ready for the patient to collect on their way out. Virtual clinics not only save patients an extra trip by allowing them to get seen by a doctor and collect their prescription at the same time, but they also provide an additional revenue stream for pharmacies and allow GPs and independent prescribing pharmacists to benefit from flexible working. This technology enables pharmacists to become tightly integrated with general practice in ways that wouldn’t otherwise be possible. Through improved collaboration between healthcare professions and the willingness to adopt new technology, community pharmacy will be at the forefront of primary care; improving the accessibility, quality and consistency of care for patients everywhere. Dr Zubair Ahmed is the Co-founder and CEO of Medicspot. Go to www.medicspot.co.uk
Takeaways
1
Pharmacists and GPs must join forces to deliver optimal care
2
A closer relationship can reduce pressure on primary care
3
A typical 50,000 patient PCN could employ six full-time clinical pharmacists
4
Pharmacies offer unparalleled access to primary care
5
Virtual clinics save time and money
References 1 www.medicspot.co.uk/reports/state-of-pharmacy-20
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THE FIVE TRENDS OF A DIGITAL PHARMA FUTURE Human and digital must work together to benefit both healthcare professionals and patients.
A
fter years of digital (or multichannel) being the Cinderella of marketing activities in pharmaceuticals, in the last few months I have seen this start to change, and change quite rapidly. A world of digital-only launches, omnichannel strategies and the adoption of agile ways of working is arriving. However, I am not an advocate of digital replacing human interactions but instead combining human and digital together to create seamless experiences for healthcare professionals and patients.
We are understanding how digital is increasingly where brand proposition and customer experience meet
WORDS BY Neil Osmond
1 2 | P H A R M A FI EL D.CO.U K
But why now? Well I wonder if we are reaching a point where the number of millennials in influential positions in pharmaceutical companies has reached a ‘tipping point’. Maybe these digital natives are replacing the establishment figures (who I heard once described as suffering from a condition known as ‘FOBO’ – the Fear of Being Outdated). Digital is increasingly becoming the place where brand proposition and customer experience meet. Perhaps the theme of the next few years will be the gap emerging between those that ‘get it’ and steal a competitive advantage, and those that don’t. Crystal balls are notoriously unreliable but as I stare into mine, here are five trends for a digital pharma future…
INTELLIGENCE
1 2 3 4 5 LESS ABOUT CHANNELS, MORE ABOUT TARGETED CONTENT
LESS MULTICHANNEL, OR EVEN OMNICHANNEL, MORE FULLY INTEGRATED CUSTOMER EXPERIENCES
We hear all the time that Amazon, Google etc. are going to enter the healthcare market and change it forever. Who knows if that will be true but I believe the best defence is for pharmaceutical companies to distil what makes these organisations popular and make it core to their value propositions. Increasingly this will mean combining insights from the real world, machine learning and artificial intelligence to deliver personalised experiences for healthcare professionals (HCPs) tailoring their patient experiences from pre-diagnosis to recovery or chronic disease management.
CASE STUDY
There is nothing new about this, I just still see it done so badly, so often. Most brand websites look like the cross-functional brand team has taken existing content, added a bit and dumped it on a website – easier for approval, harder for the user! In the real world, HCPs and patients want answers to their specific questions using as few words as possible and preferably through videos, interactive visuals and chatbots. They don’t want promotional messages, difficult navigation and key info hidden in a Summary of Product Characteristics. Answer their questions first and maybe then they might be interested in what else you have to say.
LESS ABOUT POINT IN TIME DECISIONS AND MORE ABOUT PATIENT JOURNEYS
So much of our time, energy and effort goes into influencing the decision point where a HCP writes a prescription. It’s a zero-sum game – you versus your competitors – either you win or they do. We talk patient journeys, but very little of a promotional budget seems to be directed to the 24/7, lived experience of real patients. Do we really believe that the major factor in a prescribing decision is what they heard from a pharmaceutical representative? What if HCPs are more influenced by the lived experiences of their patients? Surely we should be finding ways to help HCPs create positive 24/7 experiences for all types of patients on your medicines, and the obvious way of doing this is digitally.
LESS ABOUT RATIONAL, CLINICAL AND DATA AND MORE ABOUT EMOTIVE, EXPERIENTIAL AND BEHAVIOURAL
If we even half believe the adage that ‘people buy on emotion and justify with logic’ then the rational arguments of safety, efficacy and tolerability, one brand versus another, will never fully unlock the motivations for a prescribing decision. My wife is a practice nurse and a fiveminute conversation with her about how things work in the real world of clinical practice often gives a healthy perspective on this. You probably use Uber or Amazon, not because you like their ethics or tax behaviour but because it is easier, better and quicker with any cost saving being more of an added bonus.
LESS ABOUT SPENDING BUDGETS, MORE ABOUT MAXIMISING OUTCOMES
Whilst few brand teams would admit this, our experience is that when allocating marketing budgets in digital assets, it is more of a spend than an investment. This is probably because calculating the impact, and therefore the breakeven, is challenging. However, I recently saw some research that attempts to value every promotional activity, including digital, comparing to the value of a representative contact. Whilst fraught with challenges, at least we may be entering an era where marketers are demanding an outcome and a return rather than boxticking and creating digital gimmicks.
T
eva Pharmaceuticals has recently won awards for pushing boundaries with digital. A brand team recently launched an augmented reality detail aid using digital and sales representatives together to demonstrate good inhaler practice and mode of action and they have seen tangible positive improvements in HCP engagement. An interactive chatbot ad, directly linked to a chatbot, has also featured on websites such as MIMS, to try and answer every HCP’s specific questions in seconds rather than several clicks and lots of reading. The company even repurposed the chatbot to be a physical bot that HCPs could interact with at congresses and meetings. These are great examples of all five of the themes described above and demonstrate how a forward thinking cross-functional brand team can transform the experience of a medicine for both HCPs and their patients digitally. Neil Osmond is a Technologist and Founder of digital healthcare agency earthware. Go to www.earthware.co.uk M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2020 | 13
From digitally
naïve to native
Pharma sales models for HCP engagement are changing quickly and indefinitely, and for businesses in the sector, it’s a case of evolve or suffer.
O
ver the past 20 years, numerous factors have changed the way that the pharmaceutical sector has communicated about, positioned and sold its products. Notably, pharma’s access to healthcare professionals (HCPs) has declined and many patients now look to the internet to self-educate. How are sales representatives changing the way they approach and engage with HCPs?
This new dynamic environment has created a need for digitally enabled sales representatives that can deliver a diverse range of activities including traditional detailing, e-detailing and customer service both face-to-face and remotely. It’s also essential that activity is scheduled, captured, recorded and analysed on a single integrated platform that tracks all omnichannel communications to give representatives a live picture of all interactions with a given HCP. RISK V REWARD
A CHANGING SECTOR
Commercialisation is now more complex, and the industry needs to offer increased flexibility, allowing HCPs to choose how and when to engage. Heavy investment in digital marketing and analytics is needed to provide a comprehensive understanding of how and when prescribers and other decision-makers like to receive information.
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HCPs and customers are now much more digitally native and willing to engage with new channels. The new reality is that relying on traditional sales approaches where representatives spend their time travelling between practices, waiting for small windows of opportunity to speak to HCPs, is neither sustainable nor advantageous to either party.
Yet the reality is that a significant portion of the industry has yet to embark on the journey towards a digitally enabled representative. The pharma industry is arguably conservative in nature and invariably no one company wants to be the first to move to a new model as this is perceived as too high risk. At the same time, they also don’t want to be last, as they don’t want to be viewed as outdated and lacking innovation. Businesses cannot afford to wait until everything is perfect, as they do with many other technologies or platforms in the pharma market. The process of switching to a digital sales environment is iterative, dynamic and will constantly evolve. What businesses must do is start their journey. Once on the path towards digitalisation, they can learn as they go, improve their systems and their engagements and work towards an ideal model over time as opposed to expecting that outcome immediately.
INTELLIGENCE
Ashfield
DIGITAL CONTENT IS KING
Experience tells us that having the right content produced in an engaging and interesting way greatly enhances the effectiveness of digital interaction. Sales representatives traditionally take hard copies of study reports or presentations into meetings. Transferring that information to an e-detail aid isn’t enough. Now the challenge is that representatives are engaging with people in a new way, across different channels and the content they’re using must be more ‘alive’, animated, integrated and exciting. This is what patients and HCPs are experiencing whenever they use social media or visit a website in most sectors outside of pharma, and it’s what they will soon expect from pharma. Pharma companies that can align digitally enabled representatives with best-in-class content will have a real competitive advantage.
WORDS BY
Mick O’Leary
What businesses must do is start their journey
PERCEPTION IS REALITY
There is also a less tangible value to adopting more digital approaches. The primary goal of a digitally enabled sales representative is to have more positive, more regular, more meaningful and more time appropriate engagements with HCPs. Simultaneously, whichever companies take the lead in terms of using new technologies will attract and retain the right kind of talent as people like to work for adventurous and innovative employers. FINAL THOUGHT
There are companies which are leading the way with digital approaches, as they have the commitment to invest in people and technology, and the will to change ingrained within their DNA. The approach of these sales representatives will evolve to include new digital channels and more interactive, engaging content in line with this. More conservative organisations will root themselves in face-to-face sales practices that have been successful in the past. Both will need to access and leverage the expertise offered by progressive commercialisation partners like Ashfield, with the skills and scale to support digitalled change. Mick O’ Leary is Regional President – Commercial & Patient Solutions, North Europe, at Ashfield. Go to www.ashfieldhealthcare.com
Top 5 takeaways 1 Pharma must offer HCPs a choice of how and when to engage 2 Significant investment in digital marketing and analytics is essential 3 There is a need for digitally enabled sales representatives that can deliver a diverse range of activities 4 Don’t wait until everything is perfect 5 Early adopters will attract and retain the right talent
M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2020 | 15 Column banner for Pf Magazine (1).indd 1
20/08/2019 14:09
IN THE MIX Achieving better customer experience through digital: it’s all in the mind(set). Richard Gray WORDS BY
T
his year marks an inflection point in pharma’s digital transformation journey. As companies reflect on where they have come during the last decade, they are looking for evidence that the journey is leading them in the right direction. Whilst much has changed over the last 10 years, customer healthcare professional (HCP) facing teams still remain a critical channel within most companies’ go-to-market strategy. What is key in enabling their success as a key component of the ongoing promotional channel mix?
medical science liaisons, nurses and so on) need to be connected, integrated and aligned to ensure that customer-centric activities can be successfully delivered. As a result, the shape of field-facing teams has significantly evolved and to be successful, new skills are required to continue adding value ‘as the face of pharma’. The importance of understanding customer needs and deploying the right content, through the right channels and at the right time to improve customer experience, is now higher than ever. Digital is now a well-established component of the enabled field forces toolkit and leveraging its power effectively can make the critical difference. Investment in this capability has continued to grow but as we enter into a new decade, is it enabling customer-facing teams to work smarter, and what new ways of working are being adopted by field force teams?
CUSTOMER EXPERIENCE
The expectations of HCPs have evolved. Today, they demand a better experience from pharma and increased value from their interactions. Pharma also faces continued internal financial pressures due to increasing R&D costs and narrowing windows of return, declining access rates, reduction in face-to-face time, increased regulation and an overriding need to evolve to changing market landscapes. For commercial teams it is a complex and fast-moving landscape and the stakes are high, so getting it right the first time is imperative. Companies are reacting by implementing more agile commercial models, whilst leveraging technology, data and insights to fuel the impact of interactions. These new commercial models require much greater promotional precision, increased stakeholder and patient outcomes focus and a full multichannel approach. Multi-disciplined customer-facing teams (representatives, key account managers,
DIGITAL ADOPTION
Enabled representatives have data and technology at their fingertips, enabling them to orchestrate customer interactions across multiple channels. While many companies are still wrestling with the more complex dynamics of enabling optimum channel mix at scale, teams on the ground are successfully using digital within standard day-to-day working practices, especially email and online resources, as shown below in Figure 1. In fact, latest figures show that compared to the EU 5, the UK has the greatest proportion of representative-instigated emails being sent to HCPs to guide them towards valuable self-serve materials, with a greater impact on intent to prescribe. 26.9% of the UK HCPs receiving these emails have confirmed that they will increase (or begin) prescription, as opposed to 21.8% for the rest of the EU 5.1
Figure 1. % EMAILS RECEIVED DIRECT FROM REPRESENTATIVES
The HCP demand for a more personalised experience and expectation for digital to be part of the solution exists
UK Only
EU 5 Excl. UK
0%
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5%
10%
15%
20%
25%
30%
INSIGHT
We also see great value being achieved through the intelligent orchestration of channel interactions involving representatives, versus a purely volume-driven approach. Case studies demonstrate that a multichannel approach has tangible impacts on sales across the board, whilst optimising resource allocation across all activities by frequency, sequence and content is more likely to lead to a sustained impact. A lot of companies are now focused on understanding how to get this channel mix right through data science, advanced analytics and technology, using large and fast-moving data sets. The algorithms that generate these insights then need to be applied across the commercial organisation at an enterprise level, so that recommendations can be surfaced to field users at the right time to help them make the best possible decisions on what the next best action is for their customers. This leads us onto what the most critical factor of all is: people, with the right skills to then apply the outputs. We can see the best examples of representatives benefitting from commercial transformation within companies where change management and investment is an integral part of the process. The HCP demand for a more personalised experience and expectation for digital to be part of the solution exists. The technology and data to fuel the experience exists. It requires the ‘human touch’ to bridge the gap, along with development plans for teams to be upskilled and brought on the journey by delivering proof points.
WHAT’S NEXT?
The drive to meet enhanced customer expectations and deliver outcomes-based value through interactions has generated a true paradigm shift in how pharma is working to support commercial teams through the provision of relevant and rapid insights. HCPs demand personalised experiences which are consistently delivered across all the touchpoints of integrated multi-disciplinary customer-facing teams, requiring not just new commercial customer-facing models but also new operational capabilities to support them. Improving the sophistication of customer engagement is a great example of how artificial intelligence and machine learning will serve to evolve and enhance the current functions of pharmaceutical companies in the 2020s. Evolving algorithms and investing in data as a strategic asset to fuel them, will enable companies to address more precise business challenges. The results will enable customer-facing teams to intelligently navigate the complex web of stakeholders relevant to today’s highly specialised launches and to play a critical role in the orchestration of optimised customer experiences by applying next best recommendations in the most effective way. The focus is shifting from developing foundational infrastructure and capabilities to harness the promise of data science, to enabling insights that can be delivered at an enterprise level. Deploying customer insights at scale across the business and achieving enduser adoption will therefore prove to be one of the most significant differentiators of competitive success. Richard Gray is Director, Technology Solutions UK & Ireland at IQVIA. Go to www.iqvia.com
Think better, act smarter Brilliant people with unparalleled insights transforming contract sales
References 1 IQVIA ChannelDynamics®, JAN-DEC 2019
IQV I A.COM/CONTR ACTSALES © 2020. All rights reserved. IQVIA® is a registered trademark of IQVIA Inc. in the United States, the European Union, and various other countries
M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2020 | 17
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UP IN THE CLOUD
E
very morning thousands of people call their local doctor’s surgery to try and book an appointment, yet a proportion of those seeking help from their GP don’t need to see a doctor. The challenge is making it easy for these individuals to find the correct pathway so they can quickly get the care that they do need. Can the Cloud contribute to making this happen? As Matt Hancock 1 claims, the problem with the NHS is not solely money or resources, but the upward trajectory of demand, which is rising faster than ever before, and how the NHS manages that demand. By utilising innovative technology and taking a systems-wide approach, we can equip healthcare professionals with the right information to provide the right care at the right time to the patient, which in turn helps to manage and reduce demand. Crucially, we can also equip patients with better information with which to make choices about their care. Unfortunately, all too often the information we need or want to share is locked up in another organisation’s records, requires multiple systems to access or is simply buried in our systems. Harnessing the potential of the Cloud offers a route to realising a number of great opportunities to improve efficiency in the NHS, as well as reducing costs, saving time and improving resilience. At its most fundamental, the Cloud underpins the NHS’ efforts to bring organisations together to share information. Moreover, it can also help us empower patients to make better choices and manage their own health information. Both of these enable a better use of medical and clinical resource.
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How the NHS is utilising technology; driving the adoption of the public Cloud.
The benefits of using the Cloud will quickly become more apparent in a GP setting. There are a number of drivers encouraging the adoption of the public Cloud which offer greater openness and interoperability between systems, such as: COST
The Cloud is considered a lower cost model for managing system-wide infrastructure and connectivity; paying for services when required rather than buying always-on dedicated hardware frees up resources and capacity in IT teams to focus on adding value in new ways. The NHS could spend less and get more for its money. The NHS also benefits from choosing system suppliers that have embraced the Cloud with greater flexibility to scale up and down as required to support the NHS. INTEGRATION
Arguably the greatest benefit of the Cloud is the ability to remove barriers to working together at scale to share information for the benefit of clinicians and patients. The Cloud provides openness and flexibility to be able to quickly and easily share data between different settings and providers, meaning that patients can have uninterrupted care, with clinicians having the right information at their fingertips. Systems that have been developed with a Cloud-first approach are best placed to drive the information-sharing agenda. COMPETITION
The Cloud also helps to encourage new and innovative suppliers to enter the market in order to show what can be done when we unleash the potential of the data in our systems in new ways. By moving data and services into the Cloud, we reduce barriers to entry and put the NHS in a stronger position to determine what it specifically requires from suppliers and when to scale up or scale down.
NHS
We have only scratched the surface of understanding the benefits that come from putting healthcare data in the hands of the patient
WORDS BY Gianpiero Celino
Top 5 takeaways
SECURITY
Questions will always remain around the security and confidentiality surrounding personal data being held in the Cloud. However, the Cloud is also the driver for levelling up the security and resilience of our systems. The NHS has learned the hard way that old, unsupported and fragmented systems are an open invitation to malicious actors. The Cloud allows us to apply the most up-to-date standards and protection to our systems and data. Data security and privacy is the key to trust – and without it, the data is pointless. With the transformation to the Cloud comes great responsibility to ensure data is handled in a way which doesn’t jeopardise the confidentiality, integrity and trust which patients put into our records and systems. THE BENEFITS
The NHS needs to challenge its suppliers to demonstrate how they will help them to accelerate their journey to the Cloud and to realise the benefits for patients and clinicians. Innovative technologies continue to unlock the doors to opportunities which haven’t to date been considered possible. By elevating data and services to the Cloud, the NHS can explore and experiment with the application
of new technologies such as machine learning, which requires access to large and complex data sets in order to support clinicians in decision-making. We have only scratched the surface of understanding the benefits that come from putting healthcare data in the hands of the patient. There is great potential in the patient driving the healthcare journey and interacting with healthcare professionals armed with the data and information held about them. This becomes easier and more reliable when data is elevated from proprietary and legacy systems and made available in a secure public Cloud. Smart use of data is increasingly being recognised as a fundamental driver to reduce demand and enhance patient outcomes. However, this transformation can only be achieved by having more collaborative technologies and full real-time visibility of healthcare data for clinicians and the NHS to make the right decisions. Gianpiero Celino is Strategic Business Development Director at Cegedim UK. Go to www.cegedim.com
1 Utilising the Cloud can improve NHS efficiency, reduce costs and save time 2 The Cloud allows IT teams to focus on adding value in new ways 3 The Cloud provides openness and flexibility to quickly share data 4 Data security and privacy is the key to trust 5 Moving data and services into the Cloud reduces barriers to entry
References 1 www.gov.uk/government/speeches/what-record-nhsinvestment-means-for-each-of-my-priorities
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Unlocking INTELLIGENCE
continuity of care
The big change that self-care technologies are bringing to healthcare.
B
efore exploring the potential power of care continuity and self-care technologies, it is important to understand the backdrop faced by healthcare users and providers. The profound, groundbreaking medical discoveries of the past 250 years, combined with the great entrepreneurs who took those discoveries from laboratory to scale, laid the foundations for the transformation of public health. What followed was the explosive growth in the world’s population from just 1 billion people in 1800 to nearly 8 billion today. This undoubted success story has however brought challenges that urgently need addressing. As the global population has aged and enjoyed longer retirements, the rise of long-term chronic health conditions has matched it, placing healthcare systems and both national and personal budgets in all developed economies under ever greater strain.
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Innovation is paramount if costs are to be contained and quality of life further enhanced. But innovation alone will not succeed without the clear understanding that clinical solutions are only part of the answer. Studies suggest that medical care accounts for just 10-20% of the modifiable contributors to health outcomes, with a much greater part played by social, behavioural and environmental factors. Hence it is not just the care given at the point of most acute need that matters, but the preventative measures that might head off such a need in the first place as well as the aftercare that ensures patients go on to make lasting recoveries. SCALING UP
The new buzzword is ‘self-care’, which means care-of-self by seeking to live the healthiest life possible through knowledge, connection and good habits. It is the application of technology and the advent of smart health communities that are at the vanguard of the coming self-care revolution.
Smart health communities are all about connecting people to everything they need to live a healthy life. Instead of thinking of them as places to go when one has a health problem or has been released from hospital, think of them as through-life-support systems or ‘cradle to grave’. We are not there yet, but as digital technology take-up increases and growth becomes exponential, the cost advantages of delivering more healthcare this way will be irresistible and will throw a harsh spotlight on the way it has been delivered traditionally. Think instantaneous online doctor consultations versus taking a day off work to visit a fully staffed surgery. Or educational online programmes aimed at improving patient’s prescription drug dosage compliance versus the cost to both the individual and the system of non-compliance. PERSONALISED HEALTH
In the UK, there are already hundreds of Patient Advocacy Groups (PAGs) supporting people with long-term conditions to manage their health better.
By harnessing the power of artificial intelligence and online health communities, health advice and support are increasingly being personalised for millions around the world. HealthUnlocked, the social network for health, connects people with the same health and wellbeing needs who then interact through these communities, sharing experiences and lending support to others who may have faced the same challenges they are going through. The platform is home to over 600 online health communities, covering 300 conditions and wellbeing areas in an environment that is safe and where their personal data is secure and protected. It has been independently proved that patient use of such platforms is directly linked to improved knowledge, skills and confidence levels as well as better outcomes. The next key challenge for all self-care platforms will be to enhance the (free) offer further through commercial alliances to bring the very best of health and wellbeing advice and services to these fast-growing communities. The end goal must be to create complete ecosystems that seamlessly link the medical interface to the behavioural, environmental and social interventions in order to deliver a truly holistic service to everyone. Self-care will of course never replace clinical care, but it will alleviate the tremendous pressure that the current global model is under. Those same digital technologies will bring greater clarity to precisely what constitutes effective treatment, through the power of big data and the knowledge and insights it unleashes to help make better relative value judgements between different treatment options. Value-based payments and price transparency are already a reality, but the smart application of self-care and other relevant digital technologies can assist the more established traditional players to remain relevant as the healthcare revolution powers on. Self-care platforms will also afford businesses a direct opportunity to communicate directly with users in order to build brand loyalty and trust where the smart data confirms that it is truly deserved. Jorge Armanet is Chief Executive and Co-founder of HealthUnlocked. Go to www.about.healthunlocked.com
WORDS BY Jorge Armanet
The new buzzword is ‘self-care’
Top 5 takeaways 1 Clinical solutions are only part of the answer 2 Online health communities enable personalised health advice and support 3 Self-care alone will never replace clinical care 4 Utilising digital tech allows established players to stay relevant
productive connections Digital multichannel experiences with stakeholders in healthcare to maximise behavioural change
5 Self-care platforms can help companies to build brand loyalty and trust
M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2020 | 2 3
THE TIME IS
NOW WORDS BY Mark Brewer
There are some truly ground-breaking developments happening at the intersection between AI and pharma
AI has massive potential for the pharmaceutical industry and there’s no time to waste.
T
here’s a catch-22 for many pharma companies in the great artificial intelligence (AI) debate. They are unlikely to get a competitive, early-mover advantage unless they invest confidently in AI; but they are often reticent to invest until its success is proven. Pharma is, of course, an industry that deals daily with big data sets of immense magnitude, and it’s here that this conundrum feels particularly prescient. So waiting to formulate an AI strategy until more examples of its benefits become apparent is not advisable – by then it may be too late to catch up. But the good news is that there are some truly ground-breaking developments happening at the intersection between AI and pharma. It’s worth taking a look at three in particular to get a greater appreciation of their true potential. AI IN DRUG DISCOVERY
Insilico Medicine is a US-based bioformatics company which announced in September 2019 that it used AI to design, synthesise and validate a novel drug candidate in 46 days – 15 times faster than usual. The company developed GENTRL (Generative Tensorial Reinforcement Learning), a new AI system for drug discovery that was used to design a novel DDR1 kinase inhibitor from scratch in 21 days, then to synthesise and pre-clinically validate it in 25 days, a combined process that typically takes the pharmaceutical industry around two years.
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INTELLIGENCE
Top 5
Takeaways In the initial 21 days, the AI program generated 30,000 novel small molecules that may work against fibrosis. In the subsequent 25 days, Insilico screened out and synthesised the six most promising compounds and performed in vitro tests for selectivity and metabolic stability. AI IN CLINICAL TRIALS
An analysis of clinical trial data from January 2006 up to December 2015 found that only 9.6% of drug development programmes successfully progressed from Phase I trials to FDA-approval1. Most trials fail because the intervention does not demonstrate efficacy or safety, but other factors include flawed study design, participant drop-outs, shortage of money, or a failure to recruit enough participants. But this is where AI has the potential to save billions of dollars through increasing efficiency. Take Deep 6 AI, which develops solutions to find patients for clinical trials. Researchers at the Cedars-Sinai Medical Center recruited two patients in six months for a cardio study. Using Deep 6 AI’s system, they identified 16 patients in 30 minutes, with eight patients recruited onto the study three weeks later. Such productivity gains allow small departments to increase the number of studies they can perform. The team of three recruiters at Cedars-Sinai is now able to find patients for 30 clinical trials in a year. By comparison, before utilisation of the Deep 6 system, the centre had one recruiter, who did one study a year. AI IN CLINICAL DECISION-MAKING
Through utilising the vast amounts of genomic, biomarker, phenotype, behavioural, biographical and clinical data that is generated across the health system, AI also has the potential to transform clinical decision-making processes. For example, a Bayer and MSD partnership is developing an AI-driven software to support clinical decision-making of chronic thromboembolic pulmonary hypertension (CTEPH). The tool – which received FDA Breakthrough Device designation in December 2018 – uses machine learning
to comb through image findings from pulmonary vessels, lung perfusion, and cardiac check-ups, as well as the clinical history of the patient. Bayer and MSD hope the system will enable radiologists to analyse these diagnostic images faster and identify patients with CTEPH earlier, more efficiently and more reliably. And the resulting earlier diagnosis of CTEPH would of course also allow for the earlier use of therapies, benefitting patient care. NEXT STEPS
From the universe of companies that my colleagues and I follow, it is clear to us that usage of AI is likely to become a greater differentiator in the next five to 10 years. But the crucial thing for pharma companies to remember is that AI experts are not an unlimited resource, especially given that most of the talent in this sector naturally gravitates towards traditional IT and technology companies. In fact, even in companies dedicated to AI in healthcare, AI experts typically only comprise c. 15% of staff 2 . Meanwhile, building AI capability is not as simple as buying some new computer equipment. AI infrastructure needs to be integrated across the entire company and have collaboration and buy-in from multiple departments. It may also require process changes in how data is procured and stored. Another important motivator for building AI infrastructure is the inevitable entry of Big Tech into the healthcare field. Google, Microsoft, Amazon, Apple and Facebook have already announced different initiatives to enter the healthcare space – companies which will have fundamental advantages in terms of AI capabilities. Therefore, for the pharmaceutical industry, waiting for more examples of AI’s efficacy is not advisable. Instead, pharma companies – especially where big data is prevalent – need to be building their AI capabilities. And they need to do it now. Mark Brewer is Research Director, Life Sciences at finnCap. Go to www.finncap.com
1
AI enables faster drug discovery
2
AI can dramatically increase the number of clinical trials by identifying patients faster
3
Machine learning allows for faster diagnosis and treatment
4
Building AI capability requires buy-in from multiple departments
5
AI could become a greater differentiator within the next decade
References 1 BIO Industry Analysis | 2 Deep Knowledge
M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2020 | 2 5
INSIGHT
Dynamic connection A connected and collaborative healthcare ecosystem will drive innovation.
T
he growth in precision medicines that are customised for rare diseases and individual patients marks a new growth wave for the life science industry. These new treatments bring with them not only the offer of curing once chronic diseases, but also raise challenges on society’s ability to pay. Unlike today’s chronic disease treatments which spread the cost over years, or even decades, these newer medicines offer a cure in a short period, but at a greatly inflated short-term cost. This additional financial challenge comes at a time when budgets around the world are struggling to manage an ageing population, combined with new and costly treatments. The value of treatments versus their cost will become ever more important. Increasingly, life science companies will be expected to help transition to these new medicines by targeting those patients
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who will benefit most, and in doing so reduce waste. The explosion of scientific information and data – from clinical studies to real-world patient information – will be critical to this when combined with economic impact data. This data will be crucial to identify patients to treat and to ensure healthcare professionals, and their organisations, are up-to-date on the latest treatments. Getting the right information to the right people is key for healthcare providers (HCPs) to deliver the best possible care. LEVERAGING DATA
In 2020, organisations will better leverage data across teams to accelerate the industry’s move towards patient-centered healthcare. However, across the globe, populations are shifting, and healthcare will need to adapt. As the global population ages and the number of age-related and chronic diseases rise, healthcare spending will eventually become unsustainable for society.
Pharma sales representatives and marketers will use privacysafe predictive analytics to build a communications plan to engage HCPs
WORDS BY Chris Moore
We will see a more dynamic healthcare environment take hold. This will be characterised by greater collaboration among pharmaceutical companies and HCPs to drive greater efficiency throughout the industry. In Europe, over 75% of health spending is financed through government or compulsory insurances 1 . Out-of-pocket payments account for 18%, but this can vary greatly depending on the country. Health expenditure has grown in line with GDP growth in recent years, so the share of GDP allocated to health has stabilised1. However, with increasingly innovative treatments such as precision medicine, it’s unclear if this stabilisation trend will continue. Precision medicine requires the easy identification of patients with rare and individualised diseases. Companies are therefore becoming more agile and integrated within healthcare ecosystems, speeding treatments to the patients that need them. DATA FLOW
Looking ahead, as companies will increasingly operate in a more interconnected and dynamic environment, organisations will need to reduce siloed processes and systems – both internally and across global healthcare ecosystems. New levels of operational efficiency and collaboration will increase competition among life science companies. It will also enable pharmaceutical companies to work better with healthcare providers to deliver the right care. For example, we may begin to see a data flow from the patient or healthcare professional directly through every part of the drug development and commercialisation process. This could be from regulatory and manufacturing, to commercial and payment approval packages. As industry-wide silos break down, this information will flow to patients and associated industries, giving better visibility into data and enabling faster treatment decisions. In an ideal future scenario, data will be entered once but used many times, cutting the majority of today’s redundant processes and duplicated systems. Companies will ultimately become more efficient and agile in delivering the right treatments to the right patients.
Once this new operating model is in place, artificial intelligence (AI) will be in a strong position to be applied to monitor patterns, to connect scientific discoveries across teams, to identify the best clinical trial sites, and to match trial populations to treatment populations. This new model will lead to safer, better outcomes, and decrease waste across the healthcare industry. As the patient journey becomes more complex, an opportunity is created for pharmaceutical manufacturers and hub services to better communicate and support patients and HCPs. Pharma sales representatives and marketers will use privacy-safe predictive analytics to build a communications plan to engage HCPs at key moments along the patient journey. The use of AI will also give teams more detailed patient insights to precisely identify and target patient populations and enhance their promotional strategies. HCPs and hub services can then, in turn, reach patients at the right time to drive better diagnosis and treatment. BETTER OUTCOMES
Data and analytics will continue to play a larger role in ensuring that life science companies reach the most relevant patients and HCPs. This is at the same time as adhering to privacy regulations and, ultimately, getting more patients on the right treatments for improved health outcomes. The overarching aim of precision medicine is to drive better patient outcomes through tailored treatment approaches. The intersection of scientific discovery, new technology, and patients’ active role in their healthcare decisions will lead to increased industry collaboration. We will continue to see life science companies come together to put a holistic model of healthcare delivery in place to futureproof this new era of medicine. Chris Moore is President at Veeva Systems. Go to www.veeva.com
We foster a flexible culture at Napp where our people thrive on the ability to be agile and autonomous in response to the needs of our partners. This is innate in the way we work because we are a partnershipbased organisation, placing partnerships at the heart of everything we do and every relationship, from our wholesale distributors to NHS decision-makers.
www.napp.co.uk Date of preparation: January 2020 Approval code: UK/CORP-20003a
References 1 OECD, Health at a Glance: Europe 2018 - State of Health in the EU Cycle: https://www.oecd.org/health/health-systems/ Health-at-a-Glance-Europe-2018-CHARTSET.pdf
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SHOCK
to the system How innovative bioelectronic medical devices are transforming modern healthcare. WORDS BY Bernard Ross
E
very 37 seconds someone in the western world dies from a venous thromboembolism (VTE). In England, this equates to approximately 40,000 deaths each year. 62% of these deaths are deemed preventable given the proper treatment1 and around 30% of those who have suffered will likely endure further health problems within the next 10 years of their life. Ironically it is often the process of medical treatment that leads to VTE issues, particularly surgery. Naturally surgery requires a period where a patient is immobile, both during and after surgery. This lack of movement is often what triggers VTE. In fact, hospital-acquired thrombosis is the cause of around 55-60% of all cases2 . This is particularly common for hyperacute stroke patients who have reduced mobility throughout the recuperation period. Despite this, VTE is often overlooked as a major health problem. Currently, many practitioners use intermittent pneumatic compression (IPC) devices to help prevent blood clots in the deep veins of the legs. These devices use cuffs around a patient’s legs that fill with air and squeeze – something research has shown a third of patients find intolerable.
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NHS
Hyper-acute stroke patients contraindicated to IPC (e.g. through vascular or skin disease) or because they are intolerant of it, need an alternative intervention to prevent venous stasis. This is especially critical given that high-risk and immobile patients (unable to be prescribed drugs) would have no other mechanical VTE prevention available to them other than standard measures of hydration and aspirin. NHS services operate with finite funding and nursing resources; which can result in a lack of innovation when it comes to the development of new patient therapies. With the UK Government promising £34 billion of additional funding to the NHS, there is now a real opportunity for this to change. Action on stroke is an acknowledged priority as part of NHS England’s Long Term Plan announced in May 2019, and acute stroke VTE prevention will be part of this. THE RISE OF BIOELECTRONICS
Significant advances in bioengineering and neurology have led to the development of bioelectronic therapies, which in turn has presented new ways to treat chronic medical conditions. Bioelectronic medicine is the use of electronic devices to stimulate or dial down certain actions within the human body; instead of targeting the body’s cells like most pharmaceutical treatments, the electrical impulses target a variety of nerve networks – creating a new level of medical precision. As researchers continue to learn about the functionality of cells and how they communicate with each other, there has been an increase in the sophisticated use and understanding of bioelectronic devices. An important area of advancement is wearable bioelectronic therapy to treat acute medical conditions. Innovation that speaks to this advance is now here and about to shift modern healthcare by offering non-drug therapies allowing health professionals to treat acute vascular conditions such as,
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life threatening blood clots, complications related to swelling after orthopaedic surgery, and slow healing wounds. Although pharmaceutical treatments are frequently used to increase blood flow in patients at-risk of VTE, drug development has proven to be costly and rarely achieves the desired results in comparison to bioelectronic medicinal therapies. Device-based treatments have proven to be extremely beneficial – from both a budgetary and treatment perspective. Patients suffering from vascular disorders and pre- and post-surgical complications can now be prescribed with a viable alternative treatment pathway, one which can reduce their risk of VTE to zero 1 . The first example of wearable bioelectronic therapy, for acute conditions, is the geko™ device: the size of a wristwatch and strapped to the lower leg, it gently stimulates the common peroneal nerve, activating the calf and foot muscle pumps. This results in increased blood flow in the deep veins of the calf at a rate equal to 60% of walking. It requires no external compression of the leg and enables patients to be mobile while wearing it. While this device is primarily targeted to VTE prevention, oedema control and wound healing, within the next decade, modulating neural networks could become a mainstream treatment for many health issues such as arthritis, asthma, Alzheimer’s and even depression according to researchers. INVESTING IN SUCCESS
Bioelectronic medicine is one of the fastest growing areas in healthcare. The medical devices market is predicted to be worth more than $6 billion in 2020, growing rapidly to $8.5 billion by 2025. The market is expected to grow at an annual growth rate of 7.9%, mainly as a result of the rising research in this industry and the continual investment into the development of electroceutical devices.
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BY TREATING CONDITIONS WHERE THERE IS CURRENTLY AN UNMET NEED, BIOELECTRONIC DEVICES CAN BENEFIT 44 MILLION PATIENTS WORLDWIDE TODAY
By treating conditions where there is currently an unmet need, bioelectronic devices can benefit 44 million patients worldwide today. As the technology evolves even further, these devices could eventually be used to treat all acute and chronic circulatory conditions – improving the lives of more than 200 million patients and reducing the strain on health services with finite resources. The NHS Long Term Plan Funding Bill will enshrine in law an extra £34 billion a year by 2024 for the NHS to transform care. Deciding how some of this additional funding will be spent will be left to local clinicians; suggesting that bioelectronic therapies could continue to be rolled out in more NHS trusts to reduce VTEs in high risk patients, saving lives and money in the long term. Bernard Ross is Chief Executive Officer and founder of Sky Medical Technology. Go to www.skymedtech.com References 1 Data on file Firstkind Ltd | 2 Thrombosis UK www.thrombosisuk.org
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ENHANCED BENEFITS Specialists in Recruitment, Contract Sales Teams and Outsourcing
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CLINICAL RESEARCH & DEVELOPMENT 0113 457 0777 recruitment@evolvecouk.com www.evolvecouk.com 3 0 | P H A R M A FI EL D.CO.U K
As online and digital technology advances, Pf talks with Andy Anderson at Evolve about its impact and influence within recruitment in recent years.
How has technology evolved and influenced recruitment within the last five years? We have seen some great advances in recruitment technology over the last few years. Whilst recruitment processes haven’t changed in many respects, we have seen a significant increase in companies utilising digital interview platforms to enhance their recruitment process at all stages. Initially we observed this for entry level vacancies, however these technologies are becoming more commonplace across the board, including for more senior vacancies. In the initial stages of a recruitment process, digital interviewing systems have allowed greater flexibility for hiring managers to schedule interviews to work around demanding work schedules. Whereas previously completed in written format at assessment centres, the use of online psychometric and profiling tools has also become more widespread. In combination with digital interviewing software, there has been an increase in the speed of recruitment processes, which in today’s market is a highly influential factor in securing the best candidates for any business. How does Pharma utilise technology within the recruitment process, versus other industries? Pharma has definitely advanced its utilisation of technology within the recruitment process over the last two years. Previously we observed that other industries, for example telecoms, IT and finance, were quicker on the uptake of new technologies to enhance their hiring processes. Within our industry, there was noticeable apprehension previously with regard to adopting new systems and ways of recruiting. Nowadays, both candidates and clients recognise the benefit of these technologies, giving them the opportunity to showcase attributes which will positively influence recruitment decisions.
“Digital interviewing systems have allowed greater flexibility for hiring managers”
Moving forward, do you feel technology will continue to influence recruitment decisions? Based on feedback from our clients, our experience of working with online technology in recruitment processes has been largely positive. The growth of technology in the future will no doubt play a highly influential part in advancing recruitment processes further. We constantly see developments in existing technology as well as innovative new technologies coming to the market, all with the aim of refining and enhancing how companies hire in the most effective way to secure the best people. What technology do you feel will add further value to recruitment processes in the future? We believe the future of recruitment processes will certainly continue to evolve from a digital perspective. The use of virtual reality and artificial intelligence has already made its way into other industry sectors. The further adoption of such technologies will make them even more accessible and accepted as standard practice. Whilst there will always be a place for face-to-face interaction, digital and online technology will no doubt partner and enhance these more traditional methods. Ultimately, a cohesive partnership of both will lead to hiring the best people in the most efficient and cost-effective way. Recruitment methodology is certainly evolving, and pharma will no doubt continue to embrace these positive changes! Go to www.evolvecouk.com
NHS
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Could blockchain reduce clinical negligence claims against the NHS?
T
he NHS is one of the best healthcare systems in the world. Unfortunately, recent reports have shown that clinical negligence claims against the NHS are on the rise. According to the annual NHS Resolution report, the NHS paid out £2.4bn in claims last year and currently has around £4.3bn in outstanding legal fees. The rise in successful claims is having serious impacts on the NHS; the costs of these claims means money is being diverted away from vital under-funded resources, which directly impacts patients. For many patients, these claims are less about the monetary benefits but instead to seek answers as to why this happened or gain acknowledgement for their pain or suffering. Yet, many feel that the only way to get answers is by suing. However, blockchain could be the answer to reducing the number of claims. THE TRUST SOLUTION
Blockchain-enabled apps that hold a patient’s medical records create a more open shared system, where patients have full visibility over each and every development. With full transparency and ownership over medical information, a patient may no longer need to chase for answers. This control over medical data also promotes improved sharing of data. A blockchain ledger stores all information chronologically and securely and is completely immutable so no data can be tampered with. So, if a patient wished to get a second opinion it would be considerably easier, as the patient can now bring their entire medical history to the meeting.
Whereas currently it is very difficult to transfer all relevant documentation from one doctor to another, making it a timely and sometimes inaccurate process. This second opinion could spot something the other doctor may have overlooked, or they could be in agreement with the original consultation and reassure the patient through their treatment process. This review can also be conducted remotely. The blockchain technology is transferable to anyone to whom a patient grants access, so patients can securely send their information to a lead consultant in the required diagnostic area, a scarce resource which may not usually be available to a patient.
With full transparency and ownership over medical information, a patient may no longer need to chase for answers
WORDS BY Dr Amina Albeyatti
PREVENTATIVE ACTION
Alongside this, patients having access to real-time data allows them the opportunity to research their diagnosis and treatment. This helps to give the patient a greater understanding of their treatment, which then empowers consent choices. In some cases, a negligence claim cannot be avoided. However, a blockchain-enabled system could also be beneficial to the investigation, from both a patient and doctor perspective. The immutable quality of blockchain means that all data stored is accurate and untampered with, meaning it is perfect to use as factual evidence in any case. Overall, the NHS needs to take a more preventative approach to these types of claims and properly investigate each claim to minimise the chance of a repeat. Alongside this, they need to create a more collaborative system that involves the patient in every stage, so they don’t feel they are being left in the dark. Dr Amina Albeyatti is Head of Business Development for MyClinic. Go to www.myclinic.com M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2020 | 31
D I R ECTO RY
DIRECTORY E4H E4H is an industry leader in medical education and partnership working. We work closely with our clients, healthcare professionals and patients to understand needs and provide the right solutions. #WeAreE4H www.e4h.co.uk enquiries@e4h.co.uk 01462 226126 HEALTHUNLOCKED HealthUnlocked is the world’s largest peer-support network, connecting people with the same health and wellbeing needs. We work with patient organisations to create health communities offering therapeutic support, credible information and advice to people living with long-term conditions. www.healthunlocked.com business@healthunlocked.com 020 7407 8399
ASHFIELD Ashfield, part of UDG Healthcare plc, is a global leader in commercialisation services for the healthcare industry. We partner with our clients to build creative, scalable and tailored health solutions, to deliver positive outcomes for patients and add value to your business. www.ashfieldhealthcare.com web@ashfieldhealthcare.com 0870 850 1234 EARTHWARE Digital consultancy, websites and apps that solve real world problems. Experts in healthcare, we drive to the heart of every challenge by asking ‘Why?’. www.earthware.co.uk chris@earthware.co.uk 0845 642 9880 EVOLVE Market leading recruitment and CSO within the pharmaceutical and healthcare sectors. www.evolvecouk.com support@evolvecouk.com 0113 457 0777
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HEALTH IQ Award-winning real world data analytics, research studies and animated simulation models for market access, particularly HTA and launch, based on an outstanding NHS heritage. www.healthiq.co.uk contact@healthiq.co.uk 020 3176 6130 IQVIA IQVIA is a leading global provider of advanced analytics, technology solutions and contract research services to the life sciences industry, dedicated to delivering unique and actionable insights. In the UK, we serve pharmaceutical and biotech companies and most of the NHS Trusts to drive innovations and improve patient outcomes. www.iqvia.com MEDICSPOT Medicspot is the industry leader in digital health for community pharmacy. We work closely with independent pharmacies across the UK to help increase their profits and footfall. Medicspot converts pharmacy consulting rooms into private GP clinics with innovative diagnostic technology. www.medicspot.co.uk info@medicspot.co.uk 020 3906 6513
MEDICALCHAIN & MYCLINIC.COM Powered by Medicalchain’s blockchain technology and carefully developed by a team of doctors and developers, MyClinic. com is a healthcare portal that allows patients to easily schedule appointments, review medical records and request further investigations. www.myclinic.com contact@myclinic.com 020 3740 3349 OKRA TECHNOLOGIES OKRA is a technology company transforming life sciences with AI. OKRA combines advanced AI with a hybrid explainability engine to drive commercial/ medical outcomes. The ‘OKRA Engine’ drives real-time predictions, suggestions and reasons, empowering users to make smarter, evidence-based decisions. www.orcha.co.uk hello@orcha.co.uk 01925 606542 SKY MEDICAL TECHNOLOGY Based in the UK, Sky Medical Technology is pioneering the development and use of wearable bioelectronic medical devices to treat life threatening and chronic health issues, including blood clots, complications related to swelling after orthopaedic surgery and wound healing. www.skymedtech.com sue.davenport@firstkindmedical.com 01494 572044 VEEVA SYSTEMS Veeva Systems Inc. is a cloud-computing company focused on pharmaceutical and life sciences industry applications. www.veeva.com/eu VISION (A CEGEDIM COMPANY) Vision is a leading supplier of intelligent healthcare solutions and the only UK-wide approved supplier of IT systems for GP practices. Our mission is to lead the market with innovative healthcare technology that expedites improvements in patient care and outcomes. www.visionhealth.co.uk info@visionhealth.co.uk 020 7501 7000
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Syneos Health is the only fully integrated biopharmaceutical solutions organization with a unique approach. At Syneos Health, all the disciplines involved in bringing new therapies to market, from clinical to commercial, work together with a singular goal — greatly increasing the likelihood of customer success. We call our business model Biopharmaceutical Acceleration. You can call it the future.
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