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Prescription Digital Therapy Now A Reality

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The pursuit of offering ‘prescription digital therapeutics’ or ‘digiceuticals’ by Big Pharma, to ensure better clinical outcomes for patients, has apparently come to fruition now.

On April 18, 2018, by a media release, Novartis announced that the Sandoz Division of the Company has entered into collaboration with Pear Therapeutics to commercialize and continued development of digital therapeutics, designed to effectively treat disease and improve clinical outcomes for patients.

The collaboration brings on to the table, a synergy between Sandoz expertise in launching and commercializing various disease treatments, with Pear’s leading experience in digital therapeutics design and implementation. This deal has attracted attention of many. Mainly because, any pharma player will, for the first-time, detail a digital therapy treatment directly to the medical profession, and seek their prescription support.

It is worth noting that Pear’s flagship digital therapeutic – reSET is the first USFDA-cleared mobile medical application with both a safety and efficacy label to help treat patients with Substance Use Disorder, in September 2017. According to published reports, several studies have established that it is two-times more effective than conventional in person therapy sessions. Interestingly, the rate of treatment efficacy increases even up to tenfold, in refractory patients.

Just the beginning of a long run: 

The above market launch of a digital therapy by Novartis signals just the beginning of a long run in changing in the disease treatment archetype for better outcomes. Incidentally, prior to this announcement, on March 1, 2018, the same Company had announced, “Novartis and Pear Therapeutics to collaborate on prescription software applications aimed to treat patients with schizophrenia and multiple sclerosis.”

The media release underscored:“Psychiatric and neurodegenerative diseases place a heavy physical, mental and economic burden on patients and their families. With widespread adoption of digital devices, prescription digital therapeutics could potentially play an important role in future treatment models for a range of diseases with high unmet medical need”.

The scope and potential:

An article titled – ‘Digital therapeutics: Preparing for takeoff’,published by McKinsey & Company in February 2018, captures its scope succinctly. It says, “digital therapeutics tend to target conditions that are poorly addressed by the healthcare system today, such as chronic diseases or neurological disorders. In addition, they can often deliver treatment more cheaply than traditional therapy by reducing demands on clinicians’ time.”

A separate McKinsey interview article, titled ‘Exploring the potential of digital therapeutics’, published in the same month, elucidated the potential of digital therapy equally well.  It highlighted:“A digital therapeutic is an intervention based on software as the key ingredient, which has a direct impact on a disease. This is what distinguishes this category from the broader term digital health. We will see digital therapeutics and digital diagnostics integrate into the health system…”

‘Prescription digital therapy’ are not just ‘Fitness and Well-being’ Apps:

Prescription digital therapy are not just to monitor a person’s general fitness level against pre-identified parameters, and overall well-being. Whereas, digital therapeutics help patients to regularly and consistently monitor relevant and tailor-made disease related data - in real-time to detect behavioral, lifestyle and requisite biological changes on a daily basis. However, this is not ‘a so well-realized necessity’ today, especially, in the treatment of certain serious disease conditions, to ensure significantly better clinical outcomes for patients.

Digital therapeutics can ensure making a favorable change in patient behavior, which is not merely as efficient as administering medicines, but could also ensure greater effectiveness than conventional medications. Further, it assists patients to better understand, manage and control several disease conditions, and more importantly, sans any untoward side-effects.

Besides, with digital therapy, the required treatment interventions will reach patients faster than traditional treatment processes. Both the patient request and the medical response for the same can be quickly exchanged, together with relevant data support, through smartphones or other wearable digital interfaces – either in the form of voice or text or both. I shall dwell on this later in the article. Thus, digital therapy may not require patients to meet the doctor every time a need arises.

Moreover, fitness and wellbeing Apps do not require marketing approval from a country’s drug regulator. Mostly because, they help monitoring general and generic fitness parameters, capturing some low-risk changes. Whereas, a custom-made prescription digital therapy would necessarily require such regulatory nod.

In tandem, various studies are also being conducted on wearables, such as an Apple Watch, as an interface. The following are examples of some of these studies:

Digital therapy study with Apple Watch as an interface:

In February 2017, Takeda Pharmaceuticals U.S.A. and Cognition Kit Limited, announced a collaboration to pilot the use of a specially designed app on an Apple Watch wearable to monitor and assess cognitive function in patients with Major Depressive Disorder (MDD).

In November 2017, they presented results from ‘Digital Wearable Technology Study’ in patients with MDD. The observational study involved 30 participants, aged 18-65, with a clinical diagnosis of mild to moderate depression who have been prescribed antidepressant monotherapy for MDD.

The study also evaluated feasibility and participant compliance with measures of mood and cognition on wearable technology; and compared measures of mood and cognition on wearable technology using traditional neuropsychological testing and patient reported outcomes on depression symptoms at 6 weeks. Participants were provided with an Apple Watch on which brief cognitive and mood tests were administered daily.

The researchers observed that patients were compliant with the wearable Apple Watch device on a daily basis to evaluate mood (95 percent) and cognition (96 percent). The study also demonstrated that abbreviated daily assessments delivered through the wearable Apple Watch device corresponded with objective Cambridge Neuropsychological Test Automated Battery (CANTAB) cognitive tests and full-length patient reported outcomes, PHQ-9 and PDQ-D, assessed during weeks 1, 3 and 6. No adverse events were reported in the study.

According to another report, this user interface with Apple’s smart-watch versions 2 and 3 is now being used in a number of studies for chronic conditions, such as Parkinson’s disease – combining biometric data with user input. Again, in February 2017, Johns Hopkins University announced a project to use the smart-watch for research on possible triggers of epileptic seizures.

When used as an interface with prescription digital therapy, the provision of e-SIM and GPS in Apple Watch Series 3, I reckon, would also help patients to immediately communicate with the remote therapy centers using the same device, anytime – as and when the patients want.

Digital therapy initiatives in India:

Initiative on digital therapy has already started rolling in India, as well. Its pace is also quite encouraging. For example, Wellthy Therapeutics is building a patient centric solution for diabetes through digital intervention and management. On February 20, 2018, the Company, reportedly, shared the interim results of an ongoing real-world pilot to evaluate the effectiveness of the Wellthy Diabetes Smartphone App (WD). The results were shared at the 11th International Conference on Advanced Technologies and Treatments for Diabetes (ATTD 2018) in Vienna, Austria.

The data demonstrated how the use of WD improved glycemic control. On completion of 16 weeks, participants showed a reduction in their HbA1c by (-0.61%) on average, with 61.5% of participants having showed significant reduction in their HbA1c with an average of (-1.17%) reduction.

Conclusion:

As indicated in my article titled, ‘Digiceuticals: A Force Multiplier to Contain Chronic Diseases’, published in this blog on October 23, 2017,prescription digital therapies are primarily of two types – one for “medication augmentation” and the other for “medication replacement.”

Be that as it may, prescription digital therapyimproves clinical outcomes for patients by manifold. It also shows potential to take over from traditional treatment with medicines in several serious and virtually crippling ailments, mostly related to human behavior and lifestyle, such as a host of chronic diseases, and without causing any side-effects.

Thus, prescription digital therapy is now a reality. It has come to stay for long – can’t be wished away, any longer.

By: Tapan J. Ray

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

An Interesting Link: Productivity At Work And Employee Fitness (Part 2)

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Part 2: Mental Fitness

As I wrote in my previous article, the complex multi-factorial work-life challenges in today’s Volatile, Uncertain, Complex and Ambiguous (VUCA)) world are virtually unprecedented.

Interestingly, a sizeable part of such challenge is related to a wide variety of internal organizational factors. These often include changes at the senior management level or in the key corporate policies, or the likes. More often, the changing aspirations and outlook of both the younger and even the aging professionals, in the midst of newer complexities of life – not well-understood by the management, invite such a situation.

Taking note of the influencing factors:

Meeting challenges of some of these disruptive changes, many companies are working on the respective influencing factors in various critical areas.

According to an article, titled “Meeting the Challenge of Disruptive Change”, published by the Harvard Business Review (HBR) in its March-April 2000 issue writes: “Our research suggests that three factors affect what an organization can and cannot do: its resources, its processes, and its values.” It then elaborates by saying that the second factor – processes, also means what the company leadership uses to transform resources into products and services of greater worth.

These processes, I reckon, encompass the effective use of various ‘employee engagement’ programs. As a part of which, employee fitness programs are now being encouraged at the corporate level, seriously. I have discussed in my previous article, the ‘Physical Fitness’ aspect of improving employee productivity at work. in this article, I shall dwell on improving the ‘Mental Fitness’ facet of the same.

The area deserving greater attention:

Curiously, not as much attention and care are being taken towards ensuring a robust ‘mental fitness’ level of employees, which is as important, if not more, to achieve the same corporate objectives. A right combination of sharper mind and a healthier body will rather have a synergistic effect in this regard.

Recent data:

The January 18, 2018 article titled, “Now Is The Time For Wellbeing Programs To Focus On Mental Health,” published by the Forbes Magazine presented some interesting facts.

It wrote, employers are increasingly taking greater interest in employee wellbeing. In 2017, the average employer in the United States spent around USD 693 per employee on well-being initiatives per year. This figure is rising around USD100 per year, the author said.

However, the majority of such investment were towards physical health activities, such as installation of gym facilities on site, or giving employees fitness trackers to monitor activity levels. It was less clear, though, whether similar investment extends into mental health programs, as well.

Mental health issues at work higher than physical health conditions:

The October 2017 study titled “Thriving at work“ highlighted that the United Kingdom faces a significant mental health challenge at work. While there are more people at work with mental health conditions than ever before, 300,000 people with a long term mental health problem lose their jobs each year, and at a much higher rate than those with physical health conditions.

Another article appeared in the Indian Journal of Occupational and Environmental Medicine also observed that mental health problems have an impact on employers and businesses directly through negative impact on productivity and profits, as well as an increase in costs to deal with the issue. In addition, they impact employee morale adversely.

Mental health – the Indian scenario:

The World Health Organization recognizes that the impact of mental health problems in the workplace has serious consequences not only for the individual, but also for the productivity of the enterprise, including the developing countries, such as India.

For the country, the National Mental Health Survey 2015-16 also reveals that nearly 15 percent Indian adults need active intervention for one or more mental health issues and one in 20 Indians suffers from depression. Noting this ascending trend in the prevalence of mental disorders, workplace mental health is an essential need for the Indian Corporates to respond to, urgently.

Alongside, a 2016 study by Optum – a leading employee assistance program to many Corporates, with a sample size of 200,000 employees and covering over 30 large employers, unveiled a seemingly astonishing fact. It reported, as high as 46 percent of the workforce in India suffers from some form of stress. The same issue is applicable to the Government employees in India.

Intriguingly, its budgetary allocation to the National Program for Mental Health has been stagnant for the past three years. At ₹ 35 crore, the program, reportedly, received 0.07 percent of India’s 2017-18 health budget.

Mental health continues to be a taboo:

The ‘Thriving at work’ report further said: “Behind this, our analysis shows that around 15% of people at work have symptoms of an existing mental health condition.” “We found that in many workplaces, mental health is still a taboo subject and that opportunities are missed to prevent poor mental health and ensure employees who may be struggling to get the support they need. In many instances, employers simply don’t understand the crucial role they can play, or know where to go for advice and support,” the paper underscored.

As the above Forbes study said, it could also be due to the fact that a large number of employees believe their mental health problems are not affecting their work, so there was no need to tell their boss.

Focus only on merit, ignoring mental health may have a shorter life:

As we see around, many organizations, including large pharma players in India, are increasingly following different systems of recognizing merit to boost employee productivity. One of its visible manifestations gets reflected in the corporate policy of ‘pay for performance’. It fundamentally means: ‘exceed goals to earn more.’ This by all means is one of the very effective tools of not just achieving business excellence, but in fostering a sense of competition within the performers, besides good corporate governance.  In this context, a question often raised is: Does focusing only merit, sans adequate mental health, carry a shorter life for improving employee productivity?

Conclusion:

This process of recognizing merits, focuses mostly on boosting employee productivity, and very rarely on meeting their mental needs, wants, aspirations and outlook. As a result of this single minded corporate focus on professional merits alone, work-stress starts creating additional pressure, over and above the employees’ own family, social and other personal stress factors. It often leads to job burnout – slowly shifting the work productivity in the reverse gear, alongside an adverse impact on the quality of life of individuals.

There are instances when the employees resort to unwanted shortcuts, snowballing the situation, but only when these get detected. There are ample such evidences in the Indian pharma industry, as well. Several global pharma majors, such as GSK have taken some measures in this area. Nonetheless, it needs to go beyond what a large number of these companies display on their wellness initiatives for employees, in the respective websites.

I hope, this well-proven interesting link between employee productivity at work and their mental well-being, will be noted by more and more Indian companies, especially in the pharma sector. This may prompt them to look for a win-win blend between corporate excellence, employees’ merit-based performance and their fitness needs – both physical and mental. That’s, I reckon, is the minimal corporate requirement today, in this area. Once in place, it will keep evolving at a rapid pace, with the collective cerebral inputs of the respective organizations.

By: Tapan J. Ray 

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

 

An Interesting Link: Productivity At Work and Employee Fitness (In 2 Parts)

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Part 1: Physical Fitness

Today’s work environment is much more challenging than ever before. The challenge is undoubtedly multi-factorial. Many of these are external – mostly related to increasing complex, and difficult to fathom uncertainties and surprises in the overall business environment. Nevertheless, its sizeable part keeps generating from within the respective organizations.

These emanate from a wide variety factors, such as changes at the senior management levels or in the key corporate policies of an organization. But more importantly, changing aspirations and outlook of the new generation professionals, in the midst of all complexities of life, often play a catalytic role.

Managing changes in VUCA world:

The Corporate leadership of more and more business organizations, including pharma is fast realizing a hard fact. They are discerning, if the internal challenges are addressed with a systematic short, medium and long-term approaches, it would be possible to navigate through, with a greater degree of success than otherwise, in this Volatile, Uncertain, Complex and Ambiguous (VUCA)) world.

Scientific evidence suggests, encouraging employee fitness in this situation with a comprehensive plan, could considerably help boosting employee productivity to effectively respond to business challenges. I shall discuss this emerging scenario in two successive articles. The Part 1 will dwell on the impact of ‘Physical Fitness’ on employee productivity, and the Part 2 will argue on the relevance of ‘Mental Fitness” in achieving the same.

Working on ‘employee engagement’, including fitness:

To successfully cruise through this tough headwind, many corporate houses are working hard on various ‘employee engagement’ initiatives, to excel in creating the best possible ‘shareholder value’. These cover various hard and soft skills imparted through regular training sessions, in tandem with actively encouraging employee fitness programs at the corporate level, seriously.

There are plenty of reasons for doing so. For example, by keeping the employees away from various non-infectious chronic (NCDs) such as hypertension, diabetes, or enabling them to manage these conditions better, through fitness initiatives, the employers derive some very tangible benefits, as well. These come, over and above offering a sense of wellness to employees – in terms of improvement of per employee productivity.

Proven benefits of fitness initiatives now visible across the world:

To achieve this goal, increasing number of corporate houses around the world of all sizes, are ensuring employee fitness by providing facilities of exercise, even in the workplace.

A Brookings Institute study, titled, ‘Exercise Increases Productivity’ found that ‘regular exercise at work helps increase employees’ happiness and overall productivity in the workplace.’ In a randomized controlled trial, researchers from the University of Georgia concluded that even low to moderate daily exercise can make employees feel more energized within a few weeks. Whereas, the effect of exercise on the mood is immediate.

Another research article, published in the American Journal of Management indicated: ‘If fitness could be increased through some type of fitness program, there would be a noticeable increase in productivity.’

Yet another research publication on the subject commented: “There are clear implications not only for employee wellbeing, but also for competitive advantage and motivation by increasing opportunities for exercising at work.”

Fitness also impacts the way one thinks:

Stating that: ‘Exercise has also been shown to elevate mood, which has serious implications for workplace performance,” the article titled “Regular Exercise Is Part of Your Job”, published by the Harvard Business Review (HBR) on October 03, 2014 discussed another interesting point.

It wrote, when we think about the value of exercise, we tend to focus on the physical benefits, such as lower blood pressure, a healthier heart, a more attractive physique. Besides this fact, there are other compelling evidence suggesting that there is another, more immediate benefit of regular exercise: its impact on the way we think.

Elaborating the point, the author said: Studies indicate that our mental firepower is directly linked to our physical regimen. And nowhere are the implications more relevant than our performance at work, providing the following cognitive benefits into an employee routine at the work place:

  • Improved concentration
  • Sharper memory
  • Faster learning
  • Prolonged mental stamina
  • Enhanced creativity
  • Lower stress

In line with the Brooking Institute study, this article also reiterates that exercise has shown to elevate mood, which has serious implications for workplace performance. On the other hand, feeling irritable is not just an inconvenience. It can directly influence the degree to which one is successful.

Even the results of the Leeds Metropolitan University study show that exercise during regular work hours may boost performance. It also found: “On days when employees visited the gym, their experience at work changed. They reported managing their time more effectively, being more productive, and having smoother interactions with their colleagues. Just as important: They went home feeling more satisfied at the end of the day.”

The most common barrier:

What prevents us from exercising more often? The most common answer to this important question would probably be: ‘I don’t have the time.’ This answer could well be quite legitimate too. However, it also means that fitness programs still assume a low priority to many, despite its scientifically proven work and personal benefits, as the studies indicate.

Conclusion:

Various research studies, including the HBR article, have concluded that the cognitive benefits of exercise resulting significant improvement in employee productivity, can’t be wished away, any longer.  Which is why the research studies establishing the importance of employee fitness to boost their productivity in the workplace, are so compelling.

There is hardly any scope of doubt now that: “Exercise enables us to soak in more information, work more efficiently, and be more productive.”

This scientifically proven narrative now deserves to be practiced at a much wider scale by Indian business organizations. As an effective tool to boost employee productivity, they may wish to increasingly encourage fitness programs at the workplace. Not very strange, though, corporate physical fitness centers – on-site or outsourced, are not too common, just yet, perhaps more within the Indian pharma industry.

When actively encouraged by, particularly the pharma leadership in India, a significant value addition may take place on their ongoing initiatives for improving the much-sought after employee productivity in the workplace, in a win-win way.

By: Tapan J. Ray 

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

Quantum Value Addition With Health Apps, Going Beyond Drugs

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Besides all important brand attributes and how well those are communicated to the doctors, the ‘game winning’ differentiating factors in the prescription drug business, as it appears today, would revolve around overall quality of patient-centric approach and offerings of pharma companies, craftily tagged with the associated products.

To hasten business growth, being more and more patient-centric, in increasingly competitive, demanding and complex environment, pharma players would require to leverage the cutting-edge technology to its fullest for significant value addition in their respective sales and marketing models too.

Keeping pace with today’s ‘technology revolution’, rapid advent of various game-changing and user-friendly digital health applications for consumers are showing immense potential for a refreshing catalytic change in the overall landscape for patient-centric healthcare services as a key differentiating tool from the pharma players’ perspective.

The capability and capacity of ‘out of box’ thinking, professional expertise to choose and customize the right technological tools, making them key components of pharma sales and marketing models and above all, their effective implementation on the ground, would eventually differentiate men from the boys in the ball game of competitive excellence in the Indian pharma industry.

This emerging opportunity brings to the fore immense potential to revolutionize the treatment process of many serious chronic ailments with significant value creation, even in India, generating a unique synergy between the drugs and customized disease related digital tools.

In this evolving ball game; wearable, decent looking and user-friendly ‘Health Apps’, installable in smartphones having Internet and Bluetooth connectivity along with touch screens; signal a great potential for augmentation of the overall disease treatment process.

Consequently, it would kick-start a healthy competition within the pharma companies to continuously raising the bar of unique value offerings to patients, more than ever before.

A close experience:

Purely prompted by my keen interest in technology for a long while,the ‘Health App’ that I have bought and installed in my iPhone and wearing for sometime, is basically a multifunctional and multi-dimensional fitness tracker.

From the decent looking digital ‘Wrist Band’ that comes with it, the Health App tracks on a daily basis, kilometers that I have walked (from pre-calibrated steps), calories that I have consumed with intake of different food types and burnt up through physical workouts, total duration of time that I have slept in a day, quality of my sleep (sound and light sleep) with duration, number of times that I woke up at night, precise daily intake with quantity of nutrition, such as, fluid, carbohydrate, protein, fiber, different types of fat, salt etc., pulse rate, breathing and mood, besides many others.

Current users:

Besides some global pharma companies that I shall deliberate below, the current users of ‘Health Apps’ are mostly those people who are increasingly becoming fitness and diet conscious (at any age) and also want to take proactive measures for prevention of many chronic ailments.

A study:

According to a report co-authored by an official of IMS Institute of Healthcare Informatics, a study based on nearly 43,700 purported Health or Medical Apps available on Apple’s iTunes App Store, found that 69 percent of those Apps targeted the consumers and patients, while 31 percent were built for use by clinicians. Most of the ‘Consumer Healthcare Apps’ were simple in design and do little more than provide information.

The study observes, a large number of Health Apps are being designed to track simpler data on health and fitness. However, the more sophisticated Apps are capable to perform advanced functions, such as, real-time monitoring and high-resolution imaging.

Possibility for much wider use in healthcare:

Although, many of these Apps have been devised as personal fitness and health trackers directly by the consumers, the information and hard data thus captured can possibly be shared with the medical practitioners by the patients, as and when required. This data could serve as valuable patient life-style information inputs for the doctors, while managing their serious chronic illnesses.

Health Apps could also help the users reduce, at least, the primary care costs through preventive self-monitoring measures and take control of their own basic health.

In tandem, I reckon, there is a good possibility for a much wider use of such Health Apps in India by the pharma companies, along with many drugs, especially those, which are used for chronic ailments.

For example, real-time data tracking on:

-Exercise, diet and Body Mass Index (BMI) for patients on anti-diabetic and anti-hypertensive drugs

- Quality of sleep for patients with sleep disorders and are on related medicines

- Mood for patients taking anti-depressant medications

The data captured by the Health Apps in all such related areas could be useful for both the doctors and the patients in the process of effective disease management along with the drugs. 

Going beyond drugs:

Based on this emerging trend, it is envisaged that in not too distant future, it won’t be very uncommon for patients, suffering from especially serious chronic diseases, to get prescriptions for both the drug and an the related customized Health App, for better quality of life through effective disease control.

Similarly, some hospital discharge orders may possibly include downloading of related mobile Health App on patients’ smartphones, primarily to provide an ongoing link between the doctor and the patient for better patient care and more effective follow-up visits.

Pharma players showing interest in Health App market:

It is, therefore, no surprise that pharma players have started showing keen interest in Health App market. In fact, this emerging market is now dominated by the big pharma players, with Bayer having 11.2 percent market share, followed closely by Merck, Novartis, Pfizer, and Boehringer Ingelheim.

The top 20 Health App makers are as follows:

No Company No. Of Health Apps
1. Bayer 139
2. Merck 111
3. Novartis 108
4. Pfizer 62
5. Boehringer Ingelheim 51
6. Janssen 45
7. AstraZeneca 44
8. GlaxoSmithKline (GSK) 41
9. Roche 41
10. Johnson &Johnson (J&J) 39
11. Novo Nordisk 32
12. Siemens 29
13. Amgen 28
14. Medtronic 27
15. Abbott 24
16. Biogen Idec 20
17. Merial 20
18. Sanofi 20
19. Genentech 19
20. Allergan 17

(Source: Pocket.md as of 12/2/2013) 

A novel business expansion opportunity:

Pharma players in India may consider to actively focus on, with requisite resource deployment, to collaboratively develop and market smartphones based digital Health Apps, for quantum value addition in their brand promotion.

Moving towards this direction, pharma sales and marketing strategy for a chronic disease treatment should consider making Health Apps an integral part of doctors’ prescription along with the related drugs of the company.

Some examples:

To give an idea of the evolving trend, I am citing below a few examples, out of lot many, in this emerging area:

- Betaseron (interferon beta-1b) of Bayer: This drug is indicated for the treatment of relapsing forms of multiple sclerosis to reduce the frequency of clinical exacerbations. The company launched its first iPhone App, named ‘myBETAapp’ with ‘Personalized Tools’ to assist people on Betaseron (interferon beta-1b) in managing their Multiple Sclerosis (MS) treatment.

myBETAapp provides patients with injection reminders, injection site rotation assistance and injection history.  Through Internet, myBETAapp also gives patients access to the BETAPLUS Web page on Betaseron.com, including links to educational tools, peer support and contacts listed on the site.  With active phone service, patients enrolled in the BETAPLUS program can dial directly to speak to BETA Nurses, who are specially trained in MS.

- Tobi Podhaler (tobramycin inhalation powder) of Novartis: This drug is indicated for the treatment of Cystic Fibrosis.

Podhaler Pro App is an iPhone based navigation tool for patients and also the doctors during treatment with Tobi Podhaler. This Health App is a customizable digital pocket companion that helps, besides many others, with timely reminders to keep track of treatments, real patient stories and access to a live PodCare nurse to answer questions about taking treatment.

- Pradaxa (dabigatran etexilate)of Boehringer Ingelheim: This drug is indicated for ‘Reduction of Risk of Stroke and Systemic Embolism in Non-Valvular Atrial Fibrillation; Treatment of Deep Venous Thrombosis and Pulmonary Embolism and Reduction in the Risk of Recurrence of Deep Venous Thrombosis and Pulmonary Embolism’. It comes with a Health App, available in online ‘Apple Stores’. This is a tool providing healthcare professionals with information about stroke risk in Von-valvular Atrial Fibrillation.

Pradaxa Health App contains a ‘Stroke Risk Calculator’, ‘Bleeding Risk Calculator’, Renal function and dosing and administration information.

Pradaxa Health App also has a great resource section, split into ‘Patient and Health Care Professionals’ sections, which can be sent to patients via email.

- Xarelto (rivaroxaban) of Janssen Pharmaceuticals: This drug is indicated for ‘Reducing Stroke Risk in Patients With Non-valvular Atrial Fibrillation (AF); Treating Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) and Reducing the Risk of Recurrence; DVT Prophylaxis After Knee or Hip Replacement Surgery’. It  also comes with a Health App, called Xarelto Patient Center and available in online ‘Apple Stores’.

Xarelto Patient Center App features include, personalize questions that help patients speak with their doctors about treatment with Xarelto, Appointment reminder, Xarelto ‘Savings Programs’, Registration to receive more information, Videos that share more information on Xarelto and hear from others who have been treated with the drug, After receiving a prescription the patient can enroll in the ‘XARELTO CarePath’ patient support and savings program.

Thus, especially for high-risk ailments, such iOS Apps directed at patients with information on the drug, including interactions with other medicines, dietary requirements, fitness/health trackers, besides many others, can add additional value both to the prescribers and the patients in the process of effective disease management.

Tightening the loose knots:

A 2014 report titled, ‘r2g mobile Health Economics’ by ‘Research2Guidance’ states, even though they try hard, most of the pharma companies fail to have a significant impact on the mHealth App market. Some pharma companies have published more than 100 Apps available for iOS and Android, but have generated only limited downloads and usage.

It states, pharma companies have created only little reach within the smartphone/tablet App user base. In fact, the leading pharma companies have been able to generate 6.6m downloads since 2008 and have less than 1m active users.

Analysis and comparison of the App activities of the top 12 Pharma companies in the report, gives reasons why pharma companies have not succeeded in becoming leading mHealth Apps providers, as follows:

- The App portfolios are not globally available:  Almost half of the pharma companies’ Apps target only local markets. This means that their apps are available only in 3 or less countries.

- The App portfolio is built around the core products of the pharma companies and not around the actual market demand:  For example, if a company specializes in the treatment of hematological diseases, the App portfolio reflects that. Apps in this case would provide references to the latest research, support diagnosis and facilitate information exchange with/between the experts. There exists an App market for such products, but there are other segments e.g. health tracking, weight loss, fitness or diabetes condition management, which attract more users.

- No cross-referencing or common and recognizable design:  So far, pharma companies have not used the full potential of cross-referencing between their Apps. They also do not use common style guides for their App portfolio. Both of these could improve their App visibility as well as strengthen their corporate identity in the App market.

From this research analysis, it is quite evident that there is a need to tighten the loose knots in the Health Apps space by the pharma players. All improvement areas, as indicated above, should be addressed, sooner, especially, the need to targeting patients globally and inclusion of segments such as health/fitness tracking, weight loss, together with patient management focus areas of chronic illness conditions, such as, diabetes or hypertension, which have been attracting more users.

A comprehensive look and well thought-out action would help realizing true potential of the Health Apps market in India.

Conclusion:

Based on the emerging trend, it appears, those days are not quite far off, when it will become quite common for the doctors and also for the hospitals to co-prescribe with the drugs, user-friendly, disease related smartphone based Health Apps for the patients. This practice would provide an ongoing link between the doctors and the patient, leading to not just better quality of treatment, but a comprehensive overall healthcare in that specific disease condition.

However, currently there does exist a down side to this approach, which can’t be totally ignored either. The reason being, such Health Apps are not quite affordable to many, just yet, especially in a country like India. This affordability barrier could probably be overcome, if Indian IT software and hardware development companies consider this area lucrative from an emerging business opportunity perspective, as the country moves on with its ‘Make in India’ campaign.

If it makes sense…probably it does, it needs to be tried out sooner, in a much larger scale, for a win-win outcome.  To begin with, the interested pharma players can tailor these well differentiated value offerings, at least to suit those, who can afford such augmented treatment process for a better quality of life, going much beyond drugs.

By: Tapan J. Ray

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.