Today pharma's business model is being challenged. The industry needs to rethink how it creates value. In particular, it needs to connect to patients and caregivers in a meaningful way. It many cases this connection can be guaranteed through digital tools and strategies. This presentation focuses on these challenges and showcases some best practices that are already available in the marketplace.

1. P h a r m a C h a l l e n g e s
M A K I N G S E N S E O F A D I G I T A L W O R L D
Moving fast is not the same as going somewhere.

2. “
”
Innovation needs to be part of your culture.
Consumers are transforming faster than we are,
And if we don’t catch up, we’re in trouble.
Ian Schafer

3. D R A M A T I C C H A N G E S
Pressure for Pharma
The next wave in pharma innovation.
Operating Environment:
- Globalization
- Heightened transparency
expectations
- Increased exposure to innovative
technologies
- Social and Economic Pressures
(wider health ecosystem)
Consequences:
- Escalating costs and pricing pressures
- Increasing competition
- Shorter time in market
- Expiring patents and declining
profitability
- Mounting regulatory scrutiny

4. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Digital is Enabling Patient Centricity
Forces that are changing a provider-driven marketplace to a patient-centric health ecosystem.
- Ageing population (↑chronic disease)
- Unrelenting pressures on capacity and
financial viability
- Policy and payers seeking to control costs
and requiring evidence of value and
effectiveness
- Health technology, genomics, connected
devices, big data analytics and AI
- Blurring of provider boundaries: new entrants,
partnerships and collaboration as part of the
new health ecosystem

5. G R O W I N G R E A L I S A T I O N S
Pressure for Pharma
The need for a new business model – beyond the hype.
New patient-centric business model
- Connected devices
- Big Data Analytics
- Personalized drugs
- Smaller patient groups
- Monitoring and Managing Patient
adherence
- Health Outcomes
New Ecosystem
Regulatory Bodies
Patient Advocate Groups
Healthcare Providers
Healthcare Payers
Pharma

6. T H E R O A D T O P A T I E N T - C E N T R I C I T Y
Challenges for Patient-Centricity
The ambition to become truly patient-centric.
1
2
3
4
↑ Agility and responsiveness
to become patient-centric
Regulatory uncertainty with
regard to digital technology
Data safety, privacy and
user consent
Corporate reputation can undermine
patient engagement with pharma.
5
Attracting the talent with the skills to
support patient-centric ecosystem
6
Low levels of health and digital
literacy (patients)

7. T H E R O A D T O P A T I E N T - C E N T R I C I T Y
Challenges for Patient-Centricity
The ambition to become truly patient-centric.
1
↑ Agility and responsiveness
to become patient-centric
Margins in digital health are small
compared to pharma’s margins
Hard to make a commercial case
Requirement for constant upgrades
is at odds with an industry that takes
a decade from “bench to bedside”

8. T H E R O A D T O P A T I E N T - C E N T R I C I T Y
Challenges for Patient-Centricity
The ambition to become truly patient-centric.
2
Regulatory uncertainty with
regard to digital technology
Rapid pace of technological
advancement is adding complexity to
regulatory landscape.
FDA: Apps are devices only if they
are used in diagnosis, treatment or
prevention of disease
(Digital Health Innovation Plan)
EU MDR: all medical software apps
as medical devices, most standalone
apps will fall under Class I.

9. T H E R O A D T O P A T I E N T - C E N T R I C I T Y
Challenges for Patient-Centricity
The ambition to become truly patient-centric.
3
Data safety, privacy and
user consent
Only 76% of mHealth Apps had a
privacy policy that was readily
accessible to users
↑Health data volumes/year
48%

10. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Pharma and Patient Data
Feedback loops are the key to great results.
↑Health data volumes/year
48%
Example Oncology
Combination of data sets
Age, Gender, Diagnosis History,
Medication and Treatment History,
Laboratory Values and Hospital
Encounters
Automated-Feature-Discovery
(AFD) machine learning engine
Model insights:
- 200 lab values, chronic comorbidities
- Abnormalities in lab results (ie. Liver
function marker, increased the
likelihood of a patient transitioning to
the next line of therapy in 140% of
cases)
- Patients on maintenance therapy
were 20% less likely to transition to
the next line of therapy

11. T H E R O A D T O P A T I E N T - C E N T R I C I T Y
Challenges for Patient-Centricity
The ambition to become truly patient-centric.
4
Negative reputation
Factors such as failing to serve the needs
of neglected patient groups, excessive
pricing and a lack of transparency
Eroded public confidence in pharma
PatientView: UK-based research
company, specialize in obtaining
perspectives from patients groups
Corporate reputation can undermine
patient engagement with pharma.

12. T H E R O A D T O P A T I E N T - C E N T R I C I T Y
Challenges for Patient-Centricity
The ambition to become truly patient-centric.
76% “High” or “Some” trust in health apps
developed by patient groups
32% “High” or “Some” trust in health apps
developed by pharma
83%
“Willing” or “Somewhat willing” to
share personal data from health App
with primary or specialist doctor
30%“Willing” or “Somewhat willing” to
share personal data from health App
with pharma

13. T H E R O A D T O P A T I E N T - C E N T R I C I T Y
Challenges for Patient-Centricity
The European Health Literacy Project
6
Low levels of health and digital
literacy (patients)
Health Literacy can correlate with low
levels of engagement with health
technology
2016:
Study 4974 American adults
25,7% Low Health Literacy level had
used a patient portal
42% Adequate Health Literacy Level had
used a Patient Portal

14. D I G I T A L P H A R M A
Benefits of engaging with Pharma
Collaboration across Patients, Payers, HCPs and Regulators.
Improve Patient’s Digital and
Health Literacy
- Information clear, simple language and understandable
at basic levels
- Foster meaningful with patients and healthcare
professionals
- Provide consistent customer experience to improve
health outcomes

15. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Medical Accuracy
Improving Bedside Education
Online search engine results related to health
1300 Websites
43,5% In line with AAP
recommendations
28,1% Contained inaccurate
information
28,4%
Were not medically
relevant
in ScientificAmerican

16. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Patient Education
Improving Bedside Education: Multimedia Content
http://patientnexus.visualhealthsolutions.com/

17. T H E R O A D T O P A T I E N T - C E N T R I C I T Y
From Patient to Consumer
The ambition to become truly patient-centric.
Source: 5 elements of a successful patient engagement strategy,AthenaHealth, 2014
Health Literacy
Patient Activation: Patients become more involved in decision-making

18. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Connected Patients
Challenge: Bring drugs to market that reflect patients needs
- More informed
- ↑ Expectations
- Personalized services
- Active role in their own health

19. T H E R O A D T O P A T I E N T - C E N T R I C I T Y
Customer-Centered Digital Ecosystem
Need to shift to a more direct, personal relationship.
Source: Defining patient centricity with patients for patients and caregivers: a collaborativeandeavour, BMJ Innovations,2017

20. “
”
The biggest innovations of the 21st century
will be at the intersection of
Sun-Tzu
biology and technology.
Steve Jobs

21. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
To Err is Human
Technical advancements, Standardizing Procedures, High reliability organizing
1999: US Institute of Medicine
44000 – 98000 people die in hospitals each
year due to medical error
Today: Still at 3%-5% deaths

22. D I G I T A L P H A R M A
Electronic Patient reported Outcomes
Moovcare (Israel) – commercial version for lung cancer patients
Doctors and nurses miss many symptoms people experience
during chemotherapy
Patients requested to report 12 symptoms (ex. Sleeping &
breathing difficulties, etc)
System proactively monitored symptoms, care team was able to
intervene earlier and identify problems before they become more
severe
Patients using the app were able to stay on chemotherapy longer
than others because they were less likely to deteriorate
Less likely to be admitted to hospital
Survived 31 months vs. 26 months

23. D I G I T A L P H A R M A
Patient Managed Healthacre
The use of digital platforms for patients to own, operate and drive their own healthcare
Use social media and other
platforms to review
symptoms, disease states,
potential treatments
Data-collection Frameworks
– Apple’s ResearchKit or
platforms like
PatientsKnowBest

24. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
AI Applications in Health Care
Technical advancements, Standardizing Procedures, High reliability organizing
Mazor Robotics
Pre-op medical records in orthopedic surgery to physically
guide the surgeon’s instrument in real-time
5X reduction in surgical complications
↓ 21% in patients’ post op hospital stay
$40B savings annually

25. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
AI Applications in Health Care
Technical advancements, Standardizing Procedures, High reliability organizing
Dosing Errors
Represent 37% of all preventable medical errors
Potential $16B in savings
University of California
Correctly determined the dose of
immunosuppressant drugs to administer to
organ patients
MIT (08/2018)
Correct drug dosage for glioblastoma
Objective: Dosage regimens less toxic but
still effective
Simulated patients
Reinforced Learning technique (RL) –
receives an award or penalty depending
on whether the action works toward the
outcome
Precision medicine-based treatments

26. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
AI Applications in Health Care
Meet Molly: UCSF and NHS
Molly is a nurse avatar developed by Sense.ly – an empathy-first
engagement platform
Leverages Mayo Clinic Symptom triage algorithms to deliver care
advice through voice (no typing required) and chat functions.
Developed 10+ years ago by Mayo Clinic physicians and nurses.
Focused on specific chronic conditions like heart failure, diabetes
or COPD.
It’s human-like. It talks to patients naturally, and they talk to the
nurse as they would a real nurse or doctor.
Potential to save $20B annually and 20% of time nurses spend on
patient maintenance tasks

27. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Alice Cares
Technology with human care to support seniors

28. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
AI for Back-Office
Increasing Efficiency
Of nurses’ workload
51%
16% Of physicians’ workload
Solutions:
Voice-to-text transcription
↑ Administrative workflows
Eliminate time-consuming non-patient activities
Potential savings: $18B /year
Other areas:
Insurance Fraud
No shows or lapse on treatment
Data breaches (WannaCry or Petya)
Non patient-care:

29. “
”
We want to know what consumers are looking for,
what their values are, and how
we can meet their needs.
Gayle Fuguitt

30. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Better Patient Communication
Being more in touch with patients
Typical patient journey is ripe for digital disruption
Patient portals, apps and online communities can help

31. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Better Patient Communication
Blue is a digital touchpoint

32. P H A R M A D I G I T A L T O O L S
Mobile Health
Apps and Wearables.
Sources. Mobi Health 2018
86%
76%
72%
61%
HCPs believe mobile Apps will increase their knowledge of patient conditions
HCPs believe apps and trackers will help patients with chronic
diseases.
Of HCPs believe apps will encourage patients to take responsibility
for their health
Believe that apps will help those that are at risk of developing
preventable disease

33. P H A R M A D I G I T A L T O O L S
Mobile Health
Apps and Wearables.
Sources. Mobi Health
55%
50%
48%
46%
HCPs believe can help patients who are healthy maintain their health
Mobile technology increases the efficiency of patient treatment
Can help patients that are discharged from the hospital
The potential to improve their relationships with their patients

34. P H A R M A D I G I T A L T O O L S
mHealth Apps
Mobile is the most ubiquitous healthcare technology.
Sources. Deloitte Research, Reasearch2Guidance, 2017
260k
3,2B
5,6M
1000
mHealth Apps on the market
Downloads of mHealth Apps
Downloads are pharma mHealth Apps
Total number of mHealth Apps developed by top 12 Pharma

35. P H A R M A D I G I T A L T O O L S
mHealth Apps
Mobile is the most ubiquitous healthcare technology.
Sources. Deloitte Research, Reasearch2Guidance, 2017

36. P H A R M A D I G I T A L T O O L S
mHealth Apps
Patient Groups views on health apps used by their members .
Sources. Deloitte Research 2017

37. P H A R M A D I G I T A L T O O L S
mHealth Apps
Patient Groups views on health apps used by their members .
Sources. Deloitte Research 2017

38. P H A R M A D I G I T A L T O O L S
Pharma Apps
Capitalizing on patient familiarity and use of smartphone apps.
Sources.Reasearch2Guidance,2017
Create new relationships with
healthcare professionals
Learn how patients use and
respond to medication
Support patients to achieve better
outcomes
Target marketing strategies more
effectively
Improve productivity and
profitability
Differentiate products from
competition
Benefit from smartphone reach

39. P H A R M A D I G I T A L T O O L S
Wearables
Smartwatch and fitness bands continue to dominate the space.
Real-Time Data Collection
↑ Self-Awareness
↑ Personal Safety
Motivational tool
(eat better, lose weight, fitness)
Set goals, reminders and
incentives for healthier living
$40B
Wearable Market
Total Value in 2018

40. P H A R M A D I G I T A L T O O L S
Patient Portals
Patient portals that access medical records and communicating with clinicians dominate.
Interest
andUse
Age
Ethnicity
Education Level
Health Literacy
Health Status
Role as a caregiver
Healthcare provider
endorsement
Patient Portal Usability

41. “
”
The best marketing doesn’t feel like marketing.
Tom Fishburne

42. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Beyond the Pill
AstraZeneca’s Day-by-Day Coaching Service for patients recovering from a heart attack
After a heart attack, many people don’t change their
lifestyles or refill their medication. In the US, 200,000
people a year go on to have a second heart attack.
75 heart attack patients and caregivers to find out their
real needs. Developed unique content, training a team
of dedicated heart-health coaches, and using the latest
technology.
RESULTS:
64% of patients started a new exercise routine.
17,1% improvement in the clinically recognised Patient
Activation Measure (PAM) score.
40 health coach interactions per week.

43. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Beyond the Pill
Novartis: Social Network (P2P) for Heart Failure
Partnered with the American Heart Association and
actress/singer Queen Latifah to be a part of their Rise
Above Heart Failure initiative. They collaborate with
American Association of Heart Failure Nurses,
Association of Black Cardiologists, American College of
Cardiology and WomenHeart.
Together in HF aims to connect those affected by heart
failure, provide heart failure resources and offer content
from medical experts.
The social network features dedicated sections for heart
failure patients to share their stories and discuss how
they live with heart failure. There is also a section for
caregivers to interact with each other.
Open only to individuals
located in the United
States, content is
private and only
available to other
members.
HCPs are not
permitted to sign up in
their capacity as
healthcare practitioners;
they can register in the
capacity of a patient or
caregiver.

44. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Patient Education
iTbra
A revolutionary wearable that detects breast cancer earlier
than mammograms—to bring early detection to the masses
and save millions of lives worldwide.

45. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Self-Logging
KardiaMobile
FDA-cleared, clinical grade personal EKG monitor.
KardiaMobile captures a medical-grade EKG in 30 seconds
anywhere, anytime. Detect Atrial Fibrillation, Bradycardia,
Tachycardia or Normal heart rhythm.
More than 50 Million EKGs recorded.
https://vimeo.com/251698484

46. D I G I T A L P H A R M A
Gamification for Patient Engagement
Reward mechanism, stimulating further play and greater understanding of health conditions.
Gamification can have a positive impact on patient
engagement, health literacy and adherence.
Pediatric Clinical research Trials
Incentivization, challenge and reward can be applied using
digital technologies
Provide a platform for direct communication that is
accessible, familiar, motivating and can help educate future
generations about health
The Hospital for Sick Children Team created the Pain
Squad App for cancer patients aged 8-18 to track their
pain before, during and after procedures or treatment.

47. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Pharma and Patient Data
Secure, digital communication with providers accelerates issue resolution.
ZappRx® is a digital health company offering a
prescription & prior authorization platform.
ZappRx® can improve communication with healthcare
providers, deliver cleaner and more complete orders to
specialty pharmacies, and provide transparency into the
prescription status across all stakeholders. As a result,
specialty pharmacies can focus more on delivering
medications and improving the patient experience.
Ability to focus more on patient support

48. P H A R M A A N D T H E C O N N E C T E D P A T I E N T
Pharma and CX
Phph.ideo.com
Phantasy Pharmacy is a design exercise that comes
out of IDEO Boston/Cambridge. Designers were set
loose to reimagine these types of maladies with the
lens of childhood optimism and wonder. Their final
design outcome? A faux-pharmacy and radical
conceptual products for common childhood ailments
like eczema, earaches, pinkeye and lice.
How embarrassing moments can be transformed
into badges of honor, empowering kids to celebrate
the awkwardness of childhood.

49. “
”
Take a risk and keep testing, because what works
today won’t work tomorrow, but what worked
yesterday may work again.
Amrita Sahasrabudhe

50. D I G I T A L P H A R M A
Strategies to improve Patient Centricity
Top-Down Approach that puts patient agenda at the heart of the company.
Sources.Adapted from Eye for Pharma

51. D I G I T A L P H A R M A
Strategies to improve Patient Centricity
Top-Down Approach that puts patient agenda at the heart of the company.
Patient
Value
Units
Strategy and Change in Corporate Culture and
Structure
Teams in all major UCB therapeutic areas
Responsible for “Patient Value Practices,
Operations and Functions
Objective: Reframe Business Development
around the patients’ needs
Cross-functional Cooperation

52. D I G I T A L P H A R M A
Strategies to improve Patient Centricity
Patient Communities, Patient-centric journey and collaboration with research.
500k+
Online portal and mobile application
People with Health Conditions can share information
and data relating to health and clinical trials with other
patients and researches
Approach to map customer journeys
Objective: Improve patient outcomes and involvement in
research
Collaborated with pharma companies
Ex. UCB – epilepsy community
Shire – Track and share experiences for patients and
caregivers living with rare diseases
40M
Patients
Points of Data
about Disease

53. D I G I T A L P H A R M A
Strategies to improve Patient Centricity
Patient-Centric Development for Clinical Trials
18000
Collection of tools, including an easy to use mobile app and an
online platform that has been validated for clinical trials
Enables patients, healthcare providers and life science
companies capture and analyze data
Development with IDEO
Example: In 2016, Clinical trial to assess the impact of using
smartphone-based Parkinson’s tracker App to promote patient
self-management, enhance treatment adherence and the
quality of clinical consultation. After 16 weeks – 72%
participants continued to use the App
2017 – Partnership with AstraZeneca
64M
Patients
Points of Data
about Disease

54. D I G I T A L P H A R M A
Strategies to improve Patient Centricity
Patient-Centric Development for Clinical Trials
Technology developer that has created a range of EC and FDA-
approved mobile apps in collaboration with Big Pharma
Diabeo (Sanofi): Mobile App for patients with Type 1 and Type 2
Diabetes
Provides patients with decision-making support through algorithms
that can help calculate personalized doses of insulin and remote
management of conditions
Connections via telemedicine with healthcare providers
Helps improve hBA1c in poorly controlled Type 1 patients
Roche: Developing an app for women affected with breast cancer
Patient will manually enter their symptoms which are then analyzed
and relayed to medical team for personalized follow-up
Will facilitate tailored notifications and treatments

55. D I G I T A L P H A R M A
Strategies to improve Patient Centricity
Move toward digital CRO.
Digital Patient Unit
3M Patients
Database to provide patients with information to better manage
their personal health
Provide opportunities to participate in clinical research,
observational studies and programs to better their condition
Objective: create technology solutions that tackle some of
healthcare’s biggest challenges (ex. Integrating digital technology
within clinical trials)
Solution
Design
Studio

56. D I G I T A L P H A R M A
Strategies to improve Patient Centricity
Eliminate the risk of late-stage complications in diabetes.
Open Innovation & Crowdsourcing Platform
Increase R&D capabilities and cuts down the risk and costs
associated with research failure
Pay for solutions
370 000 registered solvers
59 000 solutions submitted
$48 000 000 Awards Posted
2000+ Challenges Outsourced for Crowdsourcing
2000+ winning solutions
https://www.innocentive.com/ar/challenge/browse
Seekers
Solvers

57. P H A R M A D I G I T A L T O O L S
Transforming the Art of the Possible
Blockchain and Data protection and transparency.
Blockchain can record irrefutable evidence on
the performance of a medicine and demonstrate
adherence to the prescribed regimes.
Overcome the limitations
of large-scale sharing of
health data, namely date
security and patient
privacy concerns.

58. D I G I T A L P H A R M A
Strategies to improve Patient Centricity
Blokchain, Data and Health.
Blockchain startup that links the physical and digital worlds with
cryptographic identity chips and blockchain technology.
Partnered with LinkLab
Lifesciences supply chain consultancy
Serialized “track and trace” pilot for pharma
Compliance protocol that will satisfy Drug Supply Chain Security
Act (DSCSA) which passed into law in 2013
By 2023 pharma companies should be able to track the production
of drugs from raw materials all the way to dispensing in an
inoperable and electronic way

59. D I G I T A L P H A R M A
Improved Patient Monitoring
Case use: GSK – form the basis of important clinical trials and studies
Apply technologies, design and
techniques developed in motorsport to
other highly regulated, data rich and
safety critical industries
Digital Therapeutics
Biotelemetry: use real time data from F1-
derived modelling and simulation software
Real time decisions (machines)
Right Time decisions (informed human
decisions/interventions)
Design Time decisions
(Long term interventions/process change)

60. Thank You