Digital health solutions are amplifying the value of medicines

Patients, providers, and payers have started requesting digital companions to help manage personalized treatments and monitor outcomes. Will a shift in the business models of pharmaceutical companies follow? In an interview for The Sidebar, Artur Olesch interviewed Olivier Delannoy, who leads key global digital initiatives across the Cardiovascular, Renal, and Metabolic portfolio at AstraZeneca

 

How are new digital technologies impacting business models at AstraZeneca?

Across the organization and the different functions, there is a clear understanding that digital technologies can drastically help us transform the enterprise and to achieve our ambitions. Across the entire value chain, from drug discovery through clinical trials, manufacturing or commercial, there are multiple opportunities and programs in place to accelerate our transformation. 

We have embraced Machine Learning and Artificial Intelligence to develop predictive science and understand how new drug candidates work with a far greater certainty, which helped us in proposing one of the best R&D pipelines in the industry. Digital technologies have already proven to be successful in enabling us to accelerate clinical trials, improve data quality, reduce costs, and provide a better patient experience. 

Finally, digital technologies are redefining the way we produce and distribute our products and the way we engage and deliver value to healthcare professionals, health systems, payers, and patients. Digital technologies have now penetrated so deep into the organization and the way we work that we can’t really speak about digital strategy anymore. It is now part of a broader unified strategy and the way we operationalize it. 

 

According to the company’s digital strategy, “AstraZeneca focuses on how digital, data and analytics can improve patient experience in trials and, more importantly, the overall outcome for those patients.” How will these objectives be implemented in practice? 

A lot has already been said on the promises of clinical trial digitization, which has obviously been amplified by the COVID-19 pandemic and the challenge of conducting trials in this context. Digital technologies are helping us to deliver patient-centric clinical trials across their full continuum. 

Patients are now being engaged and recruited with the support of digital channels and are not systematically forced to visit hospitals in order to get their data or vital signs collected. Electronic patient-reported outcomes, connected devices, and telemedicine are enabling us to keep patients safe in the comfort of their homes whilst we can collect and process data at the same time. 

Remote clinical trials powered by digital, not only make our R&D development plans more resilient in the context of a pandemic, but more importantly, they offer a much better patient experience. It reduces the number of visits to the hospital, offers a continuous online dialogue with the clinical team, and streamlines most of the procedures related to the trial. 

 

The strategy also states that through strategic partnerships, digital, data, and technology, there is the potential in the future to revolutionize how AstraZeneca engages with patients, so they can self-manage. Can you please elaborate on this?

There is much more we can do as a pharmaceutical company than just delivering drugs. In collaboration with healthcare professionals, we want to improve patient outcomes. In this context, we need to think more broadly and leverage the power of digitalization, data, and technology to improve the entire health ecosystem that can affect patients. 

As an example, we have recently announced a partnership with BrightInsight and the Massachusetts General Hospital in Boston to develop a comprehensive disease management platform named AMAZE. This platform provides an end-to-end digital solution closing the gap between patients and providers across multiple chronic conditions, including asthma, COPD, heart failure, chronic kidney disease, and diabetes.

AMAZE will improve patient engagement and therapy adherence for their own chronic diseases, as well as providing their physicians better insights to deliver more personalized care in real-time. Similarly, we’re helping the Imperial College of London to reengineer their type 2 diabetes and heart failure pathways, which includes the implementation of digital health solutions to improve the diagnosis and the remote management of these diseases.

Over the last couple of months, we’ve significantly increased the number of strategic partnerships with digital health solutions providers that can improve disease diagnosis, care management, or the patient experience so we can help to build more patient-centric and resilient health systems over time. 

 

Digital therapeutics (DTx) enters the healthcare market very fast. Will medicines in the future include a digital component – a digital platform or an app – as part of the treatment? Should the DTx, in this case, also be FDA/EMA-approved?

I have no doubt that we will see a greater combination of digital health solutions and drugs to tackle the management of chronic diseases. As the pharmaceutical industry releases an increased number of products involving sophisticated modes of action or relying on precision medicine, there is a need to identify the right patients and closely follow up the administration and the management of these new drugs. Moreover, these novel compounds are quite often more expensive than traditional medicinal products, which requires the generation and the management of real-world data to demonstrate the realization of the expected benefits of such drugs.

Digital Therapeutics (DTx), as software-based medical products, have started to demonstrate interesting perspectives, mostly to prevent, treat or manage medical disorders such as addictions or other behavioral problems. So far, the leading companies in this new field have rightly gone through the generation of clinical and real-world evidence in order to secure regulatory approval and reimbursement in some cases. 

As new market entrants, this is probably the only way to gain credibility, trust, and confidence from healthcare professionals and the general public. Over time though, and similarly to the development of the OTC drug market, we will probably see DTx being launched outside of a stringent regulatory framework, which needs to be adapted to welcome these novel therapeutic approaches.

 

Do you see an increased opportunity in partnering with DTx companies during the clinical trial phases of drug development?

We definitely have an increased number of partnerships with digital health solutions that are either potentially amplifying the value of our medicines, or making clinical trials more efficient and centered around the patients. Over the last couple of years, digital health became an integral part of our R&D strategy, helping us accelerate our pipeline, improve data quality, reduce some manual activities while also reducing study costs. 

When it comes to DTx, most of the large pharmaceutical companies are still in the process of understanding how these novel approaches can complement their portfolio or create a new revenue stream in itself. We have seen some of our peers such as Novartis, Otsuka, or Sandoz announcing DTx partnership with mitigated results so far – we are equally exploring what the best collaboration model could be. 

I see an increased chance of success when DTx solutions are closely connected to a core therapeutic area or even a specific medicine. For example, our partnership with Propeller Health and its smart inhaler helps us digitize the treatment of asthma and chronic obstructive pulmonary disease and brings a clearer picture of disease control to clinicians.

As mentioned earlier, I think there will be opportunities for digital health, and potentially DTx, to support the development and the launch of increasingly sophisticated precision medicines or medicine requiring specific administration methods. Patients, providers, and payers will request digital companions that will enable them to manage personalized treatments better and monitor outcomes. In this context, the progressive shift towards value-based reimbursement will probably accelerate the need for supporting technologies such as digital health or DTx.