“Tech is challenging the way pharma is thinking about medicine” – Mark Lightowler

Digital therapeutics could create a new treatment paradigm focused on changing patients’ behavior, according to Mark Lightowler, CEO of Phorix. The Sidebar caught up with him to find out how the technology is challenging the way pharma is thinking about medicine.

Rewind ten years and everyone in the pharma industry was suddenly talking about going “beyond the pill,” offering add-on services that would entice patients and doctors to prescribe their medicines.

But according to Mark Lightowler, CEO of Phorix, the advent of digital therapeutics (DTx) could lead to a revolutionary patient-centered approach for tackling why patients make poor health decisions in the first place.

He says that although preventive medicine has been on the agenda for years, digital therapeutics that are run on commonly used digital devices have the potential to change the way patients think about their health.

After working at Novartis on a connected inhaler Lightowler quit pharma to begin exploring this new treatment paradigm, founding the behavioral change design agency Phorix to champion behavioral change and ideas around redesigning healthcare from a patient’s perspective.

“Over the last 200 years, we have started to understand what makes people sick and started to work on preventative medicine,” Lightowler explained.

“With the arrival of new technology like smartphones, tablets, machine learning and artificial intelligence healthcare can focus on prevention, prediction, precision and personalization.

He added: “Digital therapeutics are the product of the overlap between affordable at-home monitoring and behavioral science. In this way, we can nudge people towards better health choices that improve patient outcomes across the spectrum of care.”

The ability to process high volumes of data and technology, thanks to advances such as cloud services, has helped to make digital therapeutics affordable, said Lightowler.

This is important as a high quality digital therapeutic, backed by clinical trial data on safety and efficacy, can offer an alternative to big pharma’s approach to treating certain conditions.

Behavioral insights

At the heart of DTx is an improved insight into human behavior, and what drives people to make poor health decisions.

“Our understanding that human behavior is responsible for many of healthcare outcomes through concepts like adherence, physical activity, sleep, weight management and risk-taking behavior has led companies to shift focus from a pharmacotherapy-only based approach to a more holistic way of managing patients,” said Lightowler.

But there’s nothing to say that pharma can’t get involved with DTx, according to Lightowler, who believes they could be combined with conventional medicines to produce products that are more appealing to doctors and patients.

“Digital therapeutics combined with pharmacotherapy will be a powerful combination to chronic diseases like diabetes, heart failure, psoriasis, insomnia, obstructive sleep apnea, COPD, and Asthma, and in areas like anxiety and depression.

“We should expect to see an increase in patient experience of disease management and that will be especially interesting to healthcare providers and payers.”

Digital technology allows behavioral science to be applied directly to patients’ lives. This, Lightowler said, could enable them to make decisions that could help them to manage a pre-existing condition or make the onset of a chronic disease less likely.

“Digital tools enable us to make more of those good choices and understand the general pattern of those choices, allowing unobtrusive communications that keep us motivated to achieving our health goals,” he said.

Targeted health interventions

Everyone is different and DTx offer the possibility of health interventions that are targeted to specific patients’ strengths and weaknesses.

“By understanding more about the specific needs and wants of people who the target health care interventions, will result in better designed and more effective programs,” he added.

Another factor that can affect behavior is overall health literacy, something that manufacturers of digital therapeutics are hoping to improve in the years to come.

According to Lightowler, learning more about health can improve a person’s likelihood to look after themselves.

But it’s important to note that there are some people who have the best health advice and still ignore it, Lightowler added.

“Health literacy is definitely one factor of behavior. If we don’t understand the importance of a health action, we are less able to change.

“But there are other components needed as well. We see that even in highly health-literate people there is a similar propensity to follow bad health behaviors but for other reasons.

“In the case of health behavior, there are a range of tools behavioral scientist have used such as role modelling and social proof. People follow others that influence them and if they see others doing the behavior and that is accepted in this society, they will be more likely to enact the behavior even if they do not fully understand it.”

Lightowler predicts a bright future for DTx as we learn more about how to keep people free from disease, and how to improve long-term outcomes in those diseases that can’t be prevented.

“The cost of care will be affected by this approach with improved efficacy and sustained health outcomes,” he concluded.