The wheels of innovation can turn slowly in Big Pharma
It's been nearly a year since I joined the DRG Digital | Manhattan Research team. The great colleagues I've gained and massive marketing and evidence-based dataset I've inherited have made this role one of the most exciting in my career. Like, pinch myself exciting.
Pinch. Ouch! Oh, guess I'm not dreaming.
It's also been a year in which my perspective on the life sciences industry has changed. Greatly. I've been in conversations and meetings and presentations with some twenty-odd of the world's leading pharma companies, plus dozens of smaller biotechs, publishers, healthcare agencies, and technology start-ups.
My key takeaway? There is actually innovation happening in pharma. Really. Despite what nearly every speaker at nearly every conference will tell you. The pace of change is quickening, and the warning signs are flashing, and perhaps it's become enough to push this locomotive out of the station.
There's a catch: pharma innovation is not distributed evenly. Those companies with executive appetite for pushing boundaries are motivated to think differently. And they are executing, not just talking. The rest? Protected by lucrative patents, regulatory inertia, and sales mindsets that continue to permeate, the laggards are paying lip service, mostly.
Doesn't mean innovators are automatically successful. Look at Research in Motion, whose Blackberry devices sparked the smartphone revolution – and then promptly melted in the heat generated by Steve Jobs' brilliant marketing schemes. Which leads to my third takeaway – the most important one – innovation isn't enough. The life science industry must overcome many unique challenges to remain vital in the next 10-20 years, and focusing on 'the new' will be a critical success factor. It just can't be the only one.
Here are some examples of how innovation is happening in the life sciences:
- Merck has long enjoyed a reputation as 'The Science Company' – see the oncology blockbuster Keytruda – but it's surprised me with numerous pilots to engage customers differently in the crowded medical landscape. Like its Alexa Diabetes Challenge, which surfaced unique and highly patient-centric tools to help people manage their diabetes using the power of voice technology. Merck did it the right way, partnering with an innovation group that has expertise running these types of contests, and got a chance to cozy up with some very smart people at Amazon. In Europe, where the firm is known as Merck Sharpe & Dohme, the company's Italian subsidiary trialed an eyebrow-raisingly bold offering: a Facebook chatbot for busy doctors. The tool was developed in response to increasing time demands on physicians, and could lay the foundation for other pharmas to gain regulatory approval for AI-powered chat tools.
- Contrave is a struggling product in the extremely challenging weight-loss category. Its creator, Orexigen Therapeutics, declared bankruptcy earlier this year due to underwhelming sales and is hoping to sell all rights to the product in a deal set to close tomorrow. The buyer, newly formed Nalpropion Pharmaceuticals, will also gain one of the most unique digital assets I've seen from a U.S. pharma: a telehealth prescription system called Get CONTRAVE Now. I understand telehealth has been pronounced dead by many esteemed colleagues. Yet for stigmatized conditions like obesity, telehealth could emerge as a convenient pathway for consumers to request medications directly. So far, according to Orexigen, more than 80% of respondents gave 4 or 5 stars to the service.
- In another tough disease state, glioblastoma (brain cancer), we saw medical device company Novocure launch a Facebook Live event for its Optune wearable device. This wasn't a check-the-box initiative. The company brought in an oncology nurse and filmed her discussing the device with patients and caregivers for a half-hour. According to the company's SVP, within 48 hours, views of the archived Facebook Live video had reached 12,000. That volume came as a result of advocacy partnerships and a strong social following – more than 81,000 Facebook followers in a disease with an incidence of just 2 to 3 people per 100,000.
Innovation is not distributed evenly
- I spoke with a global pharma recently and shared a slide on one of my favorite physician social networks, Figure1. The platform isn't new. It's long been a darling of the tech and business press, earning the moniker "The Instagram for Doctors" as early as 2013. The company told TechCrunch that three-quarters of U.S. medical students use the app. And now the Figure1 offers a series of sponsorship products that get beyond banner ads and focus on scientific content – exactly what doctors tell us they want from pharma. So how come only one person in the room of 15 brand marketers and technology managers had ever heard of Figure1?
- It's no longer a secret that physicians are becoming harder to reach. DRG Digital | Manhattan Research analysts continue to beat the drum on this point. HCPs are opting out of emails, using ad blockers, and spurning pharma reps. I will cautiously argue that the future of pharma commercialization starts with payers, and ends with patients. Physician marketing will continue to face an uphill climb until, at some point, it ends up as a quaint "nice to have" rather than the multi-billion-dollar industry we know today. Now, that's the future – not the present – but innovation requires us to think forward, yes? Orexigen and Novocure are seeing that future. Another pharma company I know changed course after hiring a talented consumer marketing executive from outside the industry. She's since been moved over to physician marketing because "patient isn't their focus right now." A tale as old as time.
- Facing a packed house at the Intellus Worldwide Summit, I was half-expecting someone to shout out, "We know!" during my session on using real world evidence to create patient journeys. These were life sciences market research nerds, after all. If they were still relying on traditional methods alone to understand the patient's mindset, what hope was there for innovation outside this room? Sure enough, people came up to me afterwards, one by one, to say things like: "This was fascinating stuff - it really made me think about incorporating other sources into our patient journey work." I was flattered, don't get me wrong, but why are they first hearing about this from me? In 2018?
Innovation isn't enough
- Listening in at CBI's Rare Disease Innovation Summit in Cambridge, Massachusetts, I was bewildered to hear how many orphan disease manufacturers are struggling with – wait for it – reimbursement. That's right. Company X launches a potentially life-saving drug for a rare childhood enzymatic disorder, and can't get paid for its trouble. These are diseases afflicting a few thousand (or a few hundred) individuals globally. Why innovate if there's no ability to recoup the investment? That's the trillion-dollar question facing the entire life sciences industry, as treatments for rare diseases and cancers bulk up pharma's pipelines only to bog down in formulary meetings. Which is why I believe the pharmas who are thinking innovatively about reaching payers today will be sitting at the top of the pile tomorrow.
- Finally, let me acknowledge the obvious. To date, other industries have been much more exposed to digital disruption. Retail, music, and publishing went over the waterfall years ago, flushed downward by Amazon, Apple, and Facebook. Pharma's turn at the precipice is coming. Slowly, mind you. The rumbling is faintly audible downstream. Amazon? Sure, but the real disruption is coming from the hundreds of tech companies offering non-pharmaceutical treatments for a surprisingly wide array of diseases. Consider Sleepio, one of the first sleep-improvement programs/apps that is aiming to carve out a slice of the ~$70 billion global sleep aid market. Most of those billions are currently going to Sanofi, Takeda, Pfizer, et al. Or Headspace, which recently launched a health subsidiary to develop "the world's first prescription meditation app" targeting a variety of chronic diseases. Pear's reSET was the first app approved by the FDA to treat substance use disorder last year. Numerous coaching apps have been found to reduce depression, improve diabetes outcomes, and accelerate weight loss. I'm not saying digital therapeutics will replace pharmacology. But they will challenge the calculus payers use to determine reimbursement. Since the vast majority of life sciences companies are experts in chemistry – not technology – it's not hard to see how digital therapeutics companies will begin eating pharma's lunch in a variety of treatment areas.
Despite all the headwinds, I am encouraged by what I've seen the past 10.5 months. In the U.S., EU, and many emerging markets, pharma innovators are beginning to rise to the surface. Not all their efforts will succeed, and that's okay. The ones who do will have a lasting impact on the industry and perhaps, more importantly, on patient outcomes. I'm looking forward to monitoring these commercial breakthroughs and sharing implications with you.