Digital and connected competencies, fueled by increased patient engagement and growing connectivity through the Internet of Medical Things, can provide pharmaceutical and life sciences companies with outsized competitive advantages – and the time to invest in growing these competencies is now. As the industry shift toward value-based reimbursement and outcomes-based payment accelerates, connected drug delivery offers pharma the real-world data it needs to strengthen its value to patients, payers, and providers alike.
You can’t manage or predict what you can’t measure or control.
Connected drug delivery – the addition of signal-gathering tech to a drug delivery form factor like an inhaler, injector pen, or blister pack – offers, among other things, visibility. All ecosystem stakeholders have long been lacking critical data on what happens after prescription fulfillment: Are patients adherent? Compliant? Are dosing and intervals correct? And if outcomes aren’t positive, is that a reflection of the efficacy of the drug product, or a result of noncompliance, nonoptimized dosing, or poor technique?
Pharmaceutical companies cannot hope to successfully enter outcomes-based contracts without closing these critical gaps in visibility. Payers, too, value the objectivity provided by such data, which all but eliminates the question of whether or not a patient is receiving the most appropriate and most cost-effective therapy for their condition.
“Drugs don’t work in patients who don’t take them.” -C. Everett Koop, former US Surgeon General
If outcomes-based deals are based on efficacy as measured in clinical trials – a carefully-managed snapshot of time where enrolled patient behavior doesn’t always mimic real-world habits – pharmaceutical companies will have to do what they can to ensure patients are at least following prescribing information for their medication.
The trouble is that patients often aren’t taking their medication as prescribed. Among patients with a chronic disease, medication nonadherence falls in the 50% to 60% range[1], even for well-insured patients. Adherence involves three core actions by the patient: initiation (filling the prescription and taking the first dose), implementation (following the prescribed regimen), and persistence (following the recommended dosing).
Good adherence is a byproduct of a well-considered patient experience. Connected drug delivery devices can both measure adherence and, when coupled with thoughtful patient engagement via a digital health platform such as a mobile app or virtual coaching, even help improve patient adherence[2] over time.
In clinical trials, sponsors put in place a variety of tools and controls to monitor proper drug compliance, but these are often written into protocols as part of their data collection and biostatistics plan. It’s time for the pharmaceutical industry to deliberately prioritize such tools – including using connected drug delivery devices – within their R&D pipelines as integral to the new products being investigated, so they can collect this data well beyond the phases of clinical research and reap even greater efficacy/outcomes via a combination digital + pharmaceutical filing.
Expanding Outcomes-Based Contracts
With connected drug delivery, medication appropriateness can be measured at the time of diagnosis and prescription writing, and once fulfilled, connected drug monitoring enables true precision medication intelligence, where dose adjustment and medication outcomes reporting is continuous. Connected devices also offer pharmaceutical companies the opportunity to better define the breadth of outcomes they’re measured against, and truly engage with HCPs in a way that helps patients and saves them time.
In addition to physiological measurements, like vital signs and biomarkers, connected devices can detect and measure multidimensional outcomes. Integrated into the Internet of Medical Things, data from connected drug delivery devices coupled with health records data – such as hospitalization rates or duration of hospital stay – can become powerful measurements of success, opening the door for commercialized products to be tied to overall reduced costs for patients and payers.
Truly Integrated Digital Pharmaceuticals
Akin to a dual drug therapy, a truly integrated model sees pharmaceutical and life sciences companies integrate connected tech into their drug delivery device as part of a coordinated clinical development program. Coupled with patient engagement and intervention via a complete digital health platform or digital therapeutic, the impact of connected drug delivery devices on patient outcomes becomes even greater[3].
In 2020, the global connected drug delivery devices market size was valued at $214.10MM, up 23.8% compared to the previous year.[4] Similarly, outcomes-based contracts between pharmaceutical companies and payers or PBMs, though still uncommon, are growing: a quarter of pharmaceutical executives have tried a value-based contract, according to PwC’s Health Research Institute[5]. The group notes that pressure to ink such deals is “coming from every direction.”
If the pharmaceutical industry doesn’t take the move to digital connectivity seriously, elevating initiatives from one-off pilots situated under a digital umbrella to large-scale integrations at a franchise level, they will be sorely unprepared to navigate outcomes-based deals. They’ll also miss out on proving their value to patients, protecting against market share erosion, and, ultimately, generating the evidence they need to stay relevant in today’s complex healthcare ecosystem.
[1] The Permanente Journal, The Unmet Challenge of Medication Nonadherence, 2018
[2] European Respiratory Journal, Assessment of patient engagement and adherence with once-daily indacaterol/glycopyrronium/mometasone (IND/GLY/MF) Breezhaler digital companion in asthma: interim analysis from Germany, 2021
[3] Nature’s Scientific Reports, The relationship between objective app engagement and medication adherence in asthma and COPD, 2021
[4] Grand View Research, Connected Drug Delivery Devices Market Report, 2021-2028
[5] PwC, Launching into value: Pharma’s quest to align drug prices with outcomes, 2017
