Is your organization’s strategy fit to deliver real-world health outcomes?

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EY - Lucien De Busscher

Lucien De Busscher
EY Belgium

Mobile health (mHealth) apps continue to proliferate as a way to monitor, track and even compete against ourselves or others for better health. The Internet of Things is allowing our medical histories, hospital information and even the data we share through fitness trackers to predict the possibility of a heart attack 90 days from now.  And brute computing power, combined with advances in artificial intelligence, is increasingly enabling health care professionals to search patient symptoms for faster, more accurate diagnoses, and researchers to decode the vast information contained within the human genome for new treatments and cures.

Revolutionary medical technology and treatments are emerging at a rapid-fire pace. Every day, we read about advances in health care that will increase life expectancy and improve our lives.

The fourth industrial revolution, characterized by the blurring of boundaries among physical, digital and biological worlds, is fundamentally changing health care.  At the same time, however, this revolution, combined with other megatrends – demographics, urbanization and the empowered consumer among them – is placing enormous pressure on the affordability of health care.

Given this pressure, governments, policymakers, health care systems, insurers and other stakeholders are demanding that the success of these revolutionary new treatments be based on both proven effectiveness and cost efficiency. New remedies have to be more effective than those already on the market.

Independence and objectivity are key to measuring effectiveness

But how do you define effectiveness? This requires defining parameters for success and then measuring them by identifying and capturing real-world data to provide proof of the outcome. Yet this presents another, much larger challenge: who collects, analyzes and attests the data? After all, the data needs to be seen as objective and independent of bias.

Clinical trials are a great compliance exercise. However, there is increasing demand for insights based on large-scale, real-world data. Further, payers are skeptical of the validity of clinical trials given the stake life sciences companies have in the success of the product or treatment.

On the other side, life sciences companies may not want to be held accountable for results that could be faulty simply because real-world patients may fail to adhere to the recommended treatment protocols. Additionally, isolating cause and effect is difficult in a real-world setting due to the wider variety of factors that could influence results beyond those trackable and tested for in the controlled setting of a clinical trial. Enter the independent information broker.

Until now, there has been no independent third party to fill this role. But technology companies are racing to fill the gap. There is now technology that can monitor stomach secretions and weigh a pill bottle to monitor in real time whether a patient is taking his or her medicine properly and smart contact lenses for diabetics, with built-in sensors to measure the level of glucose in the tear fluid. There are also new tools that can monitor day-by-day behavioral changes for diabetics, where 70% of diabetes issues can be resolved through the right combination of exercise, diet and pills.

Life sciences companies need to cultivate multilayer, symbiotic ecosystems

Developing leading health products and treatments and bringing them to market takes much more than a company – it takes an ecosystem. Patients, doctors and other health care providers, hospitals, universities and tech companies, biotech, pharma and medtech companies, governments, insurers and regulators – all stakeholders, both traditional and new – need to come together with a set of shared objectives.

Unlike traditional alliances that may operate at a more linear level, these ecosystem alliances take a platform-based approach in which information is shared freely and the focus is on outcome rather than output. Outcomes are where the value lies.

As the future moves more toward a pay-for-performance principle, where governments and insurers will only reimburse new technologies and treatments if they can prove their value, producing effective outcomes is critical.

Collaboration, sharing and independently verified data will unlock value

Every day, life sciences companies are making advances in medicine that no one could have imagined even a few years ago. At the same time, governments and insurers are overburdened by spiraling health care costs.

In the meantime, for new technologies and treatments to be successful, proven effectiveness and efficiency need to go hand-in-hand.

Cementing collaborative, platform-based relationships that leverage shared data, establishing smart contracts that mandate the parameters for proven effectiveness, and securing independent data to independently verify the outcomes are steps that life sciences companies can take to position themselves for success. Those who do will be able to unlock the value of their ecosystem to produce measured outcomes that enable people to live healthier, longer lives at a cost that governments and insurers are willing to pay.