December 21, 2017

App Creation and Pharma Barriers

INSIDER’S VIEW OF PHARMA BARRIERS TO APP CREATION

In this post we are looking at the insiders view on app creation and barriers. In a recent interview for Eye for Pharma, Sanofi’s Chief Data Officer, Milind Kamkolkar identified some clear reasons why most pharma apps have generally failed to have much impact.

He argues for well-funded `Digital Centres of Excellence’ within each pharma company. This is so they don’t have to “beg, borrow and steal from different brand teams, franchises or groups.”

Combining his insider insights with what patient groups tell us, there seem to be some fundamental barriers that currently make it challenging for pharma to support and maintain successful apps.

Firstly, little incentive to review and improve an app during its development and life
Secondly, reward and recognition systems that focus individuals on launching an app on time, rather than maintaining it
And thirdly, movement of app sponsors between a company’s brand teams, undermining commitments to keep the app going

Barrier 1: App created without patient input

Too often apps are still created without thorough, ongoing input and review from patient groups. The focus is on usage metrics rather than improving the app.

Milind Kamkolkar paints a bleak picture:

“The brand manager may have changed and the app is floating around in the app store with no one saying, ‘Hang on a second, do users really want to use it this way? What do we need to change to make it a more compelling experience?’ That rarely happens” – Milind Kamkolkar, Chief Data Officer, Sanofi

Barrier 2: Short term rewards

As an insider in the industry, it’s significant that Milind Kamkolkar cites a key reason why brand team support for an app falters. He says that people are still rewarded for creating the app, rather than keeping it working:

“Often, these apps are created to fulfill an objective and advance a person along a career path. So, the objective is met and they’ve got their bonus, but then what? CDOs [Chief Digital Officers] need to work closely with HR to create a plan that incentives people to persist in the world of digital health” – Milind Kamkolkar, Chief Data Officer, Sanofi

This reflects our own experience of brand team behaviour towards apps. In the early days, brand teams wanted apps as part of their marketing activities. These early efforts were often blocked by regulatory departments waiting to see how the industry would establish protective groundrules.

Once apps had become more mainstream, as Kamkolkar implies `digital engagement’ started to be built into team’s objectives, and gain some budget. However, the risk was always short-termism. Companies can move their personnel from one therapy area to another quite regularly. If the app’s sponsor moves the `new person’ may want to do their own thing rather than support someone else’s work. Plus they may not get rewarded for it.

Barrier 3: Commercial deadlines inhibit patient involvement

The time pressures faced by pharma app sponsors are intense. There’s typically a short window of time where drugs make most profit in the therapy area where the app is being developed. Brand teams still are the dominant budget holders. They need to see a fast impact from the app, even where it is unbranded or a `service to medicine’. And as Kamkolkar points out the app’s deadlines may also even hinge on the app sponsors’ own reward and recognition timings.

These time pressures make it harder to involve patient groups effectively in the app’s creation and development. It may help to explain why so few pharma apps gain traction and sustained success.

Barrier 4: Maintaining an app is time-consuming

From a patient perspective, one of the benefits of a pharma-supported app is that it will need regular thorough medical and legal reviews to make sure the information in there is both accurate and up to date. This can be a hugely complex process, particularly if the pharma company is using review software designed for reviewing documents, rather than the messier world of interactivity built into apps. This is on top of the technical updates needed to keep the app functional through waves of updates to operating systems.

Commercially, there may be little benefit or Return On Investment for maintaining a pharma-supported app. At myhealthapps.net, we receive regular complaints when pharma apps are withdrawn, or stop working. There does not seem to be a well-established protocol to warn patients that this is going to happen, which would at least enable the individual to extract or copy any information or data they want to hang on to.

Ironically, the better the app, the more of an impact sudden withdrawal has.

What of the future?

We reported recently on the lack of impact of pharma apps in the market, cited in the report from Deloitte Centre for Health Solutions: `Pharma and the Connected Patient – How Digital Technology is enabling Patient centricity’.

The figures are stark:

Pharma apps accounted for only 5.6 million downloads out of 3.2 billion mhealth apps downloads
Of all pharma app downloads, the 5 most popular apps accounted for 51%

Although the issues Sanofi’s Milind Kamkolkar raises are not new, it is important that pharma is doing an open honesty check about why digital health has for decades now proved so challenging for the industry.

In apps there are clear reasons for these challenges. Who in the company funds the app’s development? How are they rewarded? How are those apps maintained and sustained? Just as pharma failed to fulfil the potential of decades of website years, there is a danger that similar decision-making structures undermine the relevance of pharma apps for patients.

The biggest hurdle remains the business case and vision for each app. How can pharma work more effectively with patient groups to:

Identify and address a genuine, priority unmet need?
Gain a trusted channel to the market for the app?
Differentiate the app from hundreds and thousands available?
Gain practical feedback from patients from the initial concept through to managed withdrawal?

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