What future for AI in healthcare?

otcinaction

One of the chapters in Nicholas Hall’s recently published New Paradigms report, entitled The Digital Revolution, provides some compelling examples of consumer healthcare companies and OTC brands that are thriving in the digital era. While key marketers like GSK were slow to invest in digital, the tide is now turning – in its 2018 annual report, GSK said it had “significantly” increased its advertising spend in online media because it is delivering a “far higher return” than traditional TV – despite continuing reservations from some companies like P&G about the way digital budgets are deployed.

One emerging technology that has an uncertain future in healthcare is artificial intelligence. Back in March, a report published by MMC Ventures (in partnership with Barclays) predicted that AI can “unlock a paradigm shift in healthcare”, particularly in diagnosis, drug discovery and monitoring. According to MMC’s research, health & wellbeing is a “focal point” for AI entrepreneurship – 21% of start-ups serve the sector, more than any other sector – and, over the next decade, “developers will have a greater impact on the future of healthcare than doctors”.

An example of innovation here is L’Oreal’s augmented reality and artificial intelligence entity, ModiFace, which has led to the launch of a consumer digital skin ageing diagnostic tool. Targeting women, its first application is Vichy SkinConsultAI – based on ModiFace’s AI-powered algorithm – launched in Canada in January 2019 and rolling out across the brand’s websites globally over the course of this year.

483580

However, security concerns continue to be the main stumbling block for AI. According to research published in Digital Health last month, public concern about accuracy, cybersecurity and the inability of AI-led chatbots to sympathise may be standing in the way of artificial intelligence’s successful introduction into healthcare.

A University of Westminster-led team surveyed 216 participants on a range of demographic and attitudinal variables including questions about acceptability and perceived effectiveness of AI in healthcare. The results identified three broad themes: “understanding of chatbots”, “AI hesitancy” and “motivations for health chatbots”. The team suggests that designers of AI-led chatbots need to employ user-centred and theory-based approaches to address patient concerns and to optimise user experience in order to achieve the best uptake and utilisation.

Embracing Tech and Digital Health are two of the key themes at our OTC.NewDirections Executive Conference, taking place in London on 14 November 2019! Nicholas Hall will be joined by experts from companies including Bayer, Mundipharma and J&J to review these issues, as well as others impacting our industry, including the status of Medical Cannabis in Europe, Growing Brands through Innovation and the ultimate theme of ensuring that you are Keeping Consumers in the Spotlight. To find out more, or to reserve your place, please contact jennifer.odonnell@NicholasHall.com without delay!

Big Data to democratise healthcare

otcinaction

Another of the Infinity Zones that Nicholas Hall will be exploring in his upcoming New Paradigms report is Big Data. Healthcare is an increasing focus of the global Big 5 tech companies, namely Google, Apple, Facebook, Amazon and Alibaba (with the latter predicted to be the “biggest of all in future” by Nicholas). All of these companies own vast reservoirs of consumer information (“big data”) that can be leveraged to provide targeted advertising and services.

In an interview with CNBC in early 2019, Apple’s CEO Tim Cook said that health will be the company’s “greatest contribution to mankind” and indicated that various services would be rolled out later this year, building on the success of the new ECG-enabled Apple Watch. Over the weekend, it was revealed that Apple has acquired Tueo Health, a California startup developing a smartphone app that works with sensors to detect asthma-related issues in sleeping children and alert the parents or guardians.

Tueo Health

How the Tueo Health app works

In recent years, Apple has also acquired Gliimpse, a startup developing technology to aggregate medical records, and Beddit, a sleep sensor company. Apple sees its mission as “democratising” healthcare by putting its big data in the hands of consumers and empowering individuals to manage their own health via apps and dashboards. Apple’s vast user base gives it an advantage over its tech rivals, and the expected launch of its own medical devices (i.e. hearing aids) and services (i.e. blood glucose monitoring) will expand its healthcare appeal further.

As Nicholas points out, however, privacy concerns continue to plague big data initiatives and European authorities in particular have issued various fines to tech companies for breaching strict new data privacy laws (GDPR). The need for tech companies to process our personal information with ever more sensitivity will become even greater once they have access to healthcare metrics such as our blood pressure, sleep patterns, etc.

Big Data will be one of the key topics in our upcoming report, Nicholas Hall’s New Paradigms for CHC 2019: Over the Horizon, written by Nicholas himself! Examine each aspect of the CHC industry in 20 chapters, with a focus on major issues including Regulation, Pharmacy Point-of-Care, M&A, Switch and much more. Nicholas will also unveil the “infinity zones” he has identified as being crucial to the future growth of the industry. In addition to this, you can upgrade your purchase to include a customised in-house presentation or webinar with Nicholas for an additional GB£10,000. To find out more or to place your order, please contact melissa.lee@NicholasHall.com.

J&J, Sandoz seek digital health breakthroughs

OTCINACTION

Two stories we picked up this past week involve key OTC marketers, J&J and Sandoz (Novartis), and new digital healthcare initiatives. J&J subsidiary Janssen announced it is collaborating with Apple by conducting a multi-year research study investigating whether the Apple Watch can detect the onset of a stroke.

The study, due to begin later this year and tracking people aged 65+, will explore whether using a medication adherence app from J&J, in combination with Apple Watch’s ECG app, helps to accelerate diagnosis of atrial fibrillation (AFib) and improve healthcare outcomes, including the prevention of stroke. Paul Stoffels, J&J’s Chief Scientific Officer, also said: “Based on the insights generated through this research programme, we may be able to develop new ways to detect other health conditions earlier in the future that also exhibit measurable physiological symptoms.”

Screen Shot 2019-01-21 at 11.12.18.png

Sandoz has also just announced the three finalists for its second Sandoz Healthcare Access Challenge (HACk). After receiving 400 digital technology submissions from 80 countries, Sandoz narrowed the finalists down to entries from Uganda, the Netherlands and the USA. Finalists take part in a 4-day “accelerator event” in Austin, Texas in March 2019, working with Sandoz to refine their ideas into scalable solutions ahead of final judging. The three finalists are as follows:

  1. Uganda: The Mobile Clinic plans to develop an app that can be used to make emergency appointments via a toll-free number and will be directly linked to a mobile van clinic offering door-to-door services in rural areas.
  2. USA: Regulora is in development as a prescription-only digital therapeutic for IBS based on Gut Directed Hypnotherapy. The mobile app connects patients with automated digital therapy sessions from the comfort of their own home.
  3. Netherlands: Social Genomics is building an AI-based smart social network, enabling people with rare and undiagnosed diseases to connect and share stories, providing access to global real-world patient data insights about treatment options and scientific research.

Explore How Digital is Changing People’s Relationship with Health from Milena Leone, Head of Innovation and Digital Consumer Healthcare, Sanofi at Nicholas Hall’s 30th European CHC Conference in Vienna on 2-4 April 2019. Nicholas Hall will be also be joined by speakers from GSK, HRA Pharma and Prohibition Partners among many others to ensure that you are Keeping Up with the Digital Consumer. The meeting will also feature a workshop from The CHC Training Academy, enabling you to Embrace Digital Transformation. Book before 4 February and save up to GB£300 with our early bird discounts. To find out more, please contact Elizabeth.Bernos@NicholasHall.com.

App Store trend of 2018: Self-care

OTCINACTION

Apple’s distribution platform for mobile apps, the App Store, recently selected self-care as its trend of the year. Wellness apps designed to encourage healthy habits, improve sleep, reduce anxiety and increase mindfulness have been the major trend on the iOS platform over the past year, according to Apple.

Fittingly, one of these popular apps is called #SelfCare, launched by TRU LUV Media in summer 2018. Designed like a game, the app promotes emotional wellbeing via breathing exercises and other small acts of self-care. Another is called Shine – Self-Care & Meditation, which delivers free daily motivational messages, 5-minute affirmations and meditations, plus tips on how to reduce stress, improve sleep and increase focus.

BO_CA_DeveloperMarketingTrends_SelfCare_SelfCare_1300x740.jpg

The popularity of such apps is good news for OTC marketers, especially those operating in lifestyle and VMS categories that focus on mental wellbeing, i.e. sedatives & sleep aids and herbal memory & brain health. Apple noted that apps for physical health, such as those that track calories and steps, have long been popular with iOS users, but emphasised that this trend towards apps for mental health is a new phenomenon.

That said, what may be somewhat concerning to OTC marketers is that this evolving definition of self-care doesn’t appear to include self-medication. While OTC New Products Tracker lists medical device launches in 2018 that incorporate an accompanying app – such as Nokia Sleep and Natural Cycles, the latter designed to aid conception – supplements or drugs backed by a mobile app are much thinner on the ground.

Review the latest new products hitting the CHC market with OTC New Products Tracker, the ideal competitive intelligence tool. We recently unveiled a major update, with eye-catching new graphs and powerful search filters that help you visualise and explore the vast archive according to your exact requirements. To trial the updated database or for a demo, please contact waisan.lee-gabell@NicholasHall.com

 

Alibaba buys in to “digital silk road” vision

OTCINACTION

According to a report in the FT over the weekend, Chinese e-commerce retailer Alibaba is close to agreeing a deal with Russian internet company, Mail.ru, and sovereign wealth fund, Russian Direct Investment Fund, to form a joint-venture e-commerce company.

As highlighted in our earlier blog on Chinese investment in Africa, there is a clear vision from China and Chinese companies to invest in the physical infrastructure for a new silk road (Beijing’s Belt & Road Initiative) connecting Asia, the Middle East and Europe, and this latest news on a China-Russia e-commerce tie-up underlines the appetite for a digital silk road too.

Alibaba-mail.ru.jpg

In October 2017, the Russian Government approved a Ministry of Health bill to allow the online purchase and home delivery of OTCs, which came into force in January 2018. As a result, Mail.ru announced the launch of its online pharmacy in April 2018. At present, established western e-commerce giants like Amazon are largely absent from Russia, giving Alibaba the freedom to chart new territory in a market of 147mn consumers at an opportune time.

As the FT article points out, Alibaba is also fighting back against Amazon in certain markets, like Indonesia, where the US retail giant has stolen a march. For example, Alibaba has invested heavily in two e-commerce companies, Tokopedia and Lazada, both of which market goods, including healthcare products, across southeast Asia.

Explore the digital landscape at Nicholas Hall’s upcoming OTC.NewDirections Executive Conference. Other topics on the agenda include Medical Device Regulations, Medical Cannabis, Switch and Smart Probiotics. This will be an inspiring day on 12 September in London, focusing on Where Innovation Meets Regulation. For details of the full agenda or to reserve your place contact elizabeth.bernos@NicholasHall.com

E-commerce: Amazon picks up PillPack

OTCINACTION

Amazon’s latest foray into the healthcare sector – a definitive agreement to acquire US online pharmacy, PillPack – has huge disruptive potential for the traditional drugstore pharmacy sector. A start-up founded in 2013, PillPack is licensed in 49 US states to offer pre-sorted doses of medications, coordinate refills and renewals, and ensure timely home delivery to customers. Financial terms of the deal were not revealed, but the transaction is expected to close during Q2 2018, subject to regulatory approvals and other customary closing conditions.

Walmart was rumoured to be interested in acquiring PillPack earlier this year, and the company lost US$3bn in market capitalisation after the Amazon deal was announced on Thursday 28th June. The two companies are now locked in an intense global rivalry, with Walmart coming out on top in India after acquiring a 77% stake in Flipkart in May 2018. Such huge M&A investments will advance e-commerce’s share of the pharmaceuticals market in key markets like India and the US, with the potential to revolutionise the consumer healthcare sector too.

meta-pillpack-image-9e4a388dae.jpg

PillPack is currently a small operation, expected to post revenue of US$100mn this year, but Amazon’s existing customer base and shipping infrastructure could allow it to quickly scale up. Brick & mortar pharmacy chains are already seeing the consequences of the deal; as the news broke, shares in Rite Aid fell 11%, Walgreens Boots Alliance 9.9% and CVS Health 6.1%, a collective US$11bn in market value.

Though consumers in many markets remain hugely reliant on pharmacist advice when making OTC purchases, there’s no doubt that price is a very sensitive area that makes traditional brick & mortar retailers vulnerable in this evolving retail landscape. Certain OTC categories where there is a strong wellness or personal care element, such as VMS and dermatologicals, are most likely to see a significant rise in e-commerce sales.

E-commerce, as well as OTC adjacencies and digital health, are three of the hot topic areas that OTC DASHBOARD will be focusing on this year, in its weekly briefings, infographics and blogs. For a free trial of the service, please contact hannah.burke@nicholashall.com

AESGP meeting 2018: Key learnings

OTCINACTION

OTC INSIGHT Europe Editor Sarah Carter reports back from this year’s 54th AESGP Annual Meeting, which was held in Amsterdam and served as a farewell to Dr Hubertus Cranz, who retired as Director General after 30 years in the role.

Below are 8 key learnings from the meeting:

  1. Representatives from Pfizer and Hexal / Sandoz demonstrated how Rx-to-OTC switch can act as a growth driver for the consumer healthcare industry, with Nexium Control (EU Centralised Switch) and MometaHexal (Germany) given as case studies. Both asserted that the Rx heritage of the brands was instrumental in their successful switch, with both market leaders in their respective Rx spheres.
  2. However, while switch offers growth opportunities, several speakers stressed that the limited 1-year data exclusivity available with a switched product in the EU can deter marketers from making the timely and costly investment needed to switch their product.
  3. Digitalisation has transformed the rules of the healthcare industry and education. According to Google, search engines and online videos are the most important touch points for OTC purchasers, with one in 20 searches on Google related to health. In 2017, there were 40bn healthcare queries in EMEA alone.
  4. The global volume of healthcare data doubles every 18 months. It is crucial that we build trust with consumers regarding Big Data, ensuring that our industry uses this in a responsible manner, particularly salient given the introduction of the EU’s General Data Protection Regulation on 25 May 2018.
  5. Low levels of health literacy act as a barrier to self-care. We must empower consumers with the tools and knowledge necessary to play an active role in their health management, healthy ageing and prevention. Healthcare systems need conscious individuals who actively pursue a healthy lifestyle, and seek HCP advice where necessary.
  6. Technology such as wearables and apps has helped to raise health awareness and engagement among consumers, driving the trend for wellness and encouraging people to become key actors in their health management. In the industry, we see increasing purchases of long-term preventive products, rather than OTC treatments.
  7. It is vital that we understand the consumer at a much deeper level than we have done historically, as they no longer want to be sold to, but engaged with. The advent of Big Data and AI deliver us new tools to generate insights and ultimately create more meaningful connections and stronger relationships.
  8. There is little to report on regulations — still no decision on botanicals, and no real update on medical device regulations.

Only two weeks to go until the annual North American OTC Conference! Hosted by Nicholas Hall and Everything Health in Morristown, New Jersey, 20-21 June, this highly-anticipated meeting will review crucial topics impacting the competitive landscape around the central theme of The Future of Consumer Self-care: New OTC Solutions. With topics on the agenda including the e-commerce revolution, a presentation on “Magical Marketing in Healthcare” from Google and a look at the industry’s ‘Switch wish list’, this promises to be an event you can’t afford to miss. To receive a copy of the full meeting agenda or to reserve your place now, contact lianne.hill@NicholasHall.com

World first digital pill gets FDA green light

OTCINACTION

Otsuka (in association with Proteus Digital Health) has been granted approval by the US FDA for Abilify MyCite, the world’s first digital pill, which contains a sensor that tracks when the medicine has been ingested by the patient. Though Abilify is an Rx medicine for schizophrenia and bipolar disorder, its approval has far-reaching implications for both prescription drugs and consumer healthcare.

How it works: Containing a sensor the size of a grain of sand, Abilify MyCite emits an electrical signal when it comes into contact with stomach acid, and this signal is received by a patch on the patient’s rib cage. In turn, this patch communicates with a smartphone app via Bluetooth, providing data such as time of ingestion and dosage. As well as the doctor and patient, up to 4 other people (including family members) can have access to the app’s data – though, importantly, the patient has control and can revoke access.

 

Mitchell Mathis, Director of the Division of Psychiatry Products at the FDA’s Center for Drug Evaluation & Research, said: “The FDA supports the development and use of new technology in prescription drugs and is committed to working with companies to understand how technology might benefit patients and prescribers.” Inevitably, during the initial phase, the digital pill will be incorporated solely into Rx medicines – to allow the FDA to monitor its impact on safety and adherence – however, at a later date, there is nothing to stop this new technology being part of innovative Rx-to-OTC switches.

Patients, doctors and insurers are increasingly coming to appreciate the ability to access objective data about the whole range of our medical consumption – from Rx drugs to OTCs and supplements. Once the price of these new sensors is reduced to a certain level of affordability, we could see a much wider rollout of the technology.

That said, a major stumbling block could be the issue of privacy. Some are concerned that patients who fail to take their medicines on a regular basis may be punished by their health insurers, while others have worries that the technology could be used as a coercive tool against certain types of patients. However, those concerns aside, the future for healthcare looks increasingly digital and the FDA is already hiring more staff in anticipation of a raft of new applications for digital pills.

FDA permits marketing of first mobile medical app

USA’s Food & Drug Administration has permitted marketing of the first mobile medical application to help treat substance use disorders (SUD). It is planned that the reSET application, to be marketed by Pear Therapeutics, will be used with outpatient therapy to treat alcohol, cocaine, marijuana and stimulant SUDs but will not treat opioid dependence.

The reSET device was reviewed through the de novo premarket review pathway, a regulatory pathway for some low to moderate-risk devices that are novel and for which there is no legally marketed predicate device to which the device can claim substantial equivalence.

Carlos Peña, Director of the Division of Neurological & Physical Medicine Devices at the FDA’s Centre for Devices & Radiological Health commented: “This is an example of how innovative digital technologies can help provide patients access to additional tools during their treatment.” Peña continued, “More therapy tools means a greater potential to help improve outcomes, including abstinence, for patients with substance use disorder.”

Screen Shot 2017-09-14 at 3.16.41 PM

The reSET device is a mobile medical app containing a patient application and clinician dashboard. The device delivers cognitive behavioural therapy to patients to teach the user skills that aid in the treatment of SUD and are intended to increase abstinence from substance abuse and increase retention in outpatient therapy programmes.

The FDA reviewed data from a multi-site, unblinded 12-week clinical trial of 399 patients who received either standard treatment or standard treatment with the addition of a desktop-based version of reSET which could be accessed at the clinic or at home. The data showed a statistically significant increase in adherence to abstinence for the patients with alcohol, cocaine, marijuana and stimulant SUD in those who used reSET (40.3%) compared to the patients who did not (17.6%).

The reSET device is indicated as a prescription-only adjunct treatment for patients with SUD who are not currently on opioid replacement therapy, who do not abuse alcohol solely, or whose primary substance of abuse is not opioids.

App “as effective as the contraceptive pill”

A revolutionary form of contraception, especially available over-the-counter, has been long awaited. This year alone we have seen trials in male contraceptive injections and demands for numerous OTC contraceptive pills. Drastic change and action have long been in high demand.

What started out as a hobby project for Elina Berglund Scherwitzl has now become approved as the world’s first contraceptive app. The nuclear physicist, who had been working on the team that discovered the Higgs boson, felt finished with hormonal contraceptives and their physical and mental pitfalls, but was not yet ready to have a baby.

With a wealth of data skills, Elina was determined to find an alternative form of contraception. “Like many women I had tried many different contraception options since my teenage years and hadn’t really found a solution that fit me,” she explained. “It was in my quest for an effective natural alternative that I discovered that you can see when you’re fertile by your temperature, and for me that was really a revelation.”

Using complex mathematics and data analysis, Elina began developing an algorithm designed to be so accurate that it could identify exactly when in her cycle she would ovulate. This then enabled planning for when she would need to use protection, to a much higher degree of certainty than natural planning methods, which many women with timely periods are able to use.

These results proved to be so accurate that, together with her husband, fellow physicist, Raoul Scherwitzl, Elina set about founding her own business, Natural Cycles.

natural-cycles-contraception-app-2017-02-09-01.JPG

Natural Cycles is an app designed to help women around the world with their fertility and contraception needs, allowing them to collect their own temperature datasets and closely monitor their cycle trends in the process.

Launched in 2014, the app now has some 300,000 users, who pay a monthly or annual fee for the service. Following several medical trials, the app became the first tech-based device on the planet to be formally certified for use as contraception, in February this year. It gained approval for use across the EU after getting the green light from the German inspection and certification organisation Tuv Sud.

The start-up now markets itself as being “as effective as the pill” following one of the largest clinical studies in contraception involving more than 4,000 women, published in the peer-reviewed European Journal of Contraception and Reproductive Health Care.

The researchers, which included the co-founding couple, found that 7% of women who used the app in a “typical” way (allowing for some human error) got pregnant, compared to 9% taking the pill and less than 1% using IUD coils. “Just like the pill we need some effort from the user on a daily basis. But we really hope to be the default alternative if you don’t want to use hormonal contraception or IUDs,” Elina commented.

While the product is only currently certified in the EU, where its users are concentrated in the UK and the Nordics, it is available worldwide and, despite its earlier controversies, has attracted users in some 160 countries.