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Are you ready for ‘digital medicine’?

I’m prompted this week by an article in the Huffington Post by Peter Hames the CEO of Big Health, referring to the concept of ‘digital medicine’.

digital medicine mhealth

So what exactly is ‘digital medicine’?

The term ‘digital medicine’ has been coined to convey the concept of digital and mobile health technologies which actually provide a therapeutic intervention (rather than simply monitoring or educating, as has often been the case so far).

Hames and Big Health have created a Cognitive Behavioural Therapy service for sleep disorder called Sleepio, delivered via web and mobile. In a randomised control trial quoted on their website, they say “the Sleepio course helped around 75% of people with persistent sleep problems to improve their sleep to healthy levels…we found an average reduction in time taken to fall asleep of 50% and in time spent awake during the night of 60% within the Sleepio group.” This seems an impressive set of results for patients who otherwise may have had to resort to the typical remedy of sleeping pills. Who wouldn’t want to avoid the potential side-effects of a drug if they could simply follow some digital coaching?

The concept of digital medicine has also been referred to by Proteus Digital Health, creators of the ‘smart pill’ which combines with a body sensor to transmit your adherence to medicine along with some vital signs in real-time via your phone. Initially Proteus’ business model seemed to be to combine the smart pill with premium-priced medicines to provide a high-value adherence reporting capability – important since it’s estimated that 50% of medicines are not taken as prescribed. However, they seem to have pivoted their business model more recently, combining their high-tech approach with cheap generic pills to create a whole new product they class as ‘digital medicine’. The idea is that combining a cheap generic with high-quality digital support will be more effective and cheaper in the long-term than a high-priced medicine which half the patients aren’t taking.

And in slightly different language to describe the same concept, Welldoc® call their Bluestar™ prescription-only service for type 2 diabetes (based on a phone app) “Mobile Prescription Therapy” . In their studies so far the average A1c reduction is 1.9% – for a typical drug like metformin the reduction would be more typically 1.1%. Indeed, I’ve heard anecdotally that some doctors have been able to take type 2 diabetics off their medication and rely solely on the Bluestar™ service.

Time to stop popping pills?

All of these have one thing in common – they disrupt the traditional pill-prescribing paradigm, by removing the need for pills altogether (in the case of Sleepio and Welldoc), or by placing less emphasis on premium-priced pills (in the case of Proteus). This is classic product substitution in Porter’s Five Forces terminology – and it’s very threatening as they’re replacing some of the most widely-prescribed drugs today.

Now you may think that some of these claims are a little over-hyped – but all of these companies have assembled persuasive clinical evidence. If I was a pharmaceutical company, or a shareholder, I’d be somewhat concerned. For the rest of us, expect to hear a lot more about ‘digital medicine’ in the years to come.

What do you think about a future where digital medicine becomes the norm? Exciting or scary? I’d love to hear your thoughts, or you can always contact me.

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