I will use this space to give an overview of the talk I did at experiMental at UCSF on November 3rd. I was invited to give an overview of how MentalPharma, those pharmas engaged in the mental/behavioral health space, are engaging the digital mental health space, to develop digital therapeutics that are strategic complements to their current businesses.
My research for and the resultant talk turned up interesting insights as you can imagine.
- Pharma fleeing mental health, or just transitioning? I had the impression based on numerous readings and discussions over the last two years that pharma is fleeing psych and there is some truth to this as an article I came across by Dr. Nicola Davies (https://www.thepharmaletter.com/article/the-path-to-pharma-psych-innovation) who cites a statistic from NI Research, that “investment in psychopharmacological drugs has declined by 70% in the last 10 years”, owing to cost cutting and strategic refocusing, especially in neuroscience. Reading further I came to see that pharma is not so much fleeing as restaging. The fact is that pharma remains in engaged in areas of translational research improvements and drug therapy tech augmentation.
- In my research, I found Janssen (Johnson & Johnson), Lundbeck and Otsuka to be the most active pharma in the digital mental health space with applications which span across their value chains from clinical trials to genomic assessment to diagnosis to treatment to care & wellness management, and even of caregivers.
- Manufacturer, provider organization, and even non-profit, partnership is evident in this space as seen with Lundbeck work in major depression, where they have partnered with Takeda Pharma and Advocate Healthcare (System). Such partnerships signal the value of cross-disciplinary collaboration that allows different ecosystem players to make up “smart & resource gaps” each suffers with when working on this space unilaterally.
- FDA approved drug+device+sensor labels are emerging with the approvals of Abilify MyCite (Otsuka + Proteus Digital Health) and Pear Tx ReSet (Pear Tx + Novartis), and various other pending approvals between pharma and Pear Tx, Click Tx and Akili, among others. As these approvals become more prevalent, the next challenge is to gain reimbursement and clinical adoption.
- Wearables and ingestibles are prevalent as trackers and data gatherers in many cases like with Sunovion’s use of seizure detection wearable, empatica, in its clinical trials, Otsuka collaboration with Proteus Digital Health (Abilify MyCite) which involves ingestible sensors in the course of treatment & care, and Takeda’s use of the Apple SmartWatch in clinical trials. Other modalities used in pharma DMH plays include apps, games, algorithms and care management platforms.
- Population segmentation with Otsuka Mentrics is a stand out , as it integrates data across system silos to identify high-utilization populations that exact an above-index cost on the system owing to the system losing track of them, or lacking line of sight and insight into how these populations can be better served to yield improved outcomes. What I especially like about this play is its focus on population health, not just drug commercialization.
- Not only customer, but employee, wellness is seen in how Genentech has partnered with HeadSpace for employee wellness programming and this is far from the only play of this sort happening as companies increasingly acknowledge the benefit of supporting wellness in the interest of worker productivity and avoided care cost.
- Other notable mentions include
a) care4today, a suite of Janssen care apps which has a mental health version and is an example of a nice strategic adjacencies leveraging already existing programs, a point that more pharma and digital mental health partnership leaders can take to heart
b) wellby, a Japanese mobile health play, that Janssen partnered with to customize its offering for the Japanese market, a nice indigenization play, again a point for consideration as mentalpharma expands its digital therapeutics work beyond the West to the Global East and South.
All and all, we can see that pharma is quite active in the digital mental health space, and in a variety of ways that even go beyond its core drug commercialization mandate. I think we can expect to see this activity grow as the industry becomes more accountable for real world evidence measured outcomes and needs to provide value-added differentiation which justifies system investment in its products and services.
The deck I presented at experiMental is available on request in exchange for your sparing 8 minutes to complete our digital stress management survey. Additionally, I will share the results from the first wave of this survey completed earlier in 2018.