Postcard from the future: How biopharma can collaborate to reduce chronic disease

Imagine a world where we could tackle the burden of a chronic disease and protect future generations from developing it.

Imagine a world where a collaboration of players from healthcare, education and local communities takes on this challenge.

Does this scenario sound idealistic? Or does it have potential to change how we look at healthcare as a whole? Here’s one example of how it might play out:

A collaborative led by a leading pharmaceutical manufacturer and partners in medical device technology, consumer technology, behavioral science and early childhood education approaches local government and community partners to take on the challenge of improving care outcomes for those currently living with obesity and Type 2 diabetes (T2D) to reduce future incidence of both.

Their program is two-pronged:

• Outreach to those currently living with obesity and T2D: The collaborative analyzes available health system and socioeconomic data and combines it with physician, patient, educator and employer research to understand the journeys of thousands of patients. They identify the drivers of outcomes, such as nutrition and eating habits, socioeconomic factors and engagement with the health system, as well as available treatments. From there they co-design interventions that combine behavioral and environmental nudges, technology and medication. They test these interventions with small groups of patients at first and adjust their approaches based on what they learn in the field. Then they roll out refined approaches at scale via primary care physicians, pharmacists and other players outside the healthcare system.
• Disease prevention within the community: The collaborative also works with local schools to make changes across all age groups to allow for daily nutritional and physical education, shaping personal behaviors with the goal of preventing future disease. It also partners to redesign and subsidize school lunch programs and sponsor health-oriented competitions across schools.
  

After three years, program metrics show benefits for both the community and the collaborative. The T2D population exhibits improvement in metrics such as improved HbA1c averages, reduced BMI across adults, reduced cost per patient and reduced total system costs across the adult population. Reduced rates of obesity in children and a reduction of national sales of cigarettes, sugary drinks and fast food are also positive indicators. The biopharma manufacturer sees increased market share of its medicines compared to its competitors, and it is also able to leverage its relationships developed through partnerships into new ventures. The medical device partners benefit from increased market share of digital health tools. Other partners generate revenue from consulting and service fees.

This scenario is fiction, but it’s closer to reality than you might think. In the near future, prevention initiatives like this could become much more common. Biopharma can play a leading role. Here’s why:

• Aligned missions:  Biopharma manufacturers are beginning to focus on improving lives and reinventing healthcare through an increased focus on outcomes. Delivering on this mission requires a new approach.
• A focus on health equity: The pandemic has put a spotlight on issues including awareness of racial disparities in healthcare, lack of access to care and social drivers of health that affect outcomes.
• Doing well while doing good: The traditional paths to financial success (developing new blockbuster drugs, for example) are no longer reliable. Biopharma companies have an opportunity to build from a position of strength to begin a reinvention before being further disrupted.
  

Working in partnership across the industry and with a relentless focus on holistic individual and population health outcomes, biopharma can ensure that it is at the center of delivering the type of impact described here. Biopharma companies can expand their role from being a provider of medicine to influencing the prevention of disease and improving care. 

To do this, biopharma will need to create value in three spaces: preventing disease, improving access and equity, and focusing on breakthrough treatments and cures.

Preventing disease: With their scientific capabilities, global reach and strong stakeholder relationships, biopharma is well positioned to play and succeed in this space. As in our scenario, companies are already partnering at the community level on projects to prevent or manage disease. For example, Novo Nordisk’s Cities Changing Diabetes program has connected more than 40 cities with 150 partners to address the systemic issues underlying obesity and T2D. The partnership piece is key: As they become better partners, companies will also increase their capabilities to improve lives and become more interconnected in the healthcare system.

Improving access and equity: In many cases, treatments for illness are established and well understood, but there are bigger systemic barriers to improving outcomes. We know that certain groups experience an increased incidence of chronic disease as a result of social drivers of health like environmental factors, race, ethnicity and income, mental health or health literacy. How can we create a more connected healthcare system that engages more people? A focus on this question, along with collaboration across the industry, can have a profound impact. A number of companies, such as Eli Lilly, Pfizer, Johnson & Johnson and Bristol Myers Squibb are funding programs through local organizations to address disparities in underserved communities. We expect to see more of these initiatives in the future.

Focusing on breakthrough treatment and cures: While initiatives like prevention and health equity focus on helping transform healthcare, the way biopharma does business will have to change as well. There’s no doubt that biopharma will continue to focus on high-impact treatments and cures, and this work will continue to be rewarded. While the core R&D engine of biopharma will continue to develop new medicines, leading companies can harness their current capabilities to develop new ones in aspects of science that will help ensure that—in practice—their assets have true, large-scale patient and health system impact. This means changes like investing outside of the traditional realm to expand into biomedical, behavioral and implementation sciences, and digital therapeutics. Biopharma should also consider investing in areas of great need and modernizing processes and pipelines to get to market faster. Biopharma leaders tell us that these changes to strategy and portfolio are on their radar.

To successfully pursue an agenda focused on prevention, improving care and innovating in core assets, biopharma will need to build some additional competencies:

• Strengthening its understanding of health systems and payers. A better understanding of health system priorities, investments and aspirations will help manufacturers develop valuable partnerships, from research to development and commercialization. For example, in the future companies could co-develop an asset based on system needs and co-implement it through development and launch.
• Strengthening its partnering capabilities. Multistakeholder partnerships will be key to delivering transformational impact. Biopharma manufacturers are well situated to build partnerships around the world—with technology companies, other life sciences manufacturers, data companies and nontraditional partners like schools, employers and local governments to deliver holistic solutions from prevention to care and cure.
• Re-envisioning and piloting new business models. There are many ways biopharma can find and create value, but they must step away from business models that are solely based on selling medicines. Services agreements, co-development arrangements and long-term population outcome agreements are just a few possible pieces of future revenue models. The old mindset was “The system doesn’t allow it.” But a more modern approach is “Let’s create holistic solutions of such compelling value that the system will collaborate with us to make them work.”
  

Think back to our opening scenario. It’s not far away. TD2 is a starting place, but it’s only the beginning. Already companies are coming together to envision, partner and pilot to improve health, elevate outcomes and create better healthcare for all. A future where we’ve conquered even one chronic disease is worth the effort it will take to get there.