By Tram Trinh

Bayer announced a new global head for digital health and finished its 3rd accelerator batch. Merck has officially doubled the size of its venture unit and is launching its 3rd accelerator batch in 2017. Many ‘big pharma’companies including Roche, Pfizer and Takeda have started to reach out to the startup world, attending most of the key European digital health events (Health 2.0, ECHAlliance, FT healthcare, Frontiers Health etc.). Not surprisingly, these initiatives created a flow of digital health entrepreneurs rushing towards partnerships with the big pharma companies in hope to engage with a potential exit candidate.

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Pilot-isis – a typical infection of the pharma companies

Nevertheless the path to exit with a big pharma can be a daunting journey that can last a minimum of 2-3 years. Like any big corporations, they are huge organizations. Disseminating new digital health products across a base of a minimum of 100,000 employees (scattered around the globe) is a serious long-term effort that requires a lot of attention and time.

One of the major pitfalls a startup can fall into are pilots that end up getting stuck in one country/division/function and never scale globally. For example, if startups knock at the marketing door, chances are that their job priority in an affiliate or region is to launch a drug and deliver targeted numbers. Their focus is miles away from scaling up a newly experimented digital health innovation, often perceived merely as an add-on to their drug-selling business model (unless it’s an app that can be used immediately as a marketing channel to support drug branding).

“There is some unavoidable investment time”, says Fredrik Debong, co-founder of mySugr, a startup focused around diabetes. “It is important to define and agree on the KPIs with your C-level pharma contacts right from the start and maintain an up-to-date discussions you will most likely shorten the timeline.” If you start the relationship with no incentives for the pharma management to drive a project with vague uncertain envisioned results, you can be guaranteed your pilot remains a pilot for a long time.”

One success of mySugr with Novo Nordisk relies on the clarity of the promise from the start: educating the market fast based on a trusted loyal base of patients. MySugr B2C model represents a recurring loyal user base of close to 1 million patients. And recent news proved it right: Swiss Pharma € 50 bn Roche acquired MySugr in June 2017 at an estimated € 70-80  Million sale prices to advance with MySugr Roche’s own digital strategy on the diabetes market.

Medtech – alternative gate way to the health care system?

However, with medtech it appears that pilots are not needed and the timeframe between the date of initial discussions to rolling out the digital health solution can go down to 6 months, as demonstrated by mySugr in partnering with Roche. Traditional medtechs are currently in transition: they must adapt to several metrics shifts in reimbursement regulation, consumer empowerment, digital enablement and their competitive landscape. As a result they are opening up faster to increasing partnerships with the digital health startup ecosystem. Here are the 7 driving factors:

1)   New European MDR Medical Device Regulation

The 5th April 2017 EU Medical Devices Regulation requires more information transparency to consumers, vigilance and market surveillance, safety and reliability in medical devices. This is leading to portfolio rationalization at medtechs and represents an urgent incentive to invest “in new capabilities such as data analytics” EY 2016 medical technology report

2)   Shrinking revenues, pricing pressure from influential payers and hospital systems, in European socialized markets

This has forced medtechs to co-develop and partner with tech companies outside of their traditional boundaries to deliver shared-risk and value-based outcome to payers and patients. Omar Ishrak, CEO Medtronic, at JP Morgan Health Care Conference January 2016 already mentioned his “New Partnerships and Business Models based on Joint Accountability”. A few months later, Medtronic partnered with the digital brain of IBM Watson to improve diabetes treatments.

3)   Data as a common language

Christian Krey, CEO of Emperra, explains to us that “Medtech companies in our ecosystem have always been familiar with creating and using data for patients’ benefit. They understand the value of data and how to use and combine them to find new business models. Most Pharma companies still see their future in selling molecules, having a longer way to data-driven business models. For a digital health startup a partnership with a medtech company will leverage both partners.

patient centered care

4)   A “patient-centric offer” as the baseline

between medtechs and digital health startups, says Gabriel Enczmann, Director Business Development at mySugr. “They are both allowed to market and speak to patients directly while pharma is highly regulated on what can be said or not said about their product to patients “

5)   Moving “beyond the product“ into long-term Integrated health solutions.

Andreas Joehle, CEO & Chairman of the board of directors at Hartmann, stipulates clearly that his industry must re-think healthcare to create sustainable solutions: “we need to drop individual agendas and have an open-minded conversation about how to make real improvements. This needs to involve stakeholders from the entire healthcare value chain, as well as having people from outside the industry to bring new perspectives”. “Mobile apps have quickly established themselves on the healthcare scene and can help monitor everything from blood sugar levels to heart rates and cholesterol levels”

At Frontiers Health 2016, Dierk Beyer, Partner and co-founder of TransAct Advisory who see real-life digital health exit transactions confirms “If you combine a gadget with an IT platform, this can be interesting for both Medtech and startups. The links to disease monitoring represents a tremendous value to Medtech”

6)   The unique value of proximity and relationships built by startups with their end-users

Pritt Krus, CEO of Dermtest, from Estonia emphasizes how relationships catalyze sound  discussions: “As a digital health startup employing software and hardware solutions we have several potential cooperation points; yet quite often the extent and relevance of cooperation possibilities become clear only after a good relationship has been established with our main stakeholders first – doctors and patients – and there is initial traction with the service.”

This growing loyal community of doctors is what Touch Surgery, founded by CEO MD Jean Nehme, succeeded in building. Its cutting-edge surgery simulation app helps surgeons train ahead of complicated surgery procedures, or to familiarize themselves with new surgical procedures. Jean highlights that “The key to startup success is the ability to articulate the “new” and the “old” way in the startup “pain killer” value proposition to your Medtech partner. The winning agreement between both sides lies somewhere between the new disruptive way and the traditional model looking at long-term and existing practice”, which Touch Surgery did with J&J Ethicon, Stryker, Smith& Nephew and Zimmer to name just a few.

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7)   Medtechs and Digital Health Startups are ready from both an organizational and investment perspective to build strategic collaborations

Creating a global and local synergy in the partnerships

As Gabriel Enczemann from mySugr reveals, their successful startup approach has been on two levels as they are expanding from Austria, to the US, Germany, Italy, Belgium and Canada with the big Medtech Roche Diabetes. Speaking with champions and affiliates from two continents did help them build a global offering service that includes as well ready-to-pick options for country affiliates.

Synergy between startup R&D and medtech Regulatory know-how

“Partnering for a startup with a big medical device organization is like having an external regulatory department, and the startup is like the medical device organization’s innovation External lab” says Frederic Lordachs, co-founder and partner at Doctoralia from Spain.

One thing is sure: Roche’s acquisition of MySugr predicts further digital health acquisitions by Life Sciences companies, increased digital health valuations and investor interests. What digital health startups have recently built with Medtech companies will pay off in a shorter timeframe.

tram

About the author
Tram Trinh combines executive entrepreneurial and corporate health tech industry experience, as well as non-executive roles across Fortune 500, Privately-held Medium-Sized Business to Not-For-Profit organizations. She has lived and worked worldwide and founded VITANLINK to bring societal impact, co-founding and co-developing ventures in Medical Devices & Diagnostics | Telemedicine | Digital Health-eHealth | Artificial Intelligence

Picture sources
https://medtechboston.medstro.com/blog/2015/02/23/massachusetts-bets-on-digital-health https://www.healthcare-informatics.com/blogs/rajiv-leventhal/are-consumers-ready-patient-centric-healthcare
http://www.kpcb.com/blog/six-truths-digital-health-entrepreneurs-need-to-know

As a person who has had diabetes for 17 years, I am convinced that there is a way for people with this disease to live a happy and healthy life. However, we have to learn how to manage the disease in order to enjoy our time with family and friends.  Supervision of diabetes might seem hard, but, luckily for us, we have advanced smartphone technologies at our disposal.  There is plenty of different applications that help people with diabetes control the level of glucose in blood, set reminders for medication and doctor appointments or get information about healthy products.  I will share my experience with two popular applications – Glucose Buddy and Mysugr – in this blog post.

Glucose buddy

I have always been searching for an application that is functional and does not require additional apps in order to be able to control diabetes.  If you are searching for the same and you stumbled upon Glucose Buddy – you can keep searching further. This application certainly doesn’t live up to my expectations.

1_GB_Dashboard  The first thing that catches the eye immediately after opening the main page is the poor interface of the program. It seems as if the developers of the app did not put any effort into its layout and design.  It just looks bleak and boring. But nevertheless, I decided to give it a chance to prove itself as an effective tool in dealing with diabetes. After I have tested it, my worst fears were justified: The application was not of any use to me. I have encountered so many complications while using it, that I was really happy to delete it after testing. The most significant drawback was the inconvenience of data entry. I had to create an individual log for every product that I ate, for any kind of activity that I did and for every medication that I took (which may sound easy, but try spending the whole evening typing in every piece of bread you ate and you will understand me). I can’t even start explaining how hard it is to analyse all the data afterwards! After you are finished with creating thousands of new logs, you end up with a mixture of stuff showing what you did or ate throughout the day on one single log page without any order. You also don’t have an opportunity to edit the logs and the only possib ility to analyse the data is with graphs.

1_GB_Log_2

But the graphs are another sad story. First of all, the numbers on the graph are so small that it is impossible to see anything at all (considering that diabetics often have eye sight problems, this is something that is impossible to ignore). The option of zooming in and out is not available. Secondly, the graph does not show the exact time when I had high or low blood glucose levels. This information is kept on the log list, but only the information from the graph can be sent to the doctor. In that case, how can a doctor help you regulate your insulin dosage if he doesn’t even know when problems with hyper- or hypoglycemia occured? It would be more convenient to show the data with the time references because that helps patients and doctors understand how blood glucose functions during the day and help manage insulin dosage according to time.

Mysugr companion

If you like cute little monsters then you sure need to download Mysugr companion! But seriously, it is not only about the diabetes monster but about the program`s interface that I really enjoyed. I give this app 5 out of 5 points just because it doesn’t make me feel like a totally sick person when I am using it. The goal of the whole game is to tame the giggling diabetes monster by creating new logs for each day, filling out information about your diabetes measurements that you took throughout the day and receiving points for them.

2_Mysugr_1   2_Mysugr_2The first positive thing I noticed was that when you enter a blood glucose level, it indicates if it is too high or too low by marking it with an appropriate colour, so I could immediately see that something is wrong with my glucose level. The coloring is also used in the chart, so I can define if I have problems with glucose throughout a day, a week or a whole month.  In general, the application is very easy and entertaining to use.

It can be particularly helpful for children with diabetes type 1 because the app encourages them through different funny challenges to develop the habit of measuring blood glucose and learning how to take diabetes under control from the very early age.

A second useful characteristic that I have noticed was that you can take pictures of the meals, add them to a log and connect them with a specific location (which can be useful when you are going to a restaurant, for instance, and want to review later what you have eaten). This option is available free of charge for the first two weeks, later you have to go Pro for about 3 euros a month (which is a fair price for access to all the options that this app has to offer). The Pro version also has some extremely useful features, for example an insulin dosage calculator. It is very convenient for people who just got sick with diabetes and do not know yet how to calculate it correctly. I was genuinely amazed at how easy it was to use this application, how easy to enter and review the data, when you have all the information on one single page right in front of you. You can edit it as many times as you want and write down a detailed list of your activities and feelings that you can later review with your doctor. The application encourages you to type in every single detail, to plan every meal in advance, and that is exactly what helps bring diabetes under control: self discipline.

Conclusion

I reviewed two applications that aim to provide the essentials for diabetics. As you can see, they show different levels of usability. After testing Glucose Buddy for eight days, I came to realisation that my blood glucose levels were not better controlled than before I started to use the application. This fact proved the point that the application is ineffective in managing diabetes due to its failure to provide users with a convenient interface and with the good data analyses. Mysugr, on the contrary, has plenty of helpful options, is nice to use and it can easily fulfil its task as a diabetes helper. I am convinced that Mysugr can help diabetics improve the quality of their lives significantly.

Evgeniya Jung, a digital nomad, studied at the department of International Relations in Russia. She moved to Switzerland two years ago and since then she has been travelling and working on improvement of her German skills. She has particular interest in digital healthcare due to having Type 1 Diabetes, which gained her vast experience with the health care systems in different countries.

Mood picture: http://www.theatlantic.com/sponsored/ibm-transformation-of-business-part-2/diabetes-in-the-digital-age/562/