The happiness factor

As part of pharmaphorum’s Eye on Innovation series, Richard Staines spoke to John Zibert, chief medical officer at LEO Pharma’s Innovation lab, about how the company wants to develop products that treat patients with dermatological conditions – and make them happier too.

As one of the leaders in research into dermatological conditions, LEO Pharma has been doing some scientific soul-searching.

John Zibert, chief medical officer at the LEO Innovation Lab, said that the company is focused on finding solutions that solve the problems of both patients and healthcare systems.

Zibert is playing a leading role at LEO Innovation Lab, a unit that works at arm’s length from the main company to encourage original and innovative thinking with an aim to get ahead of the competition.

A kind of dermatology skunkworks, LEO Innovation Lab works to develop cutting edge technology in dermatology as first movers and take the advantage before new tech entrants such as Google and Apple.

For health systems, LEO Innovation Lab has noted that paying for quality care is becoming problematic, and patients may feel short-changed by the way clinical care is being delivered today.

LEO Innovation Lab has been focusing on reframing these problems and whether or not existing research is asking the right questions.

Zibert said: “One of the things we have been focusing on is that quality healthcare is becoming a luxury commodity. What we are trying to improve is ensuring access to healthcare for everybody, despite income, social demographics, race, culture and so forth.”

He added: “We want to innovate with the minimum of resources and do the innovations as fast as possible. It allows you to fail fast and actually go for the real success – having patients and doctors use the solutions.”

LEO Innovation Lab is not the only research unit to have come to this conclusion, and identify the need to produce innovative healthcare products, while at the same time managing development cost to keep prices of the end product manageable once it hits the market.

But it’s LEO Innovation Lab’s conclusions about the needs of patients that are the most startling. With a portfolio of medical products for skin diseases, including those to treat the common pharma target of psoriasis, the company has been looking into whether existing drugs are really meeting patients’ needs, as adherence is a huge issue.

A crucial revelation of LEO Innovation Lab’s research has been that many of the trials used to approve dermatology drugs are using a limited set of questions – for instance in the case of psoriasis the focus has been far too much on skin clearance based on the measure known as Psoriasis Area and Severity Index (PASI).

These measures are of course important, said Zibert, but they fall short of the real-world needs of patients, he argued.

“What we are trying to do is link traditional quality of life measures but also psychological measures of patients, trying to look into overall wellbeing of a patient,” he said.

“It has led us to a new dimension of quality of life, including actual happiness of patients and relating that to the original happiness measurements out in society that have been adopted among organisations such as the World Health Organisation and the Organisation for Economic Cooperation and Development.”

This new way of looking at dermatology research has produced some interesting conclusions that will inform future research from LEO, Zibert said.

“What we have identified is the gap between having psoriasis and not having psoriasis is larger than the gap that has been found comparing the richest with the poorest in Denmark, for instance.”

“That is a new way of looking at quality of life and that is super important for us to build the right solutions for patients where they actually have a true unmet need.”

One issue is that the drugs may not be treating some of the underlying psychological issues associated with psoriasis, and the effect that they have on patients’ quality of life.

Zibert explained: “What is it that has huge value for patients? We actually did some correlations to try to identify this, [and a lot of the new drugs] are focusing on PASI but is that really important?”

“If they got completely symptom free, is it the symptom that is causing them nightmares during the night? No it’s not. What has a much larger impact is actually improving their sleeping pattern. If it’s improving their psychological state of mind, not being stressed…it’s other things that actually play a huge role.”

Zibert added that there is a need for drugs and solutions covering the wider psoriasis population. Very effective disease modifying biological injections are only prescribed for patients with moderate to severe disease – which only reflect around 15% of the population, hence a focus on the wider population is also needed.

The research has also shown shortcomings in diagnosis of skin diseases, exacerbated by the worldwide shortage of qualified nurses and doctors.

Citing World Health Organisation research, Zibert noted that there will be a predicted shortage of 13 million healthcare workers.

However, the number of smartphones is increasing rapidly, with an estimated 6.3 billion likely to be in circulation in 2021, an opportunity that LEO Innovation Lab is now exploring to address access to healthcare for those living with chronic skin conditions.

The Lab has developed an AI-powered platform that can identify certain skin conditions from a smartphone image, supporting the doctor in an ever better decision making process. Built upon an algorithm that has been trained on thousands of user images, the team behind the platform are now seeking external partners to test the technology in a clinical setting.

Such technology could allow doctors to see more patients, while at the same time improving the quality of their clinical decision making and planning, said Zibert.

“The quality of life will improve because then you ensure that they get the right treatment and the right treatment plan.”

In addition to its headquarters in Copenhagen, LEO Innovation Lab has also invested in geographic areas where there is activity in the field of digital health, such as Tel Aviv, San Francisco, Toronto and Shanghai.

Zibert concluded: “Developing and diagnosing from a smartphone image is revolutionary. Nobody else has been able to do this, we know that big players like Google are in this field, but we are ahead of them. We have done this through our agile approach to innovation and including these other parameters and happiness measures in other diseases such as psoriasis.”