Tunnah’s musings: is being app-ey the key to good health?

Paul Tunnah

pharmaphorum

It may have escaped your notice so far but we’ve started having themed months on the pharmaphorum site, where we focus a slightly higher volume of content each month looking at the key issues changing pharma and the broader healthcare world.

Last month was all about market access, but we couldn’t help but get drawn back to the wonders of technology this month as we focus on mobile health, or #mhealth as those amongst the Twitterati affectionately refer to it. There is a lot of buzz going around about mobile apps at the moment and their potential to radically change the way healthcare is delivered. In fact, a recent Forbes article caught my attention when it proclaimed that such apps were a “huge threat to pharma” and prescribing them could potentially replace traditional medicines 1 .

It’s an interesting viewpoint and one that it is dangerous to immediately dismiss. After all, governments right now are interested in reducing the financial healthcare burden by managing or preventing disease in the most cost-efficient way – they don’t care whether that provides a commercial return to pharma companies or not.

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“…they don’t care whether that provides a commercial return to pharma companies or not.”

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Therefore, at first glance healthcare apps provide quite an appealing solution. Rather than focussing on treating the symptoms of a well set in disease, which is where many medicines are employed, they have the potential to significantly impact public health awareness in order to promote wellness and reduce the chances of disease onset. I’m talking here about apps that help you monitor your diet or the amount of exercise you undertake, for example. Even where prevention is too late, apps can be used to better control disease, avoiding or delaying medication or expensive hospitalisation through allowing patients to self-monitor things like glucose levels and blood pressure.

So, does pharma need to just sack its drug R&amp,D departments and go poaching Facebook or Apple’s best developers? Not just yet, I reckon. You see, despite the world of pills and apps being some way apart technically, they both face one very similar challenge to being effective – compliance.

It is well known that medicine compliance rates are far from ideal and, despite it being an area where solutions offer a strong win-win for both patients and pharma, it’s often deemed too tricky to effectively tackle. When PhRMA recently did a review of existing data on medicines adherence, it discovered that around three-quarters of adults were non-adherent with their medicines in some way and that, for chronic conditions, as many as two-thirds of patients would be failing to take their medicines as instructed 2 .

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“…does pharma need to sack its R&amp,D departments and go poaching Facebook or Apple’s best developers?”

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Those figures might sound frightening, but trust me – the world of apps is in a whole different league entirely. Data compiled by US mobile marketing firm Flurry from 550m downloads of 25 apps shows that only 4% of users still used the apps after 12 months (see figure 1). That’s really not very many at all.

Figure-1-mobile-app-retention

Figure 1: Data from Flurry on app user retention over 12 months based on 550m downloads for 25 apps 3 .

Now at this point we can start to argue the point about how the apps used for this measurement are most likely irreverent cloned gaming apps where you have to shoot something that most definitely isn’t a bird at something else that most definitely isn’t a pig (for copyright reasons, you understand). We can pontificate that when it comes to our own health things will be much different and we will, of course, take these apps seriously.

Are you sure? Do we need to go back to that 60% of folks who don’t take their pills as directed after one year for a chronic condition that they know needs chemically managing to avoid unpleasant symptoms?

There is also some evidence that when it comes to health apps, people might adopt a “see no evil, hear no evil” approach to their disease 4 . In other words, they simply don’t want an app constantly reminding them of their illness and how to best manage it, so the drop-off rate is, if anything likely to be even higher. It therefore seems that whilst we think mobile apps might be great for finding out information, we might not want to use them for preventing or managing disease in quite the same way that those planning the healthcare budgets would want us to.

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“…this will not help those patients, or patients-to-be, who do not want to be empowered.”

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My point is not to disregard the potential of apps in better managing our health, but instead to not assume they will eliminate all the problems we see with drugs. In fact, the right solutions probably sit with combining traditional medical treatments with modern technology such as apps in the right measure, but combined with one key final ingredient – human interaction.

We can rave on about the ability of the digital world and new technology to empower patients all day long (and it does indeed have significant power to do this), but this will not help those patients, or patients-to-be, who do not want to be empowered.

So let’s be brave and try all kinds of new approaches in this new mobile world, but don’t forget the lessons of the old one while we’re doing it. Until next month, stay mobile and stay well.

References:

1. Prescribable mobile apps huge threat for pharma, Forbes, May 2012: http://onforb.es/JNjaij

2. Improving prescription medicine adherence is key to better healthcare, PhRMA, January 2011: http://bit.ly/JgID98 (PDF)

3. iOS &amp, Android Apps Challenged by Traffic Acquisition Not Discovery, Flurry Blog, October 2011: http://bit.ly/rGXkLe

4. Do consumers want smartphone health apps? World of DTC Marketing, April 2011: http://bit.ly/hNerwQ

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About the author:

Paul Tunnah is Founder and Managing Director of www.pharmaphorum.com, the primary facilitator of thought leadership and innovation for the pharmaceutical industry featuring news, articles, events / company listings and online discussion. For queries he can be reached through the site contact form or on Twitter @pharmaphorum.

Do drugs hold some lessons for health apps?