US consumers, indeed global consumers, are asserting greater roles in their own health management and therapeutic diagnoses. While this new wave of DIY home health care is being fueled by individual pursuit of self-health, it is being facilitated through virtual and real access to analysis, testing, self-prescribing, Rx home delivery and virtual pharmacists. This trend is being enabled by payers and government looking to squeeze costs out of the system. No indication of this new direction could be more telling than the recent announcement by the FDA that they are considering allowing patients to use an app to determine their needs for medication (eg. lowering cholesterol), which would trigger issuance of a code to fulfill the appropriate Rx.
This disruption of the historical Patient: Health Care Practitioner model creates a unique opportunity for targeted health marketing. Traditional DTC advertising takes on new meaning as the consumer is also the health care professional. Failure by pharma to recognize this opportunity will see generic apps developed via third parties (eg. Prime Health, Kaiser Permanente, etc.), and traditional HCP relationships evaporate as patients leverage and assume a greater role in prescribing. Effectively, the equity between HCPs and pharma sales reps disappears, as does the traditional promotional model.
Setting the Foundation for the New World of HCPs
With the onset of wearables, health apps, implants, monitoring devices and voice activated “Dr Alexa”, it is becoming increasingly easier for an individual to store and track his foundational health metrics. The second stage is interpreting this information against a set of norms or broadly available standards relative to your profile, which in turn quantifies interpretation and diagnosis. This analysis may start out with consumers as an interesting exercise, but it is likely the burden of diagnosis may soon shift more and more to the individual, rather than the institution or the provider.
While physicians might argue their professional involvement is still necessary, consider a sample of 76,000 diagnostic tests requested with a clinical question from primary care physicians in 2015. Of this total, 23.5% fell into easily identified conditions that could be monitored by an “invasive wearable” and analyzed remotely. In many instances, prescription and dispensing information could be sent to you the next day. The diagnostics include disorders of lipid metabolism, essential hypertension, diabetes mellitus and cystitis. Further evaluation of the requested studies identifies a broad range of conditions that are easily monitored and evaluated relative to population norms.
Ultimately, individuals will transfer all of their information into an online portal for analysis against representative samples of their specific geo/demographics. With biometrics potentially running real-time against expected values, an alert could be sent to a PCP, insurer, Pharmacist, etc. when specific values fall outside of expected levels. Insurers will likely offer discounts for individuals that take basic Continuing Medical Education (CME) and work to record and track their general biodynamics. John Hancock is an early pioneer in this space, introducing in September 2018, a behavior change platform (Vitality) that rewards customers for managing their health by leveraging the convergence of consumer behavior and technology.
You Will Be Your Next Family Practitioner
There are a number of drivers here including individual payers, the products that are on Formulary, product price relative to the general market, access/availability, “dispensary-style” information and support, and availability through Amazon to prime members (Prime Health is on the horizon). Ultimately, the optimal approach will be to leverage deterministic, omni-channel, cross device targeting aligned with people-based marketing.
Given our ability to profile individuals, and understand their specific needs, maybe we need to start treating the information we give to patients like what we’ve been giving to HCPs. Consumers are getting smarter, especially high-value consumers, in every space. They know the tricks and the lingo since they are likely exposed to it in their daily lives like never before, and likely even in their daily activities at work. Marketers should start treating them as the experts, the Family Physician if you will. Let’s evaluate, track and think about consumers in the context of trialists, switchers and loyalists, and recognize that the new approach will be less about a message that ends with “Ask your Doctor if AB Rx is right for you”, and more along the lines of, “Here’s the data, here’s the analysis, here’s the cost comparisons based on your coverage.”
This value proposition will be driven by the broad and deep health data sets that will help us to determine faster, more efficiently with fewer misdiagnoses the next best (action) intervention appropriate for you. The evolving team will be Dr. You, your pharmacist (virtual or real), your Rx app(s) and your own data capture…. all on your time, not that of your family doctor.