Disruptions in the Healthcare Systems

We are facing unique times in terms of technologies and assets discovered and delivered to the market at unprecedented rate. This fast pace is putting health care systems in distress affecting infrastructures, assets, competences and capabilities, process and procedures in addition to the recent Covid-19 pandemic that further underscored challenges in healthcare provisioning. The pandemic has compromised hospital infrastructure capacity worldwide and has brought increased morbidity, risk of chronic diseases, and mental health problems that still impact the healthcare sector worldwide.

Within this new perspective, for the first time in many years, the Italian Health System may not have a problem with financial resources. Although caution urges the use of conditional, it is a fact that we are facing a historical novelty, as the 20 billion euros allocated to healthcare by the NRRP substantially changes the health world’s outlooks and induces more than reasonable optimism.

From a more traditional approach to an innovative model

In recent years pharma Companies have made progress towards a strong patient centric approach that has been in the past mostly delivered through and around healthcare professionals while a key paradigm shift would be to perceive the whole healthcare ecosystem composed by a broader spectrum of stakeholders and take their views into account because no one company can do it alone. Success requires integration with the external life science ecosystem: patients and patients’ association, HCPs, nurses, scientific institutions, national and local payers, technological and innovation districts, players from other industries, startups, universities, and research centers.

The Healthcare sector is an industry notoriously highly regulated, and traditionally behind in innovative transformation. To be truly innovative, therefore, collaboration and cooperation becomes the keys to success. That is why it is so important to adopt the Open Innovation paradigm, to be open to the outside world and work in partnership for the co-creation of new innovative solutions to transform the healthcare system.

Pharma Companies may then play a pivotal role within this evolutionary process by enabling the setup of Private-Public-Partnerships and bringing a solid expertise in multiple therapeutic areas, data generation capabilities, patient journey understanding and patient management optimization to sustain local ecosystems evolution.

To succeed each of these partnerships between public and private entities should follow a strong methodological approach: an exhaustive investigation of needs, a deep knowledge of current state of the art in terms of competences, assets and regulations, identification of clear pain points along the patient journey, development of a clear blueprint, without forgetting the crucial importance of sustainability and scalability stress test of the blueprints designed.

Rules to ensure a successful long-term efficacy

To ensure a long-term strategy is important to focus on four main rules:

1. Sustainability first: the concept of sustainability becomes crucial to guarantee that the development of innovative solutions and projects could self-sustain and remain on the market over time without the need for continuous economic financing from third parties. Hence, it is important that whenever a pharmaceutical company introduces a new, innovative solution on the market or within a hospital center, it must be ensured that this solution remains available to doctors and patients even after the end of the project. For this reason, it is necessary to limit investments in sponsorships and keep pushing for other types of collaborations such as partnerships which, incidentally, are also important to allow the constant exchange of information and competencies between partners and ensure the company itself can boost its skill set.
2. Understand the status quo: to ensure successful implementation of solutions and projects, it is necessary to start from an in-depth analysis and assessment of the context. Indeed, even if the solution may seem to be perfect in all its features at first, it does not necessarily mean it can work perfectly anywhere and with anyone: it may not be the right time nor the right customer. It is then compelling to fully understand the needs of our stakeholders and their reference context, mapping all the actors involved in the process, their level of competences and capabilities, constraints in time and, last but not least, understanding their existing assets and future infrastructural investments
3. Scalability is key. Projects should be designed to maximize learning curves in other therapeutic areas, different hospitals, and different geographies. Prioritizing scalability since the beginning is an essential aspect for this kind of projects, as its lower development, implementation, and maintenance costs, facilitates supplier/partners relationships and, above all, allows the improvement of an always better user experience for our patients and HCPs.
4. Don’t waste it all: we should not start from scratch but understand what can be valued and build on it. By constantly monitoring and keeping in mind good existing solutions within the company and on the market, we should be able to develop innovative solutions starting from the existing ones and build on them according to our needs. Without reinventing the wheel every time, we would be able to not only save time and resources, but also to make processes more efficient and leave room for the design and the implementation of further initiatives.

Technology is an enabler and not the end goal

In this context, it is important to better understand the role and importance of technology. Digitalization of medicine and healthcare is part of a global transformation defined as the fourth industrial revolution, which sees the widespread of technological innovations in the fields of connectivity, information control and data applied to the production of goods and services. Especially after the Covid-19 pandemic, the healthcare sector has undergone an epochal transformation that has seen the continuous arrival of new technologies and their evolution. However, we have recently witnessed a sense of urgency in enabling technologies investments that were “hyped” without having a clear sense of the problem it was meant to be solved. 

It is therefore important to remember that technology and digital solutions, are not the ultimate goal but just the enablersand they should be part of 360° transformation, meaning processes and procedures as well as change management plans should come together with any transformation.

In conclusion, considering the challenges that the future holds for us, we should decidedly define a new way of working to sustain the healthcare ecosystem evolution in the long term, starting from the exploration of forms of collaboration between the public and private sectors.

Participating start-ups entering the F4F program can propose patient-oriented digital solutions, focused on neurological disorders, via online platform open from June to September 2021

Barcelona, Spain, 17 June, 2021 – Ferrer, a privately-held Spanish pharmaceutical company whose aim is to make a positive impact in society, today announces its continued commitment to digital health with the third edition of its innovation program Ferrer 4 Future (F4F). The open innovation program aims to empower entrepreneurs and digital health businesses, to develop disruptive health solutions – using digital technology. Participating start-ups can propose digital healthcare solutions, using new technologies, against the latest challenges set by Ferrer, via an online platform ferrer4future.com

The purpose of the F4F program is the co-development of technology-based healthcare solutions, between start-ups and Ferrer. The collaboration begins with a careful selection process of proposed solutions against two challenges posed by Ferrer. Following an initial scoring process, the start-ups present and defend their solutions before the start-up advisory board, who picks the winner. The winning start-up participates in the program, which includes the possibility of piloting the solution on a real-use case and holds the potential to explore commercial alliances and collaborations with Ferrer in the future. The collaboration agreements are customized – according to the nature and maturity of each project. The duration of the co-development varies between 3 and 18 months, during which time, access to Ferrer mentors and experts, combined with access to internal resources, is guaranteed, and speeds up the creation of the solution.

Through this innovative program, we embrace the collaborative path to promote future projects with value, for patients and stakeholders alike within the healthcare system, said Tatjana Naranda, Ferrer’s Chief R&D Officer. We believe in the key role that digital health plays in the present and will play in the future when it comes to building a more efficient healthcare system – one that is accessible to all sectors of the population.

Ferrer’s F4F 2021 program offers two challenges to participating start-ups:

• Challenge 1: Is there a digital solution that may help screen people with mild cognitive impairment and distinguish if there is a pathological evolution in cognitive functions, to allow long-term monitoring of the disease and provide the appropriate treatment?
• Challenge 2: Is there an easy to use digital solution to maximise independence in the daily tasks of patients living with mild cognitive impairment, through personalized cognitive or motor rehabilitation?

The challenges require patient-centric solutions which facilitate the daily activity of healthcare professionals who are supporting patients with neurological disorders, whilst in primary healthcare settings or specialized neurology clinics, as they care for people with mild cognitive impairment. The solutions should also provide the healthcare professionals with precise follow-up tools and features.

The empowerment of patients and doctors with digital health tools to address some of the concerns around cost, equity and access to healthcare is aligned  with the company vision and the purpose of Ferrer’s digital health department; to build a healthier society through digital technologies and contribute to the sustainability of healthcare systems, added Gemma Estrada, Head of Digital Health in Ferrer.

Previous year winners

Year 2019: Wellthy Therapeutics and Ferrer have co-developed a CE marked digital solution to support patients with a chronic complex clinical condition. The software medical device enhances patients’ autonomy in the management of the disease, provides structured training and gives access to health coaches. Currently, the solution is being tested in a clinical study to measure its impact on clinical outcomes and quality of life of patients with Pulmonary Arterial Hypertension.

Year 2020: Portabiles Healthcare Technologies and Ferrer share an interest for neurological disorders that involve gait disturbances and are working together in improving monitoring and generating objective parameters to enhance therapies that better the quality of life for patients with movement disorders such as Parkinson’s Disease.

Program: at a glance

• 16/06/2021 Applications open
• 29/09/2021 Application deadline
• July-September 2021: If shortlisted, participants will deliver initial pitch
• October-November 2021: If successful, participants are given the chance to present to expert panel, lasting one hour
• Early 2022: Program initiation

Program benefits for the winner

• Mentorship & training
• Partnership
• Access to resources
• Investment

Mentorship is considered essential for the growth of startups in any field. However, we are used to think of mentorship as something ad lib and opposed to the structured program of an accelerator with its x number of batches per year. In addition, healthcare industry is very demanding and business cycles for startups are long due to the necessity to comply with healthcare policies and regulations. All this makes it not so easy for a digital health startup to benefit from occasional mentorship.

One of the alternatives to make mentorship really work could be the MIT mentoring model based on several principles:

• Long-term mentorship on a regular basis
• Group mentoring when 2-4 mentors with complementary backgrounds are working with one startup at the same time
• Top-class mentors are working on a pro-bono basis.

Thus, the model is focusing on a structured and effective mentoring throughout a continuous period of time.

We decided to take a closer look at the effectiveness of the MIT model in practice. The Nordic digital health ecosystem is a very representative example for our investigation because of the global prominence of the Northern Europe’s healthcare and the existence of the Nordic Mentor Network for Entrepreneurship (NOME). NOME, a top-class mentorship initiative for life science startups, is built on MIT mentoring model.

We interviewed several players – a science park, a startup and an accelerator – in order to find out about the strong mentorship institute and learning more about the ecosystem itself along the way. All heroes of the interview are taking part in the NOME.

Facts Check. The mentorship network rocking the whole Nordics: NOME

• Nordic Mentor Network for Entrepreneurship (NOME) is financed by the Novo Nordisk Foundation with the objective to boost the Nordic Life Science start-up environment by offering an elite mentorship program for the brightest startups.
• NOME was launched in 2017 when The Novo Nordisk Foundation awarded almost DKK 20 million (€2.68 million) to the main Danish startup ecosystem player, Accelerace, to run and develop the network.
• Other institutional partners of NOME are Turku Business Region (Finland),Vertical (Finland), Karolinska Institutet Innovations (Sweden), Medicon Village (Sweden), Oslo Cancer Cluster Incubator (Norway) and Aleap (Norway).
• NOME reviews the startup applications and selects the best companies to be a part of the program. The same selective approach applies to the mentors.

The outstanding healthcare player from the oldest Finnish city

Turku Business Region is one of the most important Finnish ecosystem players and internationally recognized cluster leaders in healthcare. HealthTurku has been on the map for more than 30 years and has been home for many spin offs coming out of such actors as Orion Pharma, Bayer or the University of Turku. Currently there are over 100 actors in the region active in the healthcare segment.

Hanna Halme, Growth Advisor, Life Science from Turku Business Region comments on the HealthTurku focus.

“The strong areas of HealthTurku have usually been drug development, diagnostics and medical devices areas. Lately there has been also a rise in the digital health solution development. For example, one of the startups growing very fast is a Turku-based Adesante (Surgery Vision) company providing VR solutions that help surgeons to make more precise planning of surgical procedures. Another bright company which is based in Oulu but was taking part in our acceleration program in Turku is Cerenion. The startup uses AI to provide a new and non-invasive way to measure brain function of intensive care patients”.

“We prefer ‘Growth Program’ to ‘Accelerator’”

Turku Business Region is the main coordinator of NOME in Finland and also initiator of ProHealth Growth program for healthcare and life sciences startups in Finland.

“NOME is a good idea because its group mentoring. Imagine a startup that listens to many different opinions of mentors along the way. Under NOME activities, there are usually 2-3 mentors dealing with the same startup and coaching it, thus making it easier to develop a consensus. NOME is also a good way for all our Nordic players to get to know each other even better than before.

On a national level, we run ProHealth Growth Program (former ProHealth Accelerator) – and we prefer to call it a growth program rather than accelerator because it very customized. Also, we are accepting startups’ applications at any time: we think that companies need to get the help in the right moment not waiting for the next batch to start. Furthermore, each startup gets assigned with a coach helping the team to move throughout the program which consists of regular workshops combined with mentorship sessions.

Since ProHealth Growth Program is very tailored-made, we don’t have a fixed duration period, it could be several months or one year, etc. Usually we have from 10 to 15 startups enrolled throughout the year”.

AI fueling healthcare

Turku- and Helsinki-based startup Etsimo Healthcare is developing a platform for delivering data-driven digital health solutions. Etsimo is a part of NOME startup portfolio and has been going through the mentorship program for a bit more than a year. Thomas Grandell, the startup’s CEO, comments on their product.

“Etsimo algorithms use all available health data to assess a patient’s current health situation, it’s urgency and the required care, and put the patient on the optimal care path. This path has 4 basic elements: self-care with care instructions, remote analysis of your case/data by a professional, remote care involving interaction with a professional over video or chat and face to face appointment. Leveraging the data, it’s also possible to predict patient’s future health risks and suggest changes in his or her behavior and lifestyle to reduce these risks.”

The company’s customers are healthcare providers, health insurance companies and national health systems like Terveystalo, the largest private healthcare service company in Finland. Apart from serving the home market in Finland, the startup successfully operates in Brazil which is a 200+ M people market. Together with its local partner Techtools, Etsimo is targeting 76+ M people collaborating with a main hospital chain and state health providers”.

Getting Mentorship to Move in Digital Health

“Etsimo is one of the NOME portfolio startups. In the beginning of the program we were assigned 3 very good mentors with different backgrounds. One of them is from Finland and has a deep experience in pharma industry, also on the international level. Then we have a Danish mentor with great entrepreneurial baggage in healthcare and another Finnish mentor from the Europen Investment Bank, who has a very good view on the EU policies and investment strategy in the field.

We have mentoring sessions about once every two months and I could say the NOME program has been very valuable for us. It is not a simple reporting about Etsimo’s progress with loose discussions afterwards, but a about really complex and in-depth discussion and analysis around the challenges we are facing and how we can move forward. I think NOME is organized just the way a mentorship program should be”.

The Rise of the Nordic Digital Health Ecosystem

On a side note, Thomas also shares some insights on the potential of the Nordics ecosystem.

“There are great skills available in the Nordics both from digital and clinical sides. In Finland, with our central health repository Kanta, we have an amount of collected healthcare data that is unmatched globally, comparable probably only to Israel. If we as a society could get access to this data more quickly and more easily, of course without jeopardizing privacy, we could utilize it to create extremely competitive digital health solutions for the global markets. Unfortunately, this advantage is decreasing with time because if we wait another 3-5 years, we will face solutions from the likes of Amazon or Apple, who have already started to go big on healthcare and have begun collecting and combining comparable data.

Another factor that became significant for the ecosystem is, of course, the Covid pandemic. I would say that from business perspective the pandemic transformed the curiosity towards digital health solutions into real interest and real intent to buy. With converging technologies like AI, wearables and IoT devices transforming healthcare, it seems like we are already at the stage we expected to be in 2-5 years from now”.

Accelerator with a tailored program in digital health

Accelerace, one of the biggest accelerators in the Nordics, is not only running the NOME initiative but also following the trend of tailored and customized program for their portfolio startups for 12 years already.

Accelerace is based in Copenhagen and tends to around 75 % Danish startups in its portfolio but also open to international companies. The program is free for startups and the business model of Accelerace is based on government funding and corporate sponsorship and also has its own fund investing from 50 to 400 k euros in the brightest startups from the programs.

Christian Waarst, Business Accelerator & Investment Manager at Accelerace, gives an overview on Accelerace’s practices in digital health.

“Usually, Accelerace runs the programs for up to 5 months depending on the needs and the development of the startups. Our program is divided into two parts the first of which is a general pre-acceleration program applicable for startups from all the verticals. It allows the startups to obtain product-market-fit, learn how to enhance the value of their product and get a better understanding of investors. This first part gives the startups a sense of what Accelerace can provide while helping them apply for the core acceleration program and from now on we are running it online.
The second part of the program is the core acceleration with both online and offline camps and individual acceleration mentoring sessions. Accelerace’s team dedicates a consultant responsible for each specific industry, in case of healthcare it’s me because I have background in medtech and biotech together with Peter Birk, Partner at Accelerace. Hence, this second part is very much tailored to each startup.”

Summing up our article heroes’ comments, we could definitely spot the trend of transformation of a classic accelerator model into long-term and focused mentorship program created for needs of each startup. Having proved its effectiveness in such challenging industry as digital health, we hope this transformed model will facilitate the development of more startup verticals, also geographically.

Follow us to stay updated about the trends in the digital health ecosystems!

As this area of pharmaceutical innovation matures ‘beyond the pill’ and ‘pill plus,’ what can players on both sides of the term sheet expect? Are things cooling off? Here to weigh in with the ‘state of play’ is Paul Tunnah, CEO of Pharmaphorum, a news site that has followed innovation in the pharmaceutical industry for ten years. In this interview from Frontiers Health, Tunnah talks trends and offers insight from his unique vantage point as an industry observer and analyst carefully watching both sides of the field.

Here are some of my key takeaways from Paul’s comments:

1. Pharma’s investment in digital health has gone from ‘patient facing’ to the ‘back end’

Tunnah takes us back five years, to a time when digital health was strictly regarded as a marketing communications play – a way to better engage patients to take their meds. Now, the boundaries have expanded, and big pharma is looking at digital health as a component of growing importance in their drug development process. From collecting and analyzing individualized patient data to reducing the cost of clinical trials, pharmaceutical companies have begun to literally let digital health startups inside and are evolving their own business processes to incorporate new tech solutions into the way they create their own IP.

2. Startups need to get good at regulatory, which means getting good at clinical validation

Sorry startups. You can forget saying that your tech will be out-of-date before a proper clinical trial can be conducted. Tunnah reminds us that the pharmaceutical industry is used to an average 10-year cycle for the development of their new products. What you’ll need to do to gain sufficient clinical validation to satisfy regulators will only take a couple years. If you’re not savvy at building an evidence base, find some help. As Tunnah says, “You gotta have evidence…that’s no different for digital health startups than it is for medicines.”

3. Pharma investors are starting to handle digital health startups the same way they handle biotech companies – carefully

There’s a shift happening in the way pharma investors are engaging digital health startups – and it’s in favor of the startups. As Tunnah puts it, pharma investors don’t want to accidentally ‘kill the golden goose,’ so they’re changing everything from the way they woo and negotiate with startups to how they finally establish their deal structures and reporting relationships to ensure that doesn’t happen.

Check out the full interview and find out more:

Please tell us about your background and what your role entails.

My role, as the Head of Science Policy at the ABPI, involves working on issues which affect our member companies in the early stages of the drug development process – so this includes basic research in the laboratory, research with animals, phase 1 clinical trials using experimental medicines – and ensuring the UK remains an attractive place to research and develop new medicines.

Prior to working at the ABPI, I worked in the Policy & Knowledge team at Prostate Cancer UK for over four years and, before that, I was working in the labs at King’s College London for my PhD in immunology of asthma and allergy.

The ABPI recently produced a VR-based experience showing breakthrough medicine. Why did you choose this format?

Our virtual reality (VR) film ‘Welcome to the Future of Medicine’, which we launched at our Annual Conference in April, uses a mix of computer-generated imagery and live action laboratory footage from a working diagnostics lab to take the user on a 360-degree journey into the world of breakthrough medicine, going inside the body to explore how the technologies being researched today may transform the treatments of tomorrow. The use of VR brings this vision to life and explains complex science in an easy and understandable way.

What are you hoping to achieve with it?

We made the film with Inition to show what ground-breaking medicines and treatments are on the horizon in the next 20 years. We wanted to bring to life some complex science and help people understand what the new therapies and innovations will be in the future. This film is an excellent vehicle to show what the experience could be like for patients, their families and health care professionals. It is a great place to start conversations about how we work together to make the most of these amazing opportunities, as well as looking at the challenges of how we get there. We had a positive reaction from our members when we premiered the film at our conference and we will be showing it at other external events over the next 12 months. It is also good content for our work with schools and universities.

Please describe some of the ground-breaking science that could one day become routine in healthcare.

Healthcare is seeing significant change right now and this is predicted to continue over the next 20-30 years. The key drivers include changing demographics and disease prevalence, changes in how healthcare is provided and advances in scientific understanding. The film features several ground-breaking discoveries that are being investigated around the world, and which have the potential to one day be used in routine care:
– Gene editing and gene therapies: Gene therapy aims to repair the direct cause of genetic disease by cutting out faulty sections of DNA and replacing them with slices of genetic material. Researchers are already looking at using it to treat Haemophilia B and investigating its potential to tackle other diseases, like cancer and infections.
– Inhalable diagnostic sensors in the body: US researchers are investigating the potential of carbon nanosensors that are 100,000 times smaller than a strand of hair to identify infection and inflammation in hip-implant patients and people with catheters. They have the potential to be used to monitor for disease and alert clinicians.
– 3D printing of medicine patches: UK scientists are currently developing and testing 3D-printed patches from various polymer grades that could allow controlled release of medicine into the body, making medicines more clinically effective.

What most excites you about the future of healthcare?

The power of patient data and their potential to be used to personalise care.

The drive towards patient-centric care will be partly due to the availability of personalised medicine

The sophistication with which this will be possible in the future, thanks to technology, is unprecedented. If information within the healthcare system, currently stored in multiple disparate databases, can be linked and combined with genomic information, then tools such as machine learning and artificial intelligence will have a huge impact in allowing healthcare professionals to be able to identify the exact treatment or combination of treatments for an individual patient. […]

What role do you see for the pharma industry in this brave new world?

I think it will be about partnership working. New science is so complex that no one organisation can hold all the knowledge to make the next generation of medicines, so progress will very much depend on partnership working. Partnerships between academia, the pharma industry, research charities and the NHS will enable patients to live longer, healthier and more productive lives. There are already good examples in the UK and we need to build on these. […]

How is the ABPI evolving to help members manage the changing environment the industry faces?

Our key role is to work with people from different organisations to collectively understand the challenges and opportunities for science and health. We need to work with our members, government, the NHS, charities, academia and many others.

The obvious challenge facing our industry currently is Brexit

Brexit poses an uncertain future for the pharmaceutical regulatory environment with a potential impact on access to treatments for patients living in the UK and in the EU. Every month, 45 million packs of medicine move from the UK to the EU, with 37 million moving the other way. Securing cooperation on the regulation, trade and supply of medicines must be a priority for both the UK Government and the EU. The ABPI is working hard to ensure that the issues facing our members are understood and acted upon wherever possible.
We’re also working with the Brexit Health Alliance, comprising of the NHS, medical research, industry, patients, and public health organisations, to ensure that issues such as healthcare research, access to technologies and treatment of patients are given the prominence and attention they deserve in the Brexit negotiations, such as regulatory alignment and a strong funding commitment to the health and public health sectors.

Aside from Brexit, investment will be needed in an integrated, digital, patient-centric system, which supports patients from prevention, through diagnosis and personalised treatment, using new technologies and treatments as they become available. This will have to be underpinned by adequate development of workforces to provide future healthcare.[…]