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By Tom Lawrie-Fussey
I’ve just attended the Parenteral Drug Association (PDA)’s Universe of Pre-filled Syringes, in Vienna, and came away intrigued about where the sector is headed, and the challenges it currently faces. First, let’s start with the obvious. Injecting yourself isn’t pleasant. But injections are very much here to stay. This is not a stop-gap in delivery solution technology; a needle that pierces your skin is an effective way of delivering drugs. And more and more products that need to be injected are coming to the market.
Yet this presents the sector with a huge new challenge; such is the scale of growth and the pace of transition from low-value generics to high-value speciality drug injection solutions. It’s predicted that by 2020, these injectable speciality medicines will account for more than half of the top 20 prescribed drugs1. But injectors still require the user to operate them. This is not a pill you simply have to swallow each morning; it’s a potentially complex procedure that you need to get right. Where the drug needs to be at the correct temperature, needs to be injected at the right depth, at the right location, even at the right angle, and for the right duration/dispense quantity. It’s not surprising that persuading the end-user to administer the drug properly, repeatedly for regular doses over many months, is hard. So difficult, in fact, that adherence is a huge problem - a global annual problem that's reportedly worth $560Bn2.
So what can we do? If these types of device really are the best way to administer so many of the drugs of the future, how can we make the process easier? Friendlier? Better? Could it ever be fun? Answer: It’s not going to be easy, and it’s not just going to be solved by a shiny new App. For starters, some of the small print in an Apple user agreement causes concern to the big pharma companies, because it suggests that Apple can use the data processed by your phone.
Also, and more crucially in my opinion, simply relying on the phone as the saviour to operator guidance, coach, motivator and overall activity tracker is not the answer. Why? Because it’s an extra step. It’s extra faff and hassle, when patients need less. I struggle to notice many end-user wins in this process: patient downloads the App, they pair or connect to it wirelessly, they use it to learn how to use the latest swanky injector, then they use it to verify they’ve taken their dose, use it to check when they’re next due a dose, and to prove they’re behaving themselves and deserve their rewards points.
There just isn’t much in the way of a short-term tangible win in most of that list. If there isn’t a clear user benefit, they probably won’t download the App in the first place and the pharma companies won’t get the repeat prescriptions and uptake in continued users they predict, because they got the product/service wrong. Therefore we need another future scenario. This brave new world is called Pharma 4.0 (1.0 being the original syringe and a bottle, 2.0 the pre-filled syringe, 3.0 the current phase of auto-injectors).
Welcome to Pharma 4.0 – the smart syringe. Legacy connected health is a start (ie bolting on some external technology to an already approved mechanical design to get the App/phone connectivity we’re beginning to see today), but this is only a tiny stepping stone; maybe 3.1. An entirely new family of device is needed, which has been designed around a clear enhancement in user experience, and where the service aspect has been factored in from the start. It’s seamless and it works. It delivers not only the correct dose, but also the correct benefits to all users - including pharma companies, the buyers/payers, healthcare professionals and most importantly of all, the patient.
Done properly, it could be the future. Done properly, it is a whole new device-led industry, maybe with entirely automated injection where the patient never sees or perhaps even feels a needle. Where a paradigm shift brings with it new technologies, new solutions, new products (inevitably with novel takes on the durable/consumable split to help the industry stomach the additional device cost). Done properly it will enhance, and perhaps even save lives, because people will find it easy to use and simple to operate. It has to appear simpler than the solutions available now, with the clever tech incorporated in such a way that the delivery task is easier. Get it right and the other users in this complex ecosystem also benefit because adherence increases, costs are saved and repeat prescription revenue is generated.
Deploying the right connectivity in the right manner that enables a simpler dispense experience may well be the key to unlocking the huge potential in this sector. When it comes to the complexity of device operation, less is more. If you think your organisation needs some help in discovering how to deliver simplicity, whilst hiding the inherent complexity, please get in touch.
1 Evaluate Pharma World Preview 2015-2020, May 2015
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