Boehringer Ingelheim is a pretty familiar name to people who follow mobile health moves from pharma companies. The large, privately-owned German firm has been involved in pilots with game developer Ayogo, smart pill bottle maker AdhereTech, and now-defunct behavior change platform Healthrageous.
While its partners have talked up these pilots, up until now the company itself has been pretty quiet about its strategies in testing out innovative health technology.
At Health 2.0 last week in Santa Clara, California, Larry Brooks, the director of the New Business Model and Healthcare Innovation group at Boehringer Ingelheim took the stage with Propeller Health CEO David Van Sickle to talk about a newly announced pilot of Propeller's technology.
"About three years ago, the company said patients, especially those with high risk diseases, shouldn’t be treated with just medications," Brooks said. "They should be treated more comprehensively. So we started the New Business Model and Healthcare Innovation group, positioned within our business development and licensing, because just as we have folks looking for new molecular markers, we really wanted to find technology that we thought was going to shape the broader healthcare delivery and financing system and have an impact on Boehringer and our prescription medication. So it continues to be a learn-by-doing type of group that continuously is signing customer-based agreements to validate whether there’s a particular technology we should be looking for, even if it's in the longer two to five year range, and not necessarily in the short term."
Brooks says that as a privately owned company, Boehringer Ingelheim is able to take risks on small pilots, then report back to the higher ups of the company to encourage larger implementations of pilots that work. He said the rate is 50 to 75 percent of projects get taken on in a larger capacity. Although the purpose of the unit is to be innovative, Brooks said, the mandate is not to look for totally new businesses.
"We look to explore various models that we think could fit into our prescription medicine business. We don’t look to these to generate independent revenue streams outside of our prescription medicine business, but instead how do we optimize the current business. And once we finalize that qualitative business case or model, then we’ll move to some kind of test to validate whether it works. So instead of doing what pharma typically does, which I think is look at $100,000 opportunity and do $200,000 of market research, we just say let’s just do this and we’ll learn through that process how people in the ecosystem view this and whether it really is something that would work. And at the end we analyze these results and know whether it’s something that should be scaled."
Boehringer teamed up with Propeller Health because a large part of its business is respiratory medications. In the pilot, Propeller Health built a sensor that could attach to the back of Boehringer Ingelheim's Respimat inhaler.
"The goal is really to passively collect this information and to try to put it to work in a new way that’s made possible by digital health interventions that are able to put computing power and new interfaces to work on the sensor-captured information," Van Sickle said. "Really trying to get contextually relevant, personally meaningful interventions in the moment, limited by a real mission in the company to do so without asking the patient and the caregiver to do much at all."
Some of the benefit of collecting the data is just learning more about patients' reasons for nonadherence. But Van Sickle also gave some specific examples of ways the sensor could improve adherence in users.
"It means things like being able to deliver subtle audiovisual cues when the medication hasn’t been used and the time for a dose has passed," he said. "Or predicting when someone is leaving their home and giving them an alert so they can take a moment to go back and get their morning dose. It means the sensors sort of knowing how much medication is remaining and suggesting an appropriate time for refilling the prescription. And it means thinking about ways to put information about the daily use of these medications to work, to think of ways we can reward individuals intrinsically and extrinsically to motivate better adherence."
Brooks said Boehringer is also looking at the pill bottle format, alluding to the company's work with AdhereTech. He said the sensor technology is there, but it's a harder problem to solve than inhalers, because with inhalers the device comes with the drug, whereas pills aren't set up to be bundled with an electronic device.
To really solve adherence, Brooks said, pharma companies are going to have to work together so they can present a unified front to payers.
"I always look at it from a customer perspective, and if I go to a health plan and I tell them that I have a solution for our inhaler, but you can’t get it for any other inhaler and you have to work with a different company for that, it’s not going to take off," he said. "So I would love it if David struck a deal with three or four of the other leading pharma companies in respiratory and we came to these payers with a whole package solution that included both brand and generic medication and any form factor the medication was delivered in."