When Innovation Isn’t Enough: Pharma’s Next Frontier

I met Mark Cuban once. Our conversation didn’t last very long.

It was at a medical conference a few years ago. Cuban felt like a great guy to approach with an idea for a healthcare startup. We were both investors in an automation software startup called Zoba, and I of course knew him from his role on the popular entrepreneurial reality TV series Shark Tank.

A few seconds into our conversation, Cuban paused. “Healthcare is hard,” he sighed. That was his way of politely telling me: for that reason, I’m out.

Cuban isn’t wrong. Healthcare is hard. It’s a complex world filled with regulations and many layers of stakeholders. Innovation often moves slower than other industries. Still, that hasn’t stopped game-changers like Cuban’s patient-friendly Cost Plus Drug Company from breaking ground. 

Healthcare transformation is trending in the right direction. Innovative companies are springing up with new cost models and new technology – like devices to monitor patient behavior and artificial intelligence to deliver insights from that data. We’re making the necessary move towards online and digital healthcare, but this shift won’t improve the patient experience on its own.

We can fill cheap prescriptions online, or track our symptoms with a wearable device. Patients are more empowered than ever, but we can’t afford to lose personal touchpoints and human empathy in our move toward the digital health future. For each innovation that brings convenience and efficiency, we need a counterpart that helps patients be proactive about pursuing the best possible health outcomes.

Complementing new pharmacy cost models with additional support

We don’t need to get into the intricacies of pharmacy benefit managers (PBMs) and reimbursements to understand the innovation underway in the pharmaceutical space. 

Here’s what we do know: a Gallup poll from late 2021 showed that 18 million Americans struggle to pay for prescribed medications. 

Mark Cuban’s Cost Plus Drugs was founded to bypass traditional PBMs (aka the healthcare industry middlemen) and sell pharmacy drugs online – direct to consumers –  at cheaper prices. It’s essentially a cash pharmacy: no health insurance accepted. Cost Plus Drugs negotiate drug prices directly with manufacturers. Cuban’s company prides itself on transparency, adding a 15% markup and small fees for labor and shipping.

This is a major win for patients. More people can access the prescription drugs they need to be healthy. Kudos to you, Mr. Cuban!

But the industry can’t stop innovating. Cuban’s company is addressing one major problem (sky-high drug prices) but also perpetuating another. Those massive fees that went to middlemen also paid for support systems. When you cut out the middlemen, you also lose resources like the expensive nurse call centers or pharmacists that can answer questions at the front desk. We’ve got substantially cheaper medication, but fewer human touchpoints that help answer patient questions and drive adherence.

Pharma companies are getting more innovative. They’ve started to create branded portals that help patients set up text reminders to take their medication or refill their prescription, access financial assistance and connect with nurses and providers. These systems are new– and not every drug has its own – but they represent a move in the right direction. 

It’s the second wave of innovation: the necessary adjustments and add-ons that help embed support and care into groundbreaking new ideas.

Driving impact from improved data collection and analysis

I’m impressed with the tools that patients have at their disposal to gather and analyze data. There are a host of examples, but I’ll mention two.

Apple Health has introduced a Medications feature, which can be linked to a user’s health records. It allows patients to create a medication list, set up reminders, and receive smart alerts from their iPhone or Apple Watch.

Propeller Health has developed a sensor that attaches to inhalers. These sensors track where, when and how often a patient uses their inhaler. The sensors automatically send that information to an app on the patient’s phone. AI analyzes the weather and other factors to help make appropriate suggestions to the patient.

These are stellar innovations, but I still think we’re missing something. Driving positive outcomes from patient data is a three-step process that we haven’t fully completed:

1. Collect patient data. Check.

2. AI analyzes the data and offers insights. Check

3. Influence patient behavioral change to drive outcomes with a personalized level of care. Incomplete.

We need to help patients be proactive about understanding and acting on all of the healthcare data that’s available to them. They can track medication on their phone or learn how the weather is affecting their breathing – but what do they do with that information? How should their behavior change when their phone pings them with some critical insight? 

It’s not as simple as telling patients what to do. Patients need to be educated, guided and influenced, especially when it comes to their health. 

To this point, robots and AI can leverage patient data and understand where the patient is in their journey. They cannot, however, effectively get the patient to act on what they need. I see a future where these products, much like drug companies, offer a more direct, human option to support their patients. Empathy, trust and education all need to be embedded into these new technologies.

Our data is only as good as what we do with it – so let’s make it easier for patients to act on the valuable data gathered by their innovative devices, and influence them toward making the right healthcare decisions. 

The two-front battle to improve the patient experience

Every step forward in the digital health transformation requires two types of innovation: a groundbreaking new model or solution and a supporting resource that helps patients navigate a new pathway.

Healthcare is hard. But it’s not impossible. Innovation and collaboration from industry leaders will ensure that we keep finding solutions to make the patient journey easier, more efficient and more effective.

I think Mark Cuban would certainly agree with that.

About Michael Sheeley
Michael Sheeley is the Co-founder and CEO of Nurse-1-1, a HIPAA-compliant live chat platform that connects patients with a nationwide network of over 2,500 NPs, RNs, PAs, and MDs. Previously he was the Co-founder and COO of RunKeeper, a mobile health and fitness company that was acquired by ASICS.

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