Future of drug development focuses on patient experience -- and digital health tools can help

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In the latest NEJM, UNC oncologist (and former MGH colleague) Ethan Basch explains with characteristic eloquence why the future of drug development will involve a more granular understanding of the patient's experience of illness.

What's especially interesting about Basch's examples are that they come from a field - cancer - in which you might think so-called "hard" endpoints (like progression-free survival [PFS], say) would be all that mattered.  But you'd be wrong.

As Basch points out, in many cases, the key points of differentiation between therapeutics are (unfortunately) not differences in PFS, but rather the way the drugs make the patients feel during (and after) treatment.  An "incremental" drug that improves the tolerability of a cancer medicine can have a profound impact on patients.

There are two broader points here.

First, the increased emphasis on patient experience reflects a broader trend in healthcare, from a view of disease that focuses on the physician's perception and assessment to a view - more appropriately -centered around the patient's experience.  The need to better measure this experience has been recognized as a vitally important goal.

Second, medicine's (including, as Basch accurately describes, pharma's) need to better understand and reliably capture the patient's experience of illness represents (as I've emphasized often in this space) a perfect fit for digital health, which should be able to provide exactly the right tools for this very important job.  This is an animating thesis of the MGH/MIT Center for Assessment Technology and Continuous Health (CATCH) (disclosure: I'm a co-founder), and many other digital health initiatives.

The need for improved patient-associated measurements is also a key reason medical product companies should care a lot more about digital health than they seem to.  As I've argued, most future drugs are likely to represent incremental improvements (again, somewhat unfortunately), and it will be essential (table-stakes) to understand, and have credible data around the often very important benefits a new product delivers to patients.

Who will deliver the robust digital health solutions medical product companies will increasingly require?  That is the question - and the opportunity.

 

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About the Author

 

David
Shaywitz
  • Dr. Shaywitz trained in internal medicine and endocrinology at MGH, and conducted his post-doctoral research in the Melton lab at Harvard. He gained experience in early clinical drug development in the Department of Experimental Medicine at Merck, then joined the Boston Consulting Group’s Healthcare and Corporate Development practices, where he focused on strategy and organizational design. He is currently Director of Strategic and Commercial Planning at Theravance, a publicly-held drug development company in South San Francisco. He recently wrote Tech Tonics: Can Passionate Entreprenuers Heal Healthcare With Technology? 

  • Email: davidshaywitz.aei@gmail.com

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