BrightInsight / Aug 13, 2019

Digital Health is an Opportunity for New Relationships Between Payers, Biopharma, and Medtech

Digital health interventions have the potential to transform the relationship between payers and biopharma companies. During a panel discussion at the very first BrightInsight Ecosystem Event, Max Cambras, Managing Director at LEK Consulting, leveraged his years of experience working with medtech and biopharma companies and pointed to new opportunities for partnering with payers.

Digital health interventions have the potential to transform the relationship between payers and biopharma companies. During a panel discussion at the very first BrightInsight Ecosystem Event, Max Cambras, Managing Director at LEK Consulting, leveraged his years of experience working with medtech and biopharma companies and pointed to new opportunities for partnering with payers. The content below includes excerpts from remarks Cambras made on-stage during the session, From the Payers and Provider’s Perspective: When Will Digital Health Scale?

“A lot of my biopharma and medtech clients have historically looked at payers as some sort of glorified, guarded cash register,” Cambras said. “This was a big problem.”

Cambras acknowledged that the relationship between payers and biopharma or medtech companies has at times been transactional, but digital health is an opportunity for a deeper partnership.

“A real outcomes-driven approach to digital health is a great starting point,” Cambras explained. “Instead of opening the conversation with ‘Are you going to put my drug on the formulary? How much of a rebate do I need to give you?’ You can start the conversation by bringing something else to the table that has mutual interest: real world data.”

Cambras argued that biopharma and medtech companies will need partners and an ecosystem strategy if they want to succeed in digital.

“The reason we need to partner with payers and providers in a relationship that is not the cash register model, is that we don’t have direct contact with our customers beyond the dosing or therapeutic experience,” Cambras said. “What will happen is, we will be fine embracing digital for digital marketing. It will take more work, but we will figure out how to get digital transformation in clinical development and clinical trials. When we ultimately get to stakeholder engagement and patient outcomes, we are going to fall short – really short. And that’s because we didn’t have effective partnerships with the groups we need to make it work: payers and providers. If you want to do this, [an ecosystem approach] is going to be a big part of it.”

That ecosystem approach will include technology partners too.

“It is incredibly important to get people to focus on what they are really good at,” Cambras said. “In terms of innovation, medtech and biopharma are profoundly good at innovating on clinical endpoints. That is a very complicated innovation process and it has taken us years and years to get to where we are today. The second you start to spread yourself out this process will start to fall apart.”

Digital therapeutics and digital wraparounds for pharmaceutical therapies will likely change the value equation between biopharma, medtech and payers, Cambras said.

“If you unpack it and anchor digital health solutions to outcomes, you are now unbundling the entire therapeutic process,” Cambras said. “Payers might end up willing to pay differently. I don’t know what that will end up looking like yet.”

While many aspects of digital health remain unclear today, there is a growing consensus that an ecosystem approach is key to scaling digital health products. Biopharma and medtech companies will forge new partnerships with technology companies, payers and providers to maximize the effect their digital products have on patient outcomes.