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Real-time digital monitoring tools in Pharma; the lessons of the SMART insulin pens

14th December, 2020

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In our work with brand teams across the Pharma industry we often talk about how digital strategies might be more closely integrated with wider brand plans.

The launch of the FDA’s Digital Health Center of Excellence at the end of September 2020 (1), a central resource intended to help both regulators and innovators promote digital health technologies, prompted us to pause for a moment and consider the impact added-value digital services and solutions that wrap around a brand have already had on patient outcomes.

One topic we’ve been following is the opportunity digital tools afford in terms of improving the monitoring of disease. A great example is the launch of the SMART insulin pens, clever delivery devices that enable easier and more accurate dose adjustments, along with the means to share real-time data between patient and physician.

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We know that patients want to take more responsibility for their own health

The importance of digital services and solutions is undoubtedly increasing as patients take on greater responsibility for their own health. They want healthcare solutions that come to them on-demand and fit in with their busy lifestyles, particularly so when managing a chronic condition.

Diabetes is one area where managing the challenges of fast-acting insulin dosing has long proven to be a barrier to robust disease control, so tools which capitalise on our new digital behaviours, and ever increasing levels of mobile phone ownership, to improve treatment regimens, was always an obvious application.

Enter Novo Nordisk’s SMART insulin pens

Injectable insulin for the treatment of diabetes has come a long way since the days of harvesting insulin from the pancreases of cows and pigs and administering doses using a vial and syringe. When the world’s first commercially available insulin pen was introduced in 1983 it constituted a leap forward in convenience for many diabetics in the management of their disease (3). That same form factor has been improved upon many times since then and the latest iteration of this technology is the SMART insulin pen (also known as S-pens).

The NovoPen 6 and the NovoPen Echo Plus, produced by Novo Nordisk, are reusable insulin pens able to record, display and wirelessly communicate to a smartphone, information about the user’s insulin schedule. This information includes the amount of time passed since the last dose, the size of the last dose and the current level of active insulin in the body or insulin on board (IOB).

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As well as allowing users access to the kind of detailed information previously only accessible to users of far more expensive insulin pumps, S-pens also make users’ lives easier by aiding in the calculation of insulin doses and corrections. The features offered by S-pens of automatic record keeping and integration with both continuous and flash glucose monitoring systems can prevent patients from having to worry about forgetting a dose, or about insulin stacking, which is particularly relevant for patients requiring multiple daily injections (5), (6), (7).

Initially these pens only worked with the smartphone app produced by Novo Nordisk, but the ability to interface with other popular glucose monitoring systems such as the Medtronic Guardian Connect system and Abbott’s FreeStyle Libre app has since been added and more are planned (8), (9).

The additional connectivity potential of the S-pen is, perhaps, the most important feature of all.

With a patient’s permission, the information gathered and stored by these S-pens and the accompanying digital services can be shared with their healthcare providers providing reliable access to the data required to develop more targeted treatment plans.

Once this digital service can be combined with sufficient 5G infrastructure it will allow the real-time sharing of relevant health data from anywhere around the world. HCPs can always be aware of the latest patient progress and can intervene promptly to recommend new courses of action if required – and of course an intervention prompts a conversation that may lead to further improvements in care.

Uptake of the S-pen has already been shown to have a positive impact on outcomes

Novo Nordisk presented data in 2019 suggesting a positive impact from their digital delivery devices10. The use of their SMART insulin pen has resulted in more time for each patient in good glucose control each day – a substantial step forward in the level of disease control that can be attained.

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However, it has been interesting to note that the connectivity functions of the S-pens have, so far at least, been used to a lesser extent than might have been expected. In a recent webinar by InCrowd, "The Impact of COVID-19 on Diabetes Patients", held in October 2020, there was little mention of the S-pens, with the presenter suggesting that perhaps patients are still reluctant to share their data on a continual basis (11).

So will new attitudes, changed by the COVID pandemic, help patients to realise the full potential of devices such as the S-pen in the coming months?

The practical advantages offered by S-pens compared to previous generations of diabetes management devices are clear, but there is more to be gained. Over the course of a lifetime a person with diabetes can spend two full years of their lives solely on the self-care required for the management of their disease (8). This will affect the individual not only practically, but can also have very real emotional implications, an aspect of disease which is often overlooked.

At a time when contact with friends, family and even medical professionals has been limited by the COVID-19 pandemic, it has never been more important to be mindful of mental wellbeing as well as physical health, and many have reported on changing values and attitudes amongst patients.

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To us, it seems that the ability of digital health services to keep patients connected with their healthcare providers has never been as highly valued, and we can’t help wonder if the connectivity offered by digital devices such as the S-pen will actually become the most important driver of use in the future; sharing data that prompts a conversation – and consequently enabling a valuable connection – between patient and physician.

If you’d like to talk about some of the digital added-value services and solutions you see as helping you to improve your customer journey, then please do get in touch.

We’d love to talk.

Sources

  1. FDA establishes Digital Health Center of Excellence | Available at https://www.mobihealthnews.com/news/fda-establishes-digital-health-center-excellence
  2. Digital Health Center of Excellence | Available at https://www.fda.gov/medical-devices/digital-health-center-excellence
  3. The pen is mightier... | Diabetes UK. Available at: https://www.diabetes.org.uk/about_us/news/diabetes-technology.
  4. NovoPen 6 and NovoPen Echo Plus: Connected Insulin Pens To Launch in Early 2019 | diaTribe. Available at: https://diatribe.org/novopen-6-and-novopen-echo-plus-connected-insulin-pens-launch-early-2019.
  5. Flash glucose monitoring | Diabetes UK. Available at: https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/testing/flash-glucose-monitoring. (Accessed: 6th October 2020)
  6. Continuous glucose monitoring (CGM) | Diabetes UK. Available at: https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/testing/continuous-glucose-monitoring-cgm.
  7. Diabetes Problems That ‘Smart’ Insulin Pens Solve. Available at: https://www.healthline.com/diabetesmine/diabetes-how-smart-insulin-pens-help.
  8. Novo Nordisk Integrates Smart Insulin Pens With Medtronic Continuous Glucose Monitoring (CGM) Devices. Available at: https://hitconsultant.net/2019/09/16/novo-nordisk-integrates-smart-insulin-pens-with-medtronic-cgm-devices/#.X3sT6hBKhpg.
  9. Abbott and Novo Nordisk plan to link diabetes devices | MedTech Dive. Available at: https://www.medtechdive.com/news/abbott-and-novo-nordisk-plan-to-link-diabetes-devices/548858/.
  10. Capital Markets Day 2019 | Available at https://www.novonordisk.com/content/dam/nncorp/global/en/investors/irmaterial/cmd/2019/Consolidated%20capital%20markets%20day%202019%20presentation.pdf
  11. The Impact of COVID-19 on diabetes patients | Available at https://incrowdnow.com/form-thankyou/?post_id=16624
  12. Google Trends: What searches tell us about our coronavirus thoughts and fears - Vox. Available at: https://www.vox.com/recode/2020/5/5/21243854/google-trends-search-coronavirus-simon-rogers.
  13. 100 projects since lockdown | discover.ai. Available at https://www.discover.ai/blog/200-days-and-100-projects-on

Further reading

The Reference Guide to Integrate Smart Insulin Pens Into Data-Driven Diabetes Care and Education Services | Hope Warshaw Associates. Available at: https://journals.sagepub.com/doi/pdf/10.1177/0145721720930183

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