I need to confess that at the start that I am suspicious when a pharmaceutical company offers to pay for anything on behalf of patients. Such programs usually have a strong link to the company's bottom line. I cite as evidence my previous note about drug company assistance programs (see: Patient Assistance Programs Keep Drug Prices High and May Actually Be Illegal). Although patients may view them as beneficial, they are designed to provide an incentive for the patients and insurance companies to continue to pay inflated prices for brand name drugs. Here's a quote from my previous note: "Offsetting the cost of some very expensive drugs serves as an incentive for patients, and their prescribing doctors, to continue to use them rather than searching for less expensive but equivalent drugs." Now comes news that AstraZeneca will pay for patients to have a personal digital health coach (see: AstraZeneca will pay for patients to have a personal digital health coach). Below are some details about the program from the article:
....Vida is partnering with AstraZeneca to launch “Day by Day”, a program that focuses specifically on cardiac rehabilitation patients.The most notable part of this partnership is AstraZeneca will pick up the fee for patients in participating hospitals and health facilities. The cost to use Vida is $45 per month or $249 per year. For AstraZeneca to pick up this cost is a huge deal. Compliance in post cardiac intervention care is critical for better outcomes. Having the ability to discharge a patient with a personal health coach who will help make sure your instructions are followed and your patient is actually following their new diet and medications is tremendous.The platform is currently unbranded, so patient’s won’t see the pharmaceutical company’s name anywhere in the service. With digital health services becoming ubiquitous and cost relatively cheap — it makes sense for pharmaceutical companies and hospital systems to lean on these services to improve patient health. For a hospital, paying $250 for a patient to use a health coach is a lot cheaper than dealing with the issues that come with 30 day readmission penalties.
In my mind, there is one primary reason for AstraZeneca to pay for a patient's health coach. It's to steer them to the company's cardiovascular and metabolic drugs (see: AstraZeneca cardiovascular & metabolic drugs). I suspect that this bias may not be always obvious to the patient but it will surely be present in some way. Vida and AstraZeneca will also have the opportunity through the health coach program to acquire information about patients that can be used later for marketing.
In this same vein, Vida and AstraZeneca are teaming up to provide an app to assist in post-heart attack recovery (see: Vida Health and AstraZeneca launch new app for post-heart attack recovery). I am a little surprised that the author of this Fortune article did not delve deeper into the motivation for AstraZeneca to develop such a product. I will bet that there are some subtle, or not so subtle hints, in the app to use AstraZeneca products. The company has also announced software to create a smart inhaler adherence program for patients (see: AstraZeneca, Adherium to create smart inhaler adherence program for patients). I have no objection to increasing patient adherence to drug regimens but such programs also increase drug sales.
To bolster my suspicions about the motivation of pharma companies regarding web sites and social media, I will refer the reader to two previous blog notes. The first described a Lilly questionnaire on the web ostensibly designed to determine if one was depressed (see: Rigged Depression Survey on the Web Steers Readers to Lilly's Cymbalta). It was rigged such that whatever answers one provided, the conclusion was that the respondent was at risk for major depression. The second note I posted four years ago about how the FDA was investigating the participation of pharma companies in social media such as Facebook (see: Limitations Placed on Big Pharma Facebook Pages). The basic premise was that the companies could covertly manipulate consumer opinions though these means. However and according to one source, the pharmaceutical industry has been largely ignoring social media, at lest for now, apparently out of concern for the FDA (see: Big Pharma Can't Figure Out Social Media, and the FDA Isn't Helping). Here's a quote from this article:
Pharmaceutical companies are finding that the best—or at least safest—route to take with social media is to just ignore it. Given the a so-far unadapted FDA regulatory scheme for communication via things like Twitter and YouTube comments, rules for how drug companies can and can’t interact with consumers online have remained prohibitively vague.