F078 DTx series 5/5: Chronic disease management in India (Abhishek Shah)
In the current COVID-19 pandemic digital health companies have an even more meaningful role in improving healthcare outcomes.
Wellthy is one of Asia's leading digital therapeutics companies that inspires and enables patients to prevent, reverse and control chronic diseases. It works with pharmaceutical, medical devices companies, payors and healthcare providers to improve health outcomes. With active therapeutic areas in diabetes and cardiology, it has published real-world evidence across 20 publications in leading peer-reviewed journals and global conferences.
Clinical studies on WhatsApp?
Abhishek Shah, CEO of Wellthy.
One of the first studies in India was conducted with the help of WhatsApp, which has a significantly different societal role in India compared to the West. According to the CEO and Founder of Wellthy Abhishek Shah, WhatsApp is becoming similarly significant in India than WeChat is in China. People communicate on Whatsapp in India, eCommerce is happening on Whatsapp, and more. Shah believes it will further evolve and gain even higher significance. “In India, the first contact with the internet for many people happens through mobile phones. These are users that don’t have access to laptops. The majority of internet consumption happens through 3G, 4G, 5G since landlines and broadband are not prevalent. The number of digital wallets in India is more than 10-times the number of credit and debit cards, giving digital platforms an unprecedented opportunity to scale,” explains Shah.
This is why Wellthy conducted one of it’s first studies on Whatsapp, with the help of 3rd party providers of medical devices and other diabetes related validated solutions.
Older users are most engaged
One of the surprising research findings for the company was that older patients are actually among the more engaged individuals. The finding was contrary to the prediction, that younger users will be the most active. Since chronic diseases are prevalent in older population, health to them is a higher priority. Consequently, older users are driving adoption.
Digital health has an important role in the current pandemic
In the current COVID-19 pandemic, Wellthy, as many other digital health companies has an even more meaningful role in improving healthcare outcome. The rules of engagement with users have completely changed however. As says Shah, habits are different - with commuting gone, people exercise less, eat differently which poses new challenges to disease management and is redefining patient needs.
Beyond India
Welthy is primarily active in India, but reaching other markets as well. The company graduated from Swiss Re's Global InsurTech Accelerator, ICICI Lombard's NOVA InsurTech Accelerator and Merck KGaA's Digital Health Accelerator, G4A Accelerator. “All these engagements gave us a better understanding of different markets but also different stakeholders. We may have worked with patients, doctors, their families, but in accelerators, we also got to learn how to work with insurance companies, Pharma industry and based on other involved companies, we saw how these pays interact with other digital health companies,” mentions Shah.
Entering any new market needs to happen with the awareness, that healthcare is local and culture plays an important part in how users will or won’t adopt solutions. “In India, where the majority of healthcare costs are paid out of pocket, if you don’t pay for healthcare it is probably not good. On the other hand in countries like Singapore or Great Britain, where you’re born in an environment with free healthcare, the relationship towards free services will be completely different,” says Shah. “This is what makes healthcare incredibly hard but also incredibly interesting.”
Tune in for the full discussion:
Some questions addressed:
In your observation, how is India currently coping with the COVID-19 pandemic?
How does it affect you, since diabetes, your main focus, is a risk factor for the severity of COVID-19? Are you in any way adjusting your solution? Are there any specific trends you are noticing among your users?
In 2018, India launched the so-called modicare - health insurance scheme which is supposed to cover the bottom 40% of the population. Where is Modicare at the moment?
You are a DTx leader in Asia and before entering the market, many Western companies tried to succeed in Asia with little to no success, because as you mentioned for Forbes India in 2017, “The genetic makeup of Asians is different, our behaviour and values are different, our cultural nuances are different,” explains Shah. Can you talk a little bit more about some crucial differences and how they affect behavioural change and the design of your solution?
How does all this affect the design of the solution? The study presented at ATTD in 2019 showed that your digital diabetes DTx increases patient engagement and as a direct consequence, health outcomes in patients with type 2 diabetes.
Going back to the beginning of your Wellthy story: can you tell me the story behind Wellthy? It’s hardly five years old and the company has active therapeutic indications in Hypertension, Dyslipidemia, Ischemic Heart Disease, Heart Failure, Type II Diabetes and Chronic Kidney Disease, with an upcoming pipeline in Respiratory indications. Is the number of indications the consequence of the fact that people in diabetes can have
comorbidities in those areas which made it easier for you to develop stand-alone solutions on top of the initial diabetes DTx?
The term DTx was coined in 2017, can you share what your vision and thinking was in 2015 when you started the company? How did you expand to new indications?
As DTx require clinical validation - can you share a bit more about the clinical trials your solutions have undergone and your assessment of those trials in terms of the difficulty of their execution compared to regular pharma clinical trials? Do you have an easy time recruiting patients, are all of them your users? How long are the trials etc.?
In 2017 you graduated from Swiss Re's Global InsurTech Accelerator, ICICI Lombard's NOVA InsurTech Accelerator and Merck KGaA's Digital Health Accelerator. Last year you entered the new cohort of digital health companies at G4A. What were the main benefits of these programs, given that they are from the West with the Western mentality and your focus is on Asia? How did they directly help you?
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