Successful patient outcomes through patient-centric education: the role manufacturers should play

May 10, 2023 | Medical Devices, Medical Nutrition & Consumer Health, Pharma & Biopharma

Successful patient outcomes through patient-centric education: the role manufacturers should play

Patient education plays a key role in patient outcomes¹ however it is often overlooked due to time constraints and patient shock at diagnosis, resulting in worst-case scenarios for the patient. A good example of this is diabetes. By managing diabetes, patients can prevent the worsening of the condition, and complications such as the need for a foot amputation. Nevertheless, almost 8,000 diabetes-related amputations are still conducted every year in the UK². Why does this happen, if it is so preventable?

How informed a patient is will shape the trajectory or their journey, their treatment, and their interaction with their healthcare professionals (HCP). On the one hand, if patients are not informed, they can struggle to understand the causes and effects of their condition, the impact of the treatment and how their own lifestyle changes could affect their journey and recovery. This is particularly important for the 1 in 3 adults living with multiple chronic conditions³, as these are often both complex and require increased focus on the side of patients for effective management. On the other hand, a lack of patient awareness also creates challenges for the HCP, as they struggle to maintain patient compliance with monitoring visits and treatment engagement. Without effective education, patient needs suffer.

Patient education needs to be improved to positively impact patient outcomes. However, as HCPs have limited time to offer additional services to patients, manufacturers have the opportunity to play a big role in supporting patients from the start and throughout their journeys, becoming a life-long value partner.

Patients experience a significant life shift during diagnosis

Being diagnosed with a chronic condition brings forward several obstacles for the patient. Firstly, patients must understand their situation and what the course of treatment entails. This is often combined with the psychological need for an acceptance of the disease or ailment, as most patients experience shock, anxiety, depression and worry at the beginning of their journey⁴.

Additionally, patients must accept that the course of their life may now turn out differently. For example, in the case of diabetes, patients need to make adjustments to their diet. In the case of vascular disease, they have to give up certain physical hobbies. In the case of an ostomy, they have to adjust basic daily necessities. A large part of this relates to understanding the causes of their condition and how making changes in their lifestyle can help improve their health and prevent themselves from worsening.

Patients have a lot to ramp-up on about their condition, however, the majority of patients have low awareness and understanding of their ailment. Sector & Segment’s research has identified that this is not only the case at diagnosis but even years after living with the condition. As a result, patients do not make sufficient life adjustments and significantly hinder their health outcomes. These are the most common challenges that we have identified throughout our work in the healthcare sector.

Patients can experience complications if they don’t understand their condition straightaway

At the beginning of their journey, patients often receive a lot of material, which naturally results in them becoming overwhelmed. These patients may not process all the information and may have difficulty remembering key aspects once home from the doctor.

At the same time, HCPs have a lot to communicate to the patient at this time. In some cases, HCPs may see that the patient is overwhelmed and may not cover every topic in depth or from every nuance. In other cases, HCPs may simply forget to cover some of the peripheral health topics (such as nutrition) if they are not the essential treatment. In some cases, if the information is not understood immediately by the patient, it can cause complications to a procedure or treatment.

Sector & Segment conducted a multi-country project where we spoke with patients who developed surgical wound dehiscence following an operation. We observed that all the patients who experienced this complication were unlikely to have a deep understanding of what was expected of them post-surgery. Patients could not recall any specific advice from their HCP – which could have been resting, not smoking or drinking alcohol, eating healthily or not touching the wound. Consequently, these patients clearly could not understand how their behaviour resulted in a surgical incision not healing but were also unaware that their actions would have affected this outcome. This causes patients to disengage from their recovery and lose trust in their HCPs as well as the products that they are using for their treatment.

Without knowing the cause, patients have no solution

With some conditions, treatment alone is not enough – understanding and reversing the cause of the problem is essential. This is the case with chronic ulcers – while there is treatment for the wound itself, the main necessity is to treat the underlying condition which is causing the ulcer (e.g. diabetes or vascular insufficiency). By not treating the cause and only the wound, the patient can expect the ulcer to recur.

Sector & Segment conducted research across 4 countries which focused on the behaviour of patients with chronic ulcers. It was observed that awareness and understanding about the underlying condition was a key element missing across most interviewees. The research found that less than 10% of patients could confidently say that they understood the link between the underlying condition and how it has caused their ulcer. The remaining patients were not confident and could not explain the connection, and therefore were not following all the treatment recommendations for the underlying condition. Some of these patients had had their ulcers for over 2 years, but were still struggling to understand the cause and the treatment. The sample contained a variety of ages, work status, professions, and education levels, with no clear link found to the patient’s background. Without this awareness, patients are stuck in an endless loop with their chronic wounds, as they are not targeting the cause of the problem. The longer they are stuck in the loop, the less trust they have in the brands they are using for their treatment and the more likely they are to abandon the treatment altogether, potentially blaming the quality of the product and not their compliance levels.

Misleadingly, the situation doesn’t look that bad

One common issue seen with patients is them believing that “the worst case will not happen to me”. Patients often misunderstand how important it is for them to change their lifestyle after being diagnosed with a chronic condition. In most cases, the symptoms of the disease appear slowly, hence patients struggle to grasp the real impact of the diagnosis and often fail to make significant changes quickly enough.

While researching the diabetes patient journey, Sector & Segment heard from nurses in multiple countries that patients who are diagnosed with type 2 diabetes often struggle to understand how dangerous their diagnosis really is. The symptoms are often detected through routine blood tests and patients rarely feel a large difference in their daily lives. For example, it has been proven often that if patients lose a significant amount of weight, then they may be able to reverse the diagnosis⁵. However, given the lack of will and understanding from patients, this occurs infrequently.

Likewise, patients who severely mismanage their diabetes can develop diabetic foot ulcers which can result in amputation – a drastic complication all patients are taught about. However, wound care nurses comment that they regularly see patients with diabetic foot ulcers who have tried to treat it at home with aloe vera, only coming to see an HCP months later when the wound has significantly deteriorated. If patients were guided to treatment earlier on in their journey, they may be more inclined to follow the treatment and use the products available for their treatment, improving their outcomes and quality of life.

Misinformation online knocks patients off-course

Once the initial shock after the diagnosis subsides, curious and proactive patients may decide to begin conducting their own research on the condition, which mostly involves online research. Patients trust reliable sources such as government healthcare websites or patient association materials – however there is also a lot of other misleading information on the internet which could point the patient in the wrong direction, such as websites which may have the word “health” in the title but don’t have HCP backing.

Sector & Segment has observed oncologists across many markets complain that cancer patients believe that “sugar feeds cancer”, after reading this online. Happening upon this information, patients cut down on their eating and begin to lose weight. In reality, a consistent calorie intake is important for cancer treatment as the patient will require this energy to recover⁶. Oncologists spend a large proportion of their monitoring sessions “debunking” this myth and convincing patients to continue their normal eating habits.

It would be logical to assume that those patients who conduct online research about their condition are generally more interested in their care and would therefore have better clinical outcomes. However, the amount of misinformation available can hinder their healing process. Likewise, some conditions can have varying degrees of co-morbidities and severity, and patients may read correct advice for their condition, but one which does not necessarily apply to them due to various factors which they, themselves, may not understand. Patient-centric materials which focus on the main challenges patient face could raise condition understanding and improve patient compliance long term.

Patient-centric tools and services are needed to support patient engagement

To support patients, the education resources available to them should focus on their needs and their challenges. For example, if patients find it difficult to assimilate necessary information following diagnosis, then resources in the form of physical or online leaflets should provide them with an easy-to-read guide of “essential things to know after diagnosis” – this would allow patients to read in their own time and be able to refer to it as needed. Currently, this information is available on the internet, but not necessarily in one place for each condition.

Resources should be designed with the patient in mind, as often patients must rely on medical websites which are geared towards HCPs and are therefore quite difficult to understand. Hence, websites with a more approachable tone may educate the patient more holistically.

Endorsements by knowledge opinion leaders and expert HCPs can also help provide credibility and show patients that a source can be trusted. Whatever the resource, it should not only educate patients broadly, but also meet the patients’ needs and challenges, to support them on their journey.

Manufacturers need to play a large role in patient support, because no one else will

HCPs and healthcare systems alone do not have the resources to develop and provide the education and materials which patients require, hence product manufacturers have a large role to play in this regard to improve patient outcomes. By supporting the patient in the beginning, they can become a value partner and gain patient loyalty throughout the journey. It is important to engage patients early on, to ensure that they have a good understanding of how their own lifestyle changes can affect their treatment and to ensure there is trust between the patient and the healthcare ecosystem. Later on, as the patient progresses with their condition and accepts it, they may have other needs which need addressing such as the variety of products and treatments available to them. Simultaneously the manufacturer can support the HCPs by lessening their burden.

By supporting the patients throughout their condition, manufacturers can improve patient compliance and engagement, as well as improving clinical outcomes and patient quality of life. Depending on the condition and the needs of the patients, manufacturers could be providing a variety of solutions.

One option would be providing bespoke educational materials, such as the dedicated website about nutrition and cancer which has been designed by Nestlé Health Science ⁷, which is a one-stop, verified source on everything a patient may want to investigate.

Similarly, manufacturers can provide tools for patients to track their daily activities and condition-related markers, an example of which is the My Ostomy Journey App by Convatec⁸, which allows patients to track daily intake, log foods, explore products and get instant help if needed.

Companies can also be offering emotional support for patients to avoid feeling alone in their fight. Pfizer designed their LivingWith app ⁹, which not only provides cancer patients with information and trackers but allows patients to find support groups and make connections with other patients in their zip code.

Sector & Segment can support you with your patient-centric strategy

Sector & Segment has extensive experience deep diving into a market to understand the true challenges the patients and HCPs experience, as well as the patient needs that are not currently being met. Our experts can tailor your strategy according to the existing market dynamics, to best support the patient population and become a valued partner throughout the patient journey.

We can leverage our experience to help you:

Map out the patient journey and identify the largest pain points at each stage
Identify, segment, and quantify your customers by needs and drivers
Conduct digital listening and identify trends in consumer voices
Translate consumer insights into improving your product offering, pipeline, and positioning
Build materials such as patient testimonials, or working with your marketing team to script testimonial videos
Test online content with patients or with doctors

Contact

Margarita Svarceva at

Margarita Svarceva

1. Adams, ‘Improving health outcomes with better patient understanding and education’, Risk Management and Healthcare Policy, 2010
2. Office for Health Improvement and Disparities UK, ‘National Diabetes Footcare Report’, updated 2021
3. Hajat C, ‘The global burden of multiple chronic conditions: A narrative review’, Preventive Medicine Reports, 2018
4. DeJean et al. ‘Patient Experiences of Depression and Anxiety with Chronic Disease’, Ontario Health Technology Assessment Series, 2013
5. ‘Reversing Type 2 Diabetes’, Diabetes UK
6. Ravasco P. ‘Nutrition in Cancer Patients’, Journal of Clinical Medicine 2019
7. Nestle Health Science: My Cancer My Nutrition
8. Convatec: My Ostomy Journey App
9. Pfizer: LivingWith

Key Insights and Takeaways: GIANT Health Conference in London

Jan 30, 2023 | Medical Devices

Key Insights and Takeaways: GIANT Health Conference in London

In December 2022, our Consulting Managers Margarita Svarceva and Peter Hays attended the GIANT Health Conference in London. The two days were filled with engaging workshops, panels, and exhibitors. The conference was attended by many key stakeholders in the healthcare and innovation ecosphere including medical innovation start-ups, health and pharmaceutical companies, investors and regulators. Attendees were a mix of British, European and North American companies. We were immersed into the world of healthcare innovation, and we saw several key trends emerging. GIANT stands for ‘Global Innovation and New Technology’ show. The yearly event brings together individuals and companies in the healthcare innovation space through a 2-day exposition with 4 thematic presentation programmes. This year’s presentations were focused on Digital Pharma, the Future of Hospitals, Mental HealthTech and the new Integrated Care Structure in the NHS. The event aims to improve health and well-being of people around the world by facilitating healthcare innovation and supporting health-tech entrepreneurs and investors. The types of exhibitors present at GIANT Health 2022 can be segmented into the following categories, albeit not exclusively:

Figure 1: Lumeus app which uses music to encourage positive emotions (lumeus-app.de)

Many companies are naturally offering a product or service through an app which can be easily accessed by the user or patient on their phone at any moment. A large majority were offering an app or included an app as part of their offering, either:

Offering a service through an online platform or phone app. Examples of this included mental health apps which support patients with chronic depression or anxiety, or platforms which allow patients with complex conditions to combine records from all their physicians in one platform, and to connect these physicians to share information and facilitate more integrated care.
Providing an app which links to a medical device or physical service. In this case, the companies are using technology for tracking and monitoring purposes but are collecting data through a physical device. This includes start-ups which are producing wearable devices for a specific patient group (e.g., Parkinson’s or Kidney disease) with the aim of alleviating symptoms, tracking essential daily markers or facilitating remote monitoring and communication, with the aim of assisting the care and treatment of a patient. These devices link to a platform or app, which is used for data collection, monitoring, communication and assistance.

Figure 2: The CUE1 is a wearable device designed by Charco Neurotech to help decrease symptoms of Parkinson’s disease (charconeurotech.com)

Some of the start-ups offered more traditional medical devices independent of an app. These innovations provide either an improvement to healthcare infrastructure or a direct solution for a patient condition. This includes small-scale point-of-care testing, which are small devices that can provide various on the spot blood tests with results being available instantly. It also includes start-ups which had created a company around a new scientific approach or method. One example includes a company using genetic materials to identify bespoke treatment approaches for Oncology patients to improve outcomes. The companies that exhibited at GIANT Health in 2022 were on a spectrum of maturity. Some were newly created start-ups and still in development phases, while others were more mature companies with demonstrable success in one country looking to expand to new markets to find new patients or customers. A large proportion of companies were in-between, with a well-established offering but looking for investment and further support.

Our Key GIANT Takeaways

S&S sat in on various panels and industry discussions about the current challenges for MedTech and digital therapy companies and in particular the challenges new health technology companies have to navigate. We took the following lessons with us.

There is a lack of funding for implementation for MedTech and digitally enabled therapeutics

Across countries, but particularly in the UK, we are currently seeing an under-funded and under-staffed healthcare system. One remedy would be new technologies and innovation to supplement care with digital systems which provide support, monitoring and/or treatment to patients who are unable to access other forms of care. The challenge, however, is that while funding is readily made available for research and development of innovative technologies, this does not extend to implementation in the UK. This results in a large pocket of innovation, which is followed by brain drain, in which start-ups are seeking to launch somewhere they will receive more support. Consequently, the UK is losing out on many of the good ideas it helped foster.

Reimbursement is highly challenging for MedTech, particularly due to the need for real-world and clinical data

Figure 3: The PL Mini is a point-of-testing device which offers 37 different tests (premalabsdiagnostics.com)

Most innovative digital therapies have a clear cost saving, process improvement or outcome improvement evidenced in their design. However, the current reimbursement frameworks treat these as a medical device rather than a treatment which comes with challenging regulatory hurdles. These start-ups are required to fulfil extensive evidence-based reimbursement criteria which can be challenging for many start-ups. Randomised control trials are expensive to conduct. Real-world data, which is collected from real patients or users as they engage with the digital treatment, are not always accepted, or are accepted with strict criteria. As a result, many digital therapies, which could complement the healthcare service, struggle to gain any reimbursement. On top of that, the NHS is a highly fragmented organisation with 42 ‘Integrated Care Systems’ (ICS). Once a new digital tool has enough evidence to even be reimbursed, they must deal with each ICS on an individual basis, which can be resource-draining for small start-ups. In reality, digital therapies are very scalable and easy to implement elsewhere once they are up and running – it is difficult to understand why they need to jump through the same hurdles again. A more open-minded NHS could integrate digital therapies to provide care to patients struggling to gain access to healthcare professionals.

There is a lack of understanding around the value of MedTech and digital therapies

Figure 4: Moonbird is an app-linked device which helps with anxiety by helping a patient control their breathing (moonbird.life)

Tech tools and innovative platforms have been used in every industry for decades now. However, the healthcare system remains very slow at adopting organisational or monitoring technology which can lessen the current burden on care services. While there is constant news and updates about new ways technology is being used to make healthcare more accessible and equitable, as the GIANT Health London 2022 conference demonstrates, the existing systems are not realising the value that this technology brings. Healthcare has been the slowest at incorporating simple organisational tools into its daily function (e.g. online booking systems), hence advanced digital therapies such as specialised remote monitoring platforms, apps which deliver anxiety-reducing support or platforms which help track patients with chronic conditions, have not been incorporated into the NHS. The sheer low level of technological solutions available to patients, points to a clear lack of understanding on the value these could bring. Overall, most healthcare systems are not designed to be open to digital therapies and MedTech, and fail to take into account how their approach needs to be adjusted to bring them into the fold.

We can help guide you through the MedTech landscape

Sector & Segment has extensive experience working with Medtech companies to tackle the challenges we identify above. Challenges of funding, reimbursement and awareness are key pain points faced by most companies in the healthcare space. We have successfully worked with MedTech clients to identify whether public reimbursement is the best solution or if direct-to-consumer channels are more lucrative; whether a product is not being used due to awareness or due to negative perceptions; whether new market entry is an attractive strategy. Our experts could help you:

Map out drivers and inhibitors in the market
Size market demand and identify key client segments
Develop a go-to-market strategy tailored to your company and products
Concept test a new platform or product with healthcare professionals or patients

Contacts

Margarita Svarceva at Peter Hays at

Margarita Svarceva

Peter Hays

Enzymes: A New Frontier in Health Supplements

Jan 12, 2023 | Medical Nutrition & Consumer Health

Enzymes: A New Frontier in Health Supplements

Within the rapidly evolving market of health supplements, enzymes have emerged as a powerful way for brands to distinguish themselves from competition. This type of innovation is crucial since consumers are increasingly discerning about ingredients and health impacts. This opportunity continues to grow rapidly – the dietary supplements market alone is projected to reach $340 billion by 2030¹. Incorporating enzymes can be a challenge, however, since their benefits are not always intuitive to consumers.

Enzyme supplements have a wide range of health benefits including alleviating digestive issues and boosting immunity. For example, consumers who can’t metabolise lactose in dairy, can take lactase supplements to avoid bloating and diarrhoea. Alternatively, they can help elderly consumers to increase their absorption of key nutrients from foods to prevent malnutrition (or sarcopenia). Malnutrition creates opportunities for infections and diseases, therefore enzymes can be critical for developing robust immunity. This can also apply to consumers keen on wellbeing and fitness since enzymes can increase nutrient absorption from meals and help them to achieve their goals. In short, enzyme supplements come with the promise of significant impacts on consumers, but their value proposition and the correct mode of use needs to be expressed clearly and convincingly.

Without clear communication, consumers can get confused or even get dissuaded from using enzyme supplements. Our research shows that when it comes to enzymes, most consumers are struggling to fully understand their benefits, their mechanism of action, and even how to consume them. This confusion can directly affect consumer perception of whether they are receiving the desired results from these products. We identified three common complexities faced by consumers and also draw inspiration from marketing strategies of successful businesses leveraging the science of enzymes in an increasingly crowded supplements market.

Taking the Pulse of the Consumer Experience around Enzymes

Figure 1: Instagram – “You don’t need digestive enzymes. You are just wasting your money on false claims”

A thorough understanding of the unmet needs and challenges faced by consumers is critical for marketing and business development teams. We monitored and analysed the opinions of consumers that use enzyme supplements across digital social platforms to identify how the enzyme supplements are received by consumers. Our research shows that many consumers in this space are primarily driven to test enzymes out of some digestive discomfort they experience. And among these consumers we were able to identify their key concerns around efficacy, directions of use, and perceived potential risks.

A common hesitation of consumers around using enzyme supplements stems from a general concern about their efficacy. There are two parts to this problem: Firstly, there is limited awareness on how the enzymes work, and secondly there is limited scientific evidence showing health benefits. Consumers struggle to fully understand the benefits of enzymes. While the “good bacteria for gut microbiome” tagline helps put benefits of probiotics in layman’s terms, our research found that the consumer experience is not the same for enzymes. The issue is further complicated when Healthcare Professionals chime in on social media to highlight that there is limited clinical evidence on the effectiveness of enzyme supplements.

Figure 2: Twitter – “I do take lactase enzyme pills, but they don’t work very well. I usually just try to eat cheese in moderation”

Owing primarily to a poor understanding of how enzymes work, consumers struggle to interpret labels on enzyme supplements. Since there are no regulated “daily values” (DV) assigned for enzymes, consumers can make assumptions about the optimal amount and use frequency for enzyme supplements. While some consumers express that they take their enzymes before/after an occasional risky meal, others state that they take them on a daily basis to boost their immunity or to build tolerance. Information such as the source of enzymes and “fillers” used to stabilise capsules are among the key information on the labels confounding consumers. And while some of this information can be found in technical details on the labels, consumers end up lost in the jargon.

Figure 3: Reddit – “Thank you everyone for your input!!!! I have a better overall opinion now due to everyone’s thoughts. I will still use enzymes because they do help me on a daily basis, but they aren’t an excuse to have whatever I want whenever I want. I will try fodzyme perhaps but I know that I cannot lean on that.”

Figure 4: Reddit – “My understanding is that the enzymes, including fodzyme, beano, lactaid, are meant to be used only on the occasional meal.”

Figure 5: Twitter – “I wish it said the individual doses of the ingredients. If it has a huge dose of serrapeptase I know some people have bad reactions to that. It’s up to you. The individual ingredients look good and I like the enteric coating.”

Consumers are also often hesitant to take enzyme supplements because they believe there is a risk of negative side effects, or a worsening of their condition. For example, although enzymes can be useful in treating bloating or irritable bowel syndrome (IBS) symptoms, some consumers worry that enzymes only offer a temporary relief or that they could worsen present symptoms with additional pain and cramping. In extreme cases, consumers fear that the enzyme supplements could induce acid reflux or even severe pain as a side-effect.

Enzyme supplements are primarily seen as digestive aids by consumers, and this perspective has constrained the expansion of these products to mass clientele. The prospect of expanding the consumer base beyond this segment is further hindered by the technical complexities explained above. Ignoring these concerns can foster uncertainty and consumer distrust.

How Can the Businesses Build Winning Propositions?

Neglecting or miscommunicating the health benefits of enzymes could mean failing to capture otherwise interested consumers. Effective consumer communication is dependent on good consumer research and a clearly defined and scalable consumer segmentation. As part of our research, we identified some ideas and best-practices from firms leveraging the science of enzymes:

Figure 6: Facebook – “It’s Official!”

When it comes to enzyme supplements, efficacy or correct use concerns can be addressed by building consumer trust with scientific evidence. One strategy for achieving both of these can be partnering with universities. For example, Fodzymes received “Monash University Low FODMAP Certification,” which adds credibility to their health benefit claims. The company (Kiwi Biotech) also announced that it has plans to conduct more peer-reviewed clinical studies with universities. Not only do these studies and certifications help with gaining consumer approval, but they can also offer persuasive evidence for Health Care Professionals. Since the FDA does not regulate the dietary supplements, organisations such as United States Pharmacopeia (USP) can provide a verification mark to confirm the claims on the labels of supplements which can help build consumer trust. Naturemade CoEnzymes is among enzyme supplements that have received this verification.

Figure 7: Wheat Rescue

Another way to demonstrate efficacy and build consumer trust can be by offering “mixed supplements” that include enzymes complementing probiotics or vitamins. This approach offers something patients can recognize while they are gradually acquainted with enzymes. This can be particularly attractive for businesses that already offer a spectrum of vitamin products. Since enzymes can increase the absorption and digestion of the complementing nutrients, these “mixed” supplements would also allow consumers to maximize the health benefits from the product. Some businesses are already taking this approach to target consumers that are interested in improving their “gut health.”

Figure 08: Facebook – Fodzyme AMA

To address any perceived risks, businesses should be ready to address these concerns directly with their customers. Successful businesses understand that being attuned to unaddressed consumer needs is critical for research and innovation. By holding “Ask Me Anything” (AMA) sessions, or offering short explanatory videos, businesses can educate their customers about the health benefits of their products. Listening on the online conversations on platforms such as the Reddit, can help businesses determine a coordinated communication approach that can effectively engage target customers in a dialogue. This would provide a real-time opportunity for businesses to hear and engage with the “voice of the customer.”

Figure 9: Reddit – Fodzyme AMA

When consumers find labels confusing to follow, they can miss out on the intended benefits. In absence of scientific evidence and standardised labelling requirements, businesses can evaluate the existing labels to alleviate the confusion over the amount and frequency of use. Addressing this challenge can also mean an opportunity for product development and allow a newcomer to innovate their way into the supplements market. For example, rather than relying on capsules that can be used before or after meals, FODZYMES comes in powder form sachets which is sprinkled over food and consumed with meals.

Reaching New Customer Segments

Businesses have an opportunity to capture additional consumers through clear and direct communication. Each consumer challenge can hold opportunities to win market share from competitors and also to grow the market size by shaping consumer habits. Furthermore, it creates opportunities for product development in ways that address consumer concerns.

Sector & Segment partners with businesses to better understand the challenges and opportunities presented by consumers globally, and build go-to-market strategies accordingly. Our research experience is tailored to capturing the needs to consumers and patients in both consumer health and healthcare spaces, including:

Segmenting and sizing their consumers by need
Conducting competitive research to understand best-in-class practices, and
Delivering primary research with consumers, key decision-makers and healthcare professionals to develop informed marketing strategies.

Marie-Élisabeth Maigre

PRNewswire

Embracing the Complexity of the Gut Health Market

Oct 21, 2022 | Medical Nutrition & Consumer Health, Pharma & Biopharma

Embracing the Complexity of the Gut Health Market

Executive Summary

The market for digestive health products has grown to ~$44Bn, driven largely by increased evidence and awareness surrounding the microbiome and probiotics. That said, a healthy digestive system requires more than just a healthy microbiome, and a multitude of other factors outside of the microbiome can influence digestive health. Increased consumer demand for holistic health products means consumer needs also extend beyond the microbiome. Probiotics are therefore in competition with a vast array of other products. The result is a fragmented market with a large number of companies marketing various solutions all claiming to aid gut health.

In such a fragmented market, companies can employ various different strategies to differentiate. These include 1) creating combination products of multiple in-demand ingredients 2) marketing superior quality and evidence, particularly towards healthcare professionals. Creating a successful differentiation strategy will require more in-depth customer research and segmentation than traditional approaches.

What is gut health? Beyond the microbiome

Gut health, or digestive health, is a hot topic right now. A 2022 survey by the IFIC (International Food Information Council) of the American population found that one in four Americans considered gut health to be the most important aspect of their overall health¹. Commercially, a report by Grand View Research valued the global digestive health market at USD 44.4 billion in 2022 and predicted it to grow at a CAGR of 8.2% until 2030². Academically, a search for the term “gut health” on google scholar now produces over 70,000 results.

This begs the question, what is gut health? Despite increased interest, there exists no consensus definition, commercial or academic³. In popular discourse, the term is often considered synonymous with maintaining healthy and stable levels of gut bacteria, collectively known as your microbiome.

To nurture one’s microbiome, it is recommended to consume products containing “biotics”, either in the form of supplements or functional foods. Traditionally, these recommendations were limited to probiotics and prebiotics, but recent advancements in microbiome research have led to increased buzz around post-, para-, and synbiotics (a full explanation of these terms can be found below)*. There exists a growing body of evidence that consuming biotics is linked with a large range of GI health benefits⁴.

But the microbiome is only one piece of the puzzle. Although there is a large amount of evidence showcasing the role of the microbiome in gastrointestinal health⁵, it is not the only factor which determines whether an individual will experience gastrointestinal (GI) issues. For example, many autoimmune disorders can impact GI wellbeing independent of their effects on the microbiome⁶. An individual may also be genetically predisposed to be at a higher risk for GI diseases⁷ and symptoms, all without displaying any evidence of having a disrupted microbiome. Conversely, another individual may have an imbalance in their microbiome for years without displaying any symptoms. A comprehensive definition of gut health must therefore extend beyond having a stable microbiome.

Figure 1: displays a suggested mapping of four major categories with which we can think about gut health, whilst also acknowledging the interconnected nature of these categories.

The complex competitive landscape of all things gut-related

Consumer needs also extend beyond the microbiome. The shift towards a more holistic approach to health means that many consumers see gut health products as a means with which to achieve general health and well-being. The same IFIC survey found that, of the consumers who claimed to use biotics, only 51% cited “supporting their microbiome” as a reason for consumption*. Other reasons cited varied, but can broadly be classified into:

Promoting general wellness and health – namely through the absence and prevention of (GI) illness
Aiding digestion & reducing (GI) symptoms
Strengthening and supporting the immune system

*It is also likely that the 51% who claimed to use biotics for their microbiome do so in the hope of seeing tangible health benefits, such as preventing GI symptoms or illnesses in the future.

These are many of the same reasons consumers cite for the consumption of products more directly associated with gut health, such as digestive enzymes and fibre supplements, but also for products such as whole grains, fruits and vegetables, fermented foods, multivitamins, and other herbal supplements.

Recent research has also showcased the positive GI effects of a multitude of other ingredients. Notable examples include supplementing Vitamins D and B1 when managing inflammatory bowel disease⁸, the effects of supplementing both digestive enzymes and various herbal supplements (such as ginger) in treating a multitude of gastrointestinal symptoms^9,10,11, and the role of minerals such as zinc in improving immune function¹².

The result is a market containing a vast array of products, all with some degree of substitutability:

Figure 2: a non-exhaustive mapping of products competing in the gut health market by health claim, product category, and ingredients

Manufacturers looking to capture some of this rapidly growing market are competing along various lines including the health claim of their products, the ingredients, the product category (foods, functional foods, dietary supplements), and the distribution channel (supermarket, pharmacy, online). Despite some increased concentration in the supplement category due to high M&A activity, the market remains highly fragmented (notable transactions included Nestle’s acquisition of various Bountiful Company brands such as Puritan’s Pride and Nature’s Bounty, and Gryphon Investor’s acquisition of Metagenics). A large number of both regional and international manufacturers, many with an extensive portfolio of different solutions, are vying for market share.

This degree of fragmentation is what makes the market ripe with opportunity. With such a wide range of consumer needs, and a diverse set of products which are able to satisfy those needs, ample opportunities exist for manufacturers to differentiate themselves through their marketing, products, and channels. To do so requires a comprehensive understanding of the competition, the commercial landscape, and the profiles of their core customers.

To combine or not?

One attractive way for manufacturers to differentiate their products from the competition is through combining different in-demand ingredients into a single product. A notable example is the recent buzz surrounding synbiotic products, a combination of pre- and probiotics. Synbiotics are now projected to grow at a higher CAGR than the probiotics market^13,14. Seed Health, a synbiotic start-up known for being endorsed by Gwyneth Paltrow’s brand ‘goop’, recently received $40m in series A funding with which they aim to go beyond the gut.

Many of the largest supplement manufacturers have also started to combine their biotic products with other ingredients including vitamins, minerals, and digestive enzymes. The packaging on these products often mentions other facets of gut health, such as relief of specific symptoms. Concerning functional foods, Activia recently launched their Activia plus range, which added Vitamins C, D, and Zinc to their probiotic yogurt drinks. The marketing materials focus heavily on the interconnectedness between gut health and the immune system.

Figure 3: various large manufacturers have chosen to combine multiple ingredients

Combining ingredients has a lot of distinct advantages beyond being able to make multiple health claims. It can help combat the choice overload consumers face when presented with so many options for their gut health, as well as help remove doubts as to whether they have chosen the correct solution. It can also help combat “pill burden” – the efforts associated with taking numerous pills on a daily basis – including storage, organisation, understanding what each pill does, and keeping track of potentially unwanted interactions. Finally, such a product might be able to command a premium price, whilst still being more cost efficient for consumers.

Nevertheless, combining ingredients comes with its own set of challenges and risks. There is a limit to the quantities of ingredients one can combine into a singular product without impacting the pleasant taste of a yogurt or keeping a pill at a swallowable size. The more ingredients one combines, the lower the dosage of each ingredient and the lower the potential efficacy of the product. Moreover, too many ingredients can also deter consumers; a long ingredient list can make a product seem less natural and therefore less appealing.

Manufacturers therefore need to be very selective in which ingredients they combine. It is crucial to choose these ingredients in a way that aligns with the wants and needs of their consumers. This in turn requires manufacturers to acquire an in-depth understanding of their customer base. To ensure a successful launch of a new combination product, it is essential to conduct scenario analysis grounded in extensive consumer research.

The role of the healthcare professional

Another angle along which manufacturers can differentiate is by targeting healthcare professionals (HCPs). Although HCPs are unlikely to prescribe gut health products outside of certain medicines to treat GI symptoms, they can be a key influence in driving patients to purchase out of pocket. The IFIC survey found that 43% of consumers would first turn to their healthcare professional to learn more about biotics. Targeting HCPs may allow manufacturers to justify a higher price point if consumers are willing to spend more for a product endorsed by their HCP.

Pure Encapsulations, a vitamin and mineral supplement manufacturer recently acquired by Nestle Health Science, are a tangible example of a company successfully employing this strategy. A 2017 study by the Institute of Functional Medicine found them to be “the most dispensed premium supplement brand by healthcare professionals.” To achieve this, their business strategy has focused on the importance of scientific evidence to build authority and gain the trust of HCPs . The company’s marketing and communications strongly emphasizes the fact that Pure has published over 50 articles in scientific journals. The company also offers both live and on-demand courses and webinars, aimed at HCPs wanting to learn more. For pharmacists interested in stocking Pure products, they promise double the margins of the average supplement.

But convincing HCPs is no easy task. Although four out of five HCPs do prescribe supplements to their patients¹⁵, creating brand loyalty requires a manufacturer to demonstrate both quality and efficacy.

HCPs are aware of the less-stringent regulations placed on supplements compared to medicines, resulting in supplements often containing less active ingredient than advertised, or not containing any of the ingredient at all. To assure quality, manufacturers need to make sure they adhere, and ideally exceed, the manufacturing standards set by regulating bodies in each of the countries they operate. Being transparent about their production process also helps to instil faith.

RCTs demonstrating clinical benefits, such as a reduction in GI symptoms, are considered the gold standard amongst HCPs to demonstrate efficacy. These can be very costly to conduct, as well as take a long time to complete. Alongside manufacturers conducting their own research, they should also make HCPs aware of all the existing evidence available on the relevant ingredient(s), so as to let them make an informed decision.

Due to the relative difficulty of targeting HCPs, a well-defined sales strategy is paramount. HCP attitudes and needs in relation to a product are likely to vary both within and between healthcare specialties. The first step in defining a sales strategy should therefore be to segment these HCPs, so as to then identify, quantify, and rank their needs.

We have a gut feeling we can help

Finding the right points of differentiation to compete in a fragmented market can be extremely challenging, but Sector & Segment can help uncover those features which resonate most with consumers and HCPs. The team at Sector & Segment have extensive experience in researching and quantifying the needs, attitudes, and preferences of both consumers and healthcare professionals.

We can leverage this experience to help you:

Identify, segment, and quantity your customer base
Translate customer insights into improving your product offering, pipeline, and positioning
Define, refine, and stress test your marketing and go-to-market strategies
Conduct competitive analysis to identify competitor value propositions and market gaps

Don’t hesitate to contact us at

Christopher James Dewilde

*Biotics Explained

The term “biotics” is used to refer to any of the following:

Prebiotics – Molecules which selectively stimulate the growth or activity of microbes which are beneficial to health. The “food” for your gut bacteria.
Probiotics – Live microorganisms that, when administered in adequate amounts, confer a health benefit to the host. The gut bacteria themselves.
Postbiotics – Metabolites produced by the microbiome, which confer a health benefit to the host. What your gut bacteria produces.
Synbiotics – A combination of pre-, pro-, or postbiotics.

Sources:

International Food Information Council, 2022 Food and Health Survey, May 2022
GVR: Probiotics Market Size, Share & Trends Analysis Report (2021 – 2030)
Staudacher & Loughman (2021)
Pandey et. al (2015)
Durack & Lynch (2019)
Cojocaru et. al (2011)
Engstrand & Graham (2020)
Masri et. al (2015)
Ianiro et. al (2016)
Giacosa et. al (2015)
Lazzini et. al (2016)
A. Prasad (2008)
Mordor Intelligence: Synbiotics Market – Growth, Trends, COVID-19 Impact, and Forecasts (2022 – 2027)
Mordor Intelligence: Probiotics Market – Growth, Trends, COVID-19 Impact, and Forecasts (2022 – 2027)
Dickinson et. al (2009)

The Value of Segmentation in Healthcare

Aug 30, 2022 | Medical Devices, Medical Nutrition & Consumer Health, Pharma & Biopharma

The Value of Segmentation in Healthcare

A trend towards the personalisation of medical care

Over the past decades, healthcare systems have been progressively shifting towards a more integrated and patient-centric approach to care. One form of this shift is tailoring treatments to the specific characteristics of the patient (e.g., phenotypes & genotypes), as evidenced by the framework created under the International Consortium for Personalized Medicine (ICPerMed). Another form, however, and the focus of this article, is the development of care-plans, products, and services that meet patients’ lifestyle needs and personal preferences in addition to clinical needs.

“…the importance of ‘what matters to someone’ is not just ‘what’s the matter with someone’. Since individuals’ values and preferences differ, ensuring choice and sharing control can meaningfully improve care outcomes.”

This second type of personalisation is increasingly being recognized by healthcare services. “Personalised care” is one of the five major practical objectives laid out by NHS England in their 2019 long-term plan, recognising that “…the importance of ‘what matters to someone’ is not just ‘what’s the matter with someone’. Since individuals’ values and preferences differ, ensuring choice and sharing control can meaningfully improve care outcomes.” In short, healthcare services seek to improve patient outcomes by both being more responsive to patient needs and providing patients with more agency.

This new mindset adds complexity to patient care and delivery of solutions: more stakeholders (patients and their caregivers) are now involved in care decision-making and non-clinical factors must be considered across hospital and community settings. These non-clinical factors, such as patient lifestyles and preferences, are much harder to measure for medical professionals, especially given the budget and staffing shortages faced in many healthcare systems. On the other hand, these challenges represent an opportunity for healthcare companies to enhance their own offerings.

Manufacturers also have an opportunity to play a role in creating long-term value for patients through personalization of care. Thanks to developments in telehealth services, app and web-based patient programmes and the integration of smart technology in wearable medical devices, companies can reach patients across a variety of channels and extend their services and product offerings more efficiently. This presents an opportunity to become the “partner of choice” with patients and caregivers along their journey.

Patient segmentation is now more important than ever

To take advantage of this opportunity, medical players are increasingly moving from a product to a patient-centric mindset. This requires developing a deeper understanding of psychological and behavioural facets of patients, and using that understanding to tailor services, communication materials, and products to wider patient needs.

Building this understanding is especially important in the case of body-modifying surgeries or wearable medical devices that can have long term repercussions on a patient’s self-image, confidence, and social life. It is common for patients to experience stigmas associated with living with an insulin pump for diabetic patients, with aids following hearing loss, or with an ostomy bag following a bladder or bowel resection. Needless to say, these patients have a complex set of personal, medical, and practical needs that require HCPs to engage on a deeper level and on topics that go beyond the learnings of a traditional curriculum or patient-approach.

Going down the Direct-To-Consumer communication (DTC) route may not be a suitable option for all Medical Supply or MedTech companies. For example, some companies have made a deliberate strategic choice to focus all their go-to-market efforts on Healthcare Professionals (HCPs) and payers in order to establish strong medical credibility and/or differentiate from Over-the-Counter (OTC) players. In other cases, local regulations may be restrictive and not allow for much direct communication to patients.

Yet, even in these varied cases and circumstances, building a deeper understanding of patients still represents an opportunity to develop tailored tools and services to support the work of HCPs and drive prescriptions and/or recommendations to their patients. In the UK, the NHS notes that “creating genuine partnerships requires professionals to work differently, as well as a systematic approach to engaging patients in decisions about their health and wellbeing”. To this end, HCPs have become more open to ad-hoc training and support tools to facilitate “the conversations which help patients make the decisions that are right for them”.

What we have learnt from recent segmentation work in medical devices

Sector & Segment recently conducted a large multi-country patient segmentation for one of our clients working in the field of medical devices with the goal of supplementing previous segmentation research on HCPs.

While interviewing HCPs, we learned that while clinical needs were assessed on a patient-by-patient basis, many HCPs divided their patients in terms of 1. broad age groups (18-30, 30-60 and over 60 years old) to assess lifestyle-related needs and 2. underlying medical conditions (chronic, acute, and emergency patients) to assess needs related to the level of psychological support required. This in turn would be used to determine how they would approach patients in terms of time and attention paid to address patients’ personal needs. For example, we found that HCPs spent more time with younger patients and were more likely to provide them with support on selecting a product that fit their daily life or with information on wider topics. By contrast, HCPs spent less time with “older” patients and prioritized meeting medical and practical needs, often overlooking the rest.

What we learnt working with patients, however, is that grouping them using broad segmentation criteria throws only a partial light on the challenges that they face, their needs, and the type of support that they seek along their journey.

1. Patient preferences and behaviours are complex, and age is not the sole factor when seeking to explain or predict them

While it is true that there are patient needs associated with age, like planning for a family or building a career, as well as practical challenges such as reduced dexterity and autonomy, those needs are not the sole determinant of patient behaviour. In our study, patients willing to engage with others about their condition and be proactive in researching information and products were equally present across all age groups. This revelation disproved our initial hypothesis that more mature patients were more likely to follow their HCPs recommendations rather than playing an active role in the decision making relating to their care. In fact, when looking at the distribution of behaviours and needs by age, the 60–75-year-old bracket had a similar distribution as other “younger” groups.

2. Needs and behaviours resulting from an underlying condition are not “set in stone” but can evolve over the course of the journey

A patient’s underlying condition plays a key role not only in determining their medical needs but also in shaping their emotional journey. Depending on their condition, patients may take a different approach preparing for and accepting the same surgical procedure. For example, if we consider the same surgical procedure conducted on three different types of patients: one with a chronic illness, one with cancer, and one involved in an accident, we will see different initial attitudes and behaviours.

For the chronic patient, the surgery may be a step in a long treatment after enduring years of pain, and they may be more mentally prepared for this event
For the cancer patient, this surgery could be just the beginning of their battle with cancer and represent uncertainty about the ultimate outcome
For a patient who underwent the same surgery as a result of an accident or trauma their initial reaction is likely to be shock due to the unexpected outcome

These differences in reactions, attitudes, and behaviours, however, are likely to change as the patient progresses through their journey. What we found, for example, is that trauma and oncology patients developed a more positive attitude towards the same procedure by the end of the second year, while chronic patients who were initially more positive in relative terms, took much longer to come to terms with their new life and required more constant support. This evolution in needs indicates the importance of breaking down the patient journey into phases and approaching each phase as an individual journey. Ultimately, this allows for a mapping of how needs and behaviours evolve over time and an opportunity to target patients with greater precision.

3. Furthermore, when patients present multiple comorbidities, behaviours/preferences associated with each condition may overlap or differ

A patient’s behaviours may not even be consistent when it comes to their approach to comorbidities. Our research has found that when patients have multiple comorbidities, they would often take on different behaviours and attitudes depending on the condition they are focused on, as well as prioritise one condition over another. This is commonly seen in chronic patients who often have several conditions or co-morbidities. For example, a diabetes patient may also have hypertension or cardiac disease, or a head & neck cancer patient may also have dysphagia. We have observed that patients with hypertension and diabetes are likely to prioritise hypertension because this represents the more serious condition which can lead to a heart attack, while diabetes has a slower progression and therefore a slower impact. In this case, a patient can be “proactive” towards their hypertension (engaging with HCPs, conducting their own research, connecting with other patients), while at the same time being “passive” towards their diabetes (not following the prescribed diet, not monitoring their glucose levels as closely, missing appointments). This further demonstrated the relevance of specific segmentations, since patients’ behaviours, attitudes and needs shift considerably between conditions and areas of care.

How not to lose a patient in 1 year

It probably doesn’t come as a surprise that over half of the patients in our research sample were dissatisfied with the level of information and support received from their HCP. They frequently found the support they received to be too generic or not relevant to their practical and emotional needs in that moment. Furthermore, they often did not follow their HCP product recommendation, switching to other manufacturers within one year from point of discharge.

From a manufacturer’s point of view, understanding who these patients are, why they stayed or why they switched and how they made this decision, can be paramount in setting out a sales and marketing strategy and developing detailed action plans.

Having well defined and quantifiable patient segments based on needs, channel of information and source of influence, as well as attitude and behaviours can help answer questions like:

What patient-segments should we prioritise?
What channels should we use to reach these patients more effectively and efficiently?
Do we already have products in the market to support these patients’ needs? How should we position our portfolio against patients’ needs? Should we prioritise some innovations over others? Do we need to rationalise our portfolio?
How can we offer more value to patients?

How we can help

Our experts can support your growth strategy by identifying and quantifying your customer segments, guiding your team to set priorities, develop tools and position your service and product offering for long-term success.

Contact Marie-Elisabeth Maigre (Consulting Director) at and Giada Garofalo (Director of Research) at to learn more.

Giada Garofalo

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