This article touches upon two zones –

• Zone A: Why patients is no longer a patient, but a Paclisumer = patient + client + consumer
• Zone B: What kind of jobs (customer motivations in business settings) does a paclisumer wants to fulfill for his malady (disease or condition).

As a result we will see the genesis of Malady-Canvas©, which will support life-sciences companies to increase their revenue streams.

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So let us move to a galaxy not so far away. Things are not the same any more. Why?

The pill is no longer a pill. It is an intelligent solution, taken by a super intelligent user or a paclisumer; advised by a hermit who has powers next to God, and is guided by multiple disciples!

So is the future far away? No the future is now. What can a corporate do to prepare for this future?

Wave?

Bazingaaa! Not a wave but waves! The answer is Option D, with ‘WAVES’. Welcome to Pharma 3.1, or as I like to call it as Techno Wellness 1.0.

Let me begin by entering my TARDIS and going back to the year 2001. During my MBA class I was asked a question (ok the class was asked a question, I used to sit in last bench) – What is the purpose of a corporation? Many answers came, but the one that struck as correct was “The purpose of a corporation is to create value for its shareholders”. Shareholder value is created by profitability, and profitability is in turn by higher revenues and lower cost. Simple – Well No!

With increasing competition and changing market dynamics there is stress in revenues, so a corporation needs to start looking for ways to boost revenues or find new revenue streams. In the Lifesciences space, corporations are facing increasing challenge. Why?

Busting of the blockbuster model, maturing regulated markets with high diagnosis rate and treatment rate, highly generics driven environment (impacting profit) and more and more constrains. Constrains are not new, but the current business models are centered on increasing revenue streams using current portfolio (by enhancing market penetration) or new portfolio connected to the same therapy group.  There isn’t anything wrong in this, as this was the way things were done. But what happens if we look into different business model from other industries. Can something be learnt?

Lets look at the used and abused example of Apple – iPhone! Yes again. But what still hits me is the control it has on the market. 10% volume share (+400 million customers) and 70% of profits. Such a skewed ratio.

Why? The difference is the enchanted 400 million customers. They are connected to the soul of the brand and trust it. There are iPhone users and others (muggles)! So the portfolio of apple is mapped around the user and it is not only supported by other Apple products but a lot of customized apps and solutions around the user. The appleites use Apple or these other products to get a job done.

A job to be done (frame work from Clayton M. Christensen) is a helpful way to look at motivations of a customer in commercial eco-system. A customer uses a product to get a job done, which is specific to him and his circumstances. The concept says that if a marketer understands the jobs to be done, a well-crafted product can be created. Simple example on as simple as a milk-shake, where it was seen at a particular location 40% of those who bought the milkshake were in the morning and it was on the go (take-away). The reason milk-shake job was to keep company with the person for boring commute to where they were going. So the job for the milkshake was “to keep company”.

Now in the world of life-sciences and patient care, it is about outcome, but what about jobs-to-be-done, keeping the disease in mind?

The life-sciences corporate with a strong mother brand have two things going good for them. A captive patient, who taking the corporate’s intelligent solutions to treat his or her malady. And the other is the concerned care giver or physician who wants to treat his patient with utmost care. So why not build a portfolio for revenue streams around these captive patient-physician node (like Apple or Google)?

With changes happening and tech dominated firms entering in life-sciences and patient care, the future business model needs to change. The business model has to move from cure, to management, wellness, and prevention in a more holistic level. This way a whole new eco-system of offering and partnership needs to be created.

All this can be done after understanding the Malady-Canvas, but first let us understand about ‘paclisumer’.

Who is a Paclisumer?

I am a Paclisumer! Pronounced as ‘peɪ ˈklʌɪ ‘sjuːmə.

Confused? It’s a human with his own gravitas of choice using trinity of minds;PATient – CLIend – conSUMER. (alternate – Palisumer, with i sort of silent)

• Pa: Mind of a patient
• Cli: Mind of client
• Sumer: Mind of consumer

I, as a paclisumer am taking intelligent (self-assumption) decisions (bias) myself based on constrains and the environment around me. These decisions will frame my choices on drugs, wellbeing and diagnostic. So I am a supper intelligent user taking an intelligent solution. I am hence a Paclisumer. Now do you kapeesh?

Introduction to Malady-Canvas:

Malady is from Old French maladie, (malade ‘sick’), based on Latin male ‘ill’ + habitus ‘having (as a condition)’. In short a human having a condition which makes him ill. But as a human, am I always ill or sick? May be not, but I may always have a condition, and my decision making changes on which hat I wear. For a corporate to take care of me whether in the hat of sickness, recovery or wellness needs to know my choice.

The Malady-Canvas, is a way to map out the malady ecosystem in which I operate. And who am I? Am I a patient? No the patient is dead. Long live the patient.

A malady is unique for each paclisumer in terms of what decisions he takes. The decision will depend on the treatment, care and wellness he needs. It can be in any combination of mind, body and soul.

The Malady-Canvas, is a way to map out the malady ecosystem, as each malady is unique in terms of nodal connection for a patient. One needs to understand during a treatment on the spread of solutions one is taking for the job he needs to get done.

The Malady-Canvas has six sectors and an axis. The sectors and axis in Malady-Canvas is known as TRIUMPH. They are present in two hemispheres.

Top Hemisphere – Body & Mind:

• T- Treatment: Get cured completely. Example, if I have a bacterial infection I take anti-bacterial to treat the infection and recover completely.
• M – Manage: Management of the malady, as there is no cure. Example, chronic care like diabetes, cardiovascular, arthritis drugs.
• P – Prevent: Protects from the malady. This can be scientific with evidence (illuminate) or placebo or limited evidence (illusionary) Example; vaccines, wellness activities like exercises, selenium to improve immunity against HIV.

Bottom Hemisphere – Mind and Soul:

• R- Reduce: Alleviate symptoms. No cure here, but sector for symptomatic relief. Drugs here used will take care of symptoms rising due to malady or other drugs. Example; rubefacient action of a pain balm where the heat generated dissipates the pain, or lactobacillus been taken to avoid loose motion, when amoxicillin is been taken for anti-bacterial treatment.
• H – Holistic: An approach which was present from the time of Hippocrates. It is about connect with alternative medicine, where it can help the paclisumer an overall positive experience. Example, TCM (Traditional Chinese Medicines), been integrated into evidence based clinical practice.

The Axis & Across

• I – Illuminate or Illusion: This is the axis of education for paclisumer. Two ends ‘Illuminate’, where he is aware and educated on the malady. Or ‘Illusion’, where less evidence is present.
• U –Upgrade: This is present in both hemisphere. It is the use of tech, diagnostic, clothes, wearable, food and related components to alleviate, manage, cure or prevent the malady. Example; DNA tests to provide probability of future maladies, 3-D printed ribs.

Triumph: Treatment – Reduce – Illuminate/Illusion – Ubiquitous Upgrade –Manage – Prevent – Holistic. So the corporates face the TRIUMPH paradox of where to participate or play?

The Malady-Canvas, is where a paclisumer can be present on multiple sectors depending on his and the hermit’s (physician) decision making. In these sectors, he can be in patient mode, client mode or consumer mode. He can also be in multiple modes simultaneously, so the decision-making will be complex.

Case Study, in the near (not so far) future:

My name is Morgan Jones, a 53 year old paclisumer with Type I diabetes malady. I live in Sioux Falls, South Dakota in the land of the free working for brewing firm. I do travel a lot to North Africa and my favorite author is George Orwell.  I can share some information on how I am managing diabetes currently and my wish list using the Malady-Canvas.

• Treatment: Nothing for now as diabetes cannot be treated. But waiting for a ubiquitous upgrade from University of California implantable substitute organ aka, artificial pancreas. Or perhaps, a BioHub from University of Miami’s Diabetes Research Institute, which will give it with the islet cells for my pancreas.
• Reduce: B-12 supplements to reduce chances of my nerves getting destroyed by diabetic neuropathy.
• Illuminate: I go through various websites like, Wikipedia, local helpline of my community diabetes center and also read diabetes technology & therapeutics magazine website.
• Upgrade: Food, I need to ensure I take low carb diet taking a lot of fibers, wish I had a smart food for diabetes like me. May be in the future smart foods will come. But with the new google lens I can monitor my blood sugar
• Manage: Insulin, only one. But I want to reduce the units I consume.
• Prevent: I cannot prevent it, but can make an attempt to see complications are reduced and my diabetes is under control. I have a meal plan, an exercise plan and others.
• Holistic: Vitamin supplements, and even thinking of going for an acupuncture process.

So how will it help in creating revenue streams for corporates? It is about participation and providing an immersive experience for the paclisumer.

For example in diabetes malady, the question becomes how much market share a corporate can take in the over $100 billion diabetes management market (medication, diagnosis and care) globally? As only participation in sectors will allow more and higher revenue streams created by the paclisumer. This is the TRIUMPH paradox that the current life-sciences companies will be facing.

In short, if you don’t participate you are not serving your paclisumer in this life. So do your Karma and see the result come on its own.

Can one corporate fulfill it all or be at most of the places where the revenue streams can be optimized or maxed out for creating shareholder value? The answer is yes, if the business model and value proposition evolves. Why is this important?

Because the future is changing? And the future is now!

The paclisumer is undergoing a medical treatment as a patient, he takes professional advice as a client and finally as a consumer an economic good is been taken. A good where there are multiple choices. In the future there is going to be higher customization of experience. The population will be looking for three factors in any solution – simplicity, service and safety.

So let me look into the crystal ball and get a glance into the future.

Factor 1 – Use of cloud-tech and robots to increase compliance and wellness among paclisumers: By 2030 it is estimated 80% of earthlings in developed countries and 55% in developing ones will live in cities. Family structures are breaking, and there is a high chance that a paclisumer may be living alone. Hence, a higher probability of lower compliance. But enter Miss Alexa. Ok, also known as Amazon Echo.

It is a cloud based intelligent voice command device which can do a lot of activities, including reminding. Think by 2030 what will this technology do. The IoT (Internet of Things) is just a start. Maybe a dispenser or a robot who will provide the drug, keep track if the paclisumer are compliant and refill comes automatically.

Net Impact: Higher compliance will result in more revenues in current revenue streams.

Factor 2 – Faster adoption of technologies allowing higher illumination on malady: New technologies are being adopted faster as the diffusion rates increase. Also the life cycle is getting shorter. At one time, it used to take 52 years for 5% of population to take up a new technology. In-between 1975 to 2000, the 5% adoption became 25% and the number of years – 3. This is going to continue.

Net Impact: Lowering of cost, increased reach to the masses allowing increase in volume due to tech-health solutions. Hence more revenue streams.

Factor 3 – Chemistry is back, and the Terminator will be real; but to help intervene the malady early: It is true that over 60% of death is by chronic diseases, but with progression of technology and more intelligent paclisumer the intervention will be earlier. Brain structure and hormonal analysis will allow for advanced biomarkers to provide the hermit powers to help the paclisumer not to be a patient, but client and consumer for a particular malady. 3-D printing technology will develop implants and there will be increase in augmentation (artificial parts) of the human body. Google already speaks of nanobots in our blood stream, brains on the cloud, and immortality (maybe memories) by 2035.  So some paclisumars may become bionic. But there will be no Hasta Lavista paclisumer 🙂

Net Impact: Increase in prevention and wellness activities and the need to have related portfolios.

Other factors which will lead to different biases and impact our decision making are: Rise in number of NGO’s, women empowerment, smarter food produced by “pharmers” (food with therapeutic properties and vaccines), smart clothes providing live data feed to health care practitioners.

The future is not of life-sciences, but of techno-wellness. The corporate that positions itself as a Techno-Wellness firm with the power to participate across multiple sectors in the Malady-Canvas for different maladies will be the leader in future. Now is the time to count the maladies, and see where can one participate. For this the need to start STP – Segment, Target and Position in a different way. This will ultimately lead to increasing shareholder value.

The future is about providing the paclisumer the optimum experience.  Maybe the future tag lines for corporate will be “We keep you healthy” or “No one restores you better”. And it had already started, reference Sanofi-Aventis + Google. They may become Google-SA in the future. So are they the first Techno Wellness corporate? Time will tell.

So the question for corporates are who will take the red pill or take the blue pill? How far does the rabbit hole goes?

Watch this space!