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Periodic Reporting for period 1 - OWISE4EU (OWise for Europe - A feasibility study of a pan-European mobile app providing people with cancer with useful tools and treatment information in one easily accessible place.)

Reporting period: 2016-03-01 to 2016-08-31

Summary of the context and overall objectives of the project

Cancer is a big issue in Europe. Annually more than 3 million people are diagnosed with the disease and it is one of the greatest health threats that the continent knows. Top priorities for European countries include the implementation of patient-centred care, improvement of cancer health literacy, enhanced access to optimal care and improved clinical outcomes. The success of OWise, the mobile cancer patient support and patient-reported data platform originally launched in the Netherlands, has strongly encouraged us to consider an expansion of OWise across the EU with the aim to making a rapid and positive impact on the lives of EU cancer patients while also improving immediate cancer care and clinical outcomes.

The objective of the present feasibility study was to evaluate the likelihood of success of launching OWise in a number of EU countries and to reach at least 1 million new cancer patients in the next 4 years. EU country specific variables were assessed such as the incidence of cancer and cancer types, the use of mobile broadband and the organisation of national health care systems.

A top 5 of EU countries was identified that would be highly suitable for the introduction of OWise. These include Germany, the UK, France, Italy and Spain, with combined more than 1.7 million new cancer patients each year and more than 240 million mobile broadband users.

In-depth analysis was carried out for the top 5 of EU countries to gain insight into the preferred national routes for product testing, evaluation and introduction. Although the health eco-systems of the top 5 are very different, common approaches were found for cancer care across the different countries albeit with areas of focus. Tailored OWise evaluation and marketing plans were created for each country, with associated milestones and estimates for success.

By creating an in-depth understanding of the way EU cancer patients receive treatment, by appreciating how mobile phone use has developed on the continent and by gaining insight into the different national health care organisational structures, targeted strategies for the introduction of OWise could be designed for a number of key EU states. These country-specific strategic plans could enable us to expand Px ’ operations into 4 more EU countries and to employ OWise to optimise the efficiency of cancer care in a large part of Europe, potentially improving the quality of life of over a million cancer patients during the next 4 years.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

In this Feasibility Study we have assessed these characteristics in the different EU countries. We have subsequently selected the top countries that collectively count for at least 1.5 million new cancer diagnoses per year and that have a high level of mobile broadband use.

A subgroup of large EU countries was selected for further research. This step focussed on the type of health care system employed in the selected countries, the effectiveness these organisations and the patient experience reported for the health care systems.

Subsequently, an in-depth review of the top 5 selected countries, was conducted and focussed on a range of aspects, from how health care was purchased, to the mechanisms to introduce new health care innovations and the organisation of cancer care (see results Table 1).

Following this analysis, specific product test and launch plans were designed per country, taking all research findings into account. This led to a country-specific action plan detailing the testing of the patient population, the market readiness and the early introduction of the country-specific versions of OWise. Per country an assessment was made on the number of cancer patients which could be reached and the market penetration following a complete product roll-out during the next 4 years.

More specifically, the work package for this project comprised of:
• Market analysis of all EU countries, concerning:
o Incidence of cancer
o Mobile broad band us
• Health care analysis of a subgroup of EU countries
o Economic model of the health care system per country
o Effectiveness of the health care organisations
o Reported patient experience and satisfaction per country
• In-depth review of selected top 5 EU countries based on
o Health care procurement
o Health care innovation strategy
o Cancer care organisation, outcomes and cancer strategic plans
• Generation of country-specific market access plans, covering
o Product prototype testing in target population
o Product development
o Identification of most appropriate distribution channels
o Identification of potential partnership opportunities
o Assessment of market readiness
o Product marketing approach

Final Recommendation for the OWIse Top EU Countries

Germany
Germany appears a country with a great infrastructure to introduce OWise to. The low mobile broad band use may be an obstacle but if alliances can be formed with the country’s key cancer organisations, great strides could be made to apply OWise to address the needs to improve cancer patient experience.

United Kingdom
Based on the past year’s experience and being part of the NHS Innovation Accelerator has demonstrated that the UK is a good territory for OWise with very positive reception from clinical research leaders, nurse specialists and patient organisations. Hence, it may be a good blue print for other countries with a Beveridge health care model.

France
France appears an ideal country for the introduction of OWise, based on the presence of INCa and UNICANCER and the well-defined cancer strategy where OWise could play a significant role. However, with one or two organisations so key to the potential success of OWise in the country it is strongly recommended to test the interest and need of an OWise platform with the above mentioned organisations and health care insurers first prior to planning further activities.

Italy
Based on the fragmentation of the Italian health care system and the lack of explicit focus on patient experience in the Italian cancer strategy, we believe we would encounter considerable barriers to enter the Italian market with OWise. Key collaborations with clinicians at several key cancer institutions would be required to change this view.

Spain
The combination of 1) the health economic pressures on Spain’s health care system with 2) national cancer strategy’s explicit statements to employ innovative health IT and remote-patient monitoring tools and 3) the need to improve patient-information sharing and communication make Spain a good country to introduce OWise to. The concentrated cancer care as carried out in a number of key cancer clinics make it an attractive territory to explore the roll-out of a Spanish version of OWise. For the company the additional benefit of this version may be an extended exposure to other Spanish speaking nations.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

We wanted to develop a solid business plan to expand into these European countries, aiming to reach 1 million cancer patients during the next four years and to support them during their cancer treatment and to improve their outcomes. Consequently, the socio-economic impact the company anticipated to make would be likely to have a considerable effect on the quality of life of European cancer patients and on the efficiency of health care systems in the EU.

The results of the present Phase 1 study is that we could identify four suitable EU countries for roll out of the supportive OWise patient experience and patient-reported outcome platform. By planning to introduce OWise in the target EU countries to four (Germany, UK, France and Spain) we showed that more than 1.3 million new cancer patients each year (or more than 30% of the annually diagnosed cancer patients) could potentially be reached and be supported by OWis in these territories each year.

The present study demonstrated that the outlined strategy and recommendations may be a very valuable approach to make a significant impact on the lives of a large proportion (around a third) of all EU cancer patients. Also, the above results demonstrate that the employment of OWise
1) may fit with the national cancer strategies of those countries,
2) could have a positive impact on the treatment and outcomes of the cancer patients in these countries,
3) may result in an efficiency gain in cancer care and may improve the cost-effectiveness of the health care systems of several of major EU countries.

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