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We may talk about always putting the patient at the heart of healthcare, but in some less established world markets, is this feasible? The rise of chronic diseases in some regions, combined with an ageing and growing population, is putting unbearable pressure on health-care systems already at capacity. 

Poorly-developed primary care systems in many emerging markets mean wellness and prevention are often neither central to healthcare strategy nor a focus on public health investment. This means that options that could potentially prevent chronic diseases, such as vaccines, weight management and nutrition, may be lacking. Established routine screening programmes are also less commonplace, which can be especially problematic for asymptomatic conditions, as patients may not be aware they are suffering from a chronic disease until a late stage. With patients often paying out-of-pocket for treatment, concerns about cost may prevent them seeing a doctor until symptoms become severe, which can end up limiting their treatment options. Patients in areas where there is poor infrastructure may not be willing to travel unless symptoms are life-threatening because of the additional cost.

In a previous article, Director Sue Rees looked at how pharma companies could be more patient-centric in emerging markets by using mobile technology to deliver health solutions. We wanted to explore this idea further so we commissioned a small study with M3 and Research Now SSI into attitudes to digital adoption in China and Brazil in comparison with the US. We surveyed 148 chronic disease patients ages 35-54 and 240 primary care physicians from the US, Brazil and China.

In our study, we asked physicians how many consultations they have in a typical day - and as expected, in emerging markets the number is much higher - doctors have 35% more consultations in a day in Brazil and 50% more in China than in the US. As a result of this time pressure at consultation, a significantly higher proportion of patients in emerging markets are turning to digital sources, searching for information doctors don't have time to tell them - 71% of patients in Brazil and 91% in China compared to just 48% of US patients.

We also wanted to explore how much patients trusted their doctor compared with online sources and apps. Fortunately, in all markets there is currently more trust in the doctor, but in emerging markets, a greater proportion trust digital sources than is the case in the US and there is a greater level of middle ground, where either source is equally trusted. This could signal an opportunity for the pharmaceutical industry to fulfil an unmet need that is not being met by physicians. 

Our survey also found that physicians in emerging markets are happy for patients to turn to digital sources for their health information, particularly in China. Doctors in Brazil like the idea of online sources for diet and exercise and for disease understanding but have more concern about the use of compliance tools or treatment information.

In these emerging markets, there is clearly an appetite for digital sources and patients are already starting to use healthcare apps more regularly.

The gaps in the healthcare system, in terms of what the doctor can provide and the infrastructural insufficiencies associated with accessing healthcare in emerging markets, mean there is a desire and a need for digitally delivered healthcare services that pharma has an opportunity to fill. However, fulfilling that need does require a strong, consumer-level understanding of patient needs and behaviour, particularly important in emerging markets, where the patient is often the only constant in their journey. 

Just as we know that not all consumers or all doctors are the same, so we need to appreciate that not all patients are the same, nor do they have the same needs and preferences, either offline or online. When developing digital services, we would advise pharma to develop a technographic profile of patients and segment using these profiles, incorporating relevant cultural or behavioural factors.