By Deborah Borfitz

March 19, 2021 | The entry of non-pharma companies into the clinical research space, including CVS Health and Salesforce, was the subject of a keynote presentation at the recent Summit for Clinical Ops Executives (SCOPE). Hyper-local engagement and hyper-customized communications are “two sides of the same coin” and both are necessary as the industry continues its shift toward decentralized clinical trial strategies, says moderator Shwen Gwee, vice president and head of global digital strategy at Bristol Myers Squibb. 

The pharmaceutical industry has been conducting trials the same way for a long time now, Gwee say, but over the last decade big-tech consumer companies have been taking them in a whole new direction. Apple, for example, is doing heart studies leveraging its smartwatches and has also introduced an open-source framework called ResearchKit that that can collect data on people remotely.

Alphabet-owned Verily is aiming to enroll an initial 10,000 patients in Project Baseline to make a complete map of human health and sister company Google has launched the Google Health Studies app allowing Android users to participate in medical studies virtually, he shares. ERT and Orbita have also teamed up to capture trial data on Amazon voice-activated platforms.  

On-demand cloud computing from Amazon Web Services is being used for in silica research, Gwee continues. Several years ago, Facebook met with drug marketers about recruiting people for clinical trials. Facebook AI has an open-source study platform and is now building a smartwatch to collect health data.

Sponsors and CROs have also been working with the rideshare companies Uber and Lyft to overcome some of the transportation-related access barriers to trial participation, adds Gwee.

Supporting Roles

CVS Health and Salesforce have also been surprisingly active in the research realm. CVS Health has converted 1,300 of its MinuteClinic locations into HealthHUBs focused on chronic disease management and, as a high-volume COVID-19 testing site, has more recently been helping sponsors find potential COVID-19 trial participants. It is uniquely positioned to add efficiency to the research process, according to Lou Sanquini, vice president of Aetna (a CVS Health company). 

The CVS Heath ecosystem includes pharmacies, kidney care, and a diabetes program, in addition to the U.S.-based HealthHUBs supporting clinical trial services, Sanquini says. The advantages of HealthHUBs over MinuteClinics include concierge services to improve the patient experience and a broader range of health services, including durable medical equipment and connected glucometers. 

While many services are delivered in person, HealthHUB also offers virtual patient visits and home delivery of medications, says Sanquini. CVS specialty infusion services are available through Coram, which supports HealthHUBs, he adds.

Salesforce has for years now been supporting clinical trials with its industry-leading customer relationship management platform, says Gary Gabriel, Ph.D., the company’s healthcare and life sciences lead. Customers include Janssen, AbbVie, and Takeda. 

For Janssen, Salesforce built a patient portal where current and past trial participants can go to find study results as well as general information about diseases and trials written in plain language, Gabriel shares. The site collects patient feedback and tracks individuals once their trial participation has ended “in a way that’s comfortable for them.” 

A recent project for AbbVie was more closely aligned with Salesforce’s traditional book of work breaking down technology silos between departments in an organization. It built a clinical operations platform unifying CTMS tools with information on recruitment, drug safety, health economics, investigator-initiated studies, and issue management. 

Humanizing Participants

CVS Health has an obvious location advantage, which could help improve access to trials and otherwise hard-to-reach populations as well as retention of enrolled participants, says Sanquini. Notably, 80% of the U.S. population lives with three to five miles of a CVS store and collectively they report 4.5 million visits daily. 

Its customer base represents a diverse range of populations that study sponsors are targeting for enrollment, he says. Lessons in the realities of research are coming from a partnership with the Biomedical Advanced Research and Development Authority (Coram is part of a trial involving home infusions of monoclonal antibodies to COVID-19 patients), and more general enrollment support for COVID-19 treatment and vaccine trials.

Salesforce has learned from the retail sector about the importance of talking “with” consumers, says Gabriel, who views this as the best way to improve the clinical trial experience across the board. The teachers include brands like L’Oréal and Unilever whose products are used by billions of people every day.

Targets for future partnerships include developers of next-generation cell and gene therapies, Gabriel says. Specifically, he imagines Salesforce serving clinical R&D in terms of recruitment, safety assessments, and patient support once drugs hit the market.

“The key to all this is data,” concludes Gabriel. When properly joined together, data can help “humanize” trial participants as well as improve signal detection and enable operational efficiencies.