Digital respiratory ecosystem: companies are positioning themselves to capture the respiratory market potential

Chronic respiratory diseases affect around 500 million of people globally. This huge opportunity is, however, not yet been properly addressed. The digital respiratory market is still at an emerging stage, with players positioning themselves to be ready when the market will take off. Many digital offerings are still at the stage of formation, whereas others are yet to be commercially launched. However, the digital respiratory ecosystem has established itself and is set to expand.

Digital respiratory ecosystem refers to the population of companies that are involved into the value chain of digital respiratory solutions. Since the emergence of the app market in 2008, the number of respiratory app publishers has been steadily increasing. According to Research2Guidance’s “The Global Digital Respiratory Solutions Market 2009-2023” report, there are now about 300 companies of various sizes and backgrounds currently available in the respiratory market. They can be divided into six general categories:

▪ Digital solution providers
▪ Connected inhaler technology companies
▪ Manufacturers of connected handheld spirometers
▪ Pharmaceutical companies and generic drug manufacturers
▪ Manufacturers of drug delivery systems
▪ Connectivity vendors.


Digital solution providers constitute the biggest group of market players. Their offerings are mainly based around a mobile app. As a result, they dominate the mobile respiratory segment, accounting for about 80% of the total respiratory apps available in mobile app stores. (Explore more key digital respiratory solutions market insights in the new report “The Global Digital Respiratory Solutions Market 2009-2023). Digital solution providers are also the most diverse group of players, which includes app developers, app service providers, software developers, platform solution providers, etc. The most illustrative examples of such solution providers include Asthma MD, Kaia Health Software, @Point of Care, Qurasoft, etc. As a rule, the companies from this category do not produce any hardware. However, some of them can offer connectivity opportunities by engaging third-party devices. Tactio Health, a device-agnostic healthcare solution provider that offers access to various consumer and medical devices via its platform, is an example of such a company. In terms of company size, most of digital solution providers are start-ups. Yet some of them have developed into more mature and established businesses.

Connected inhaler technology companies have developed connected inhaler sensors, mostly as add-on solutions to existing device-drug combinations. These inhaler sensors are connectable to cloud platforms to enable distant patient monitoring and provide it as a SaaS service. Apart from that, some connected inhaler technology companies develop new AI-based features, which will be able to deliver more personalized and enriched services. Propeller Health, Adherium, Cohero Health and Amiko are the most prominent examples of this category of players.

Propeller Health has the highest number of partnerships with pharma companies, so its add-ons cover nearly the whole range of the currently available types of inhalers: MDIs, diskus products, respimats and ellipta inhalers. Due to the partnership with GSK, Propeller Health’s portfolio includes such the world’s top inhaled corticosteroid drugs as Advair and Flovent. The company has also succeeded in reaching to research institutions and healthcare organizations.

Adherium mostly leverages on its 10-year non-exclusive global Master Supply and Development agreement with AstraZeneca, which covers the third world’s biggest-selling respiratory drug Symbicort. However, the company is overly dependent on this partnership and is therefore trying to diversify its business by offering its Hailie solution for over-the-counter sales in the US. At the time of writing, the sales of these Symbicort-compatible add-on sensors have not yet started.

Manufacturers of connected handheld spirometers offer handheld spirometers featuring Bluetooth connectivity and data synchronization with a mobile app. For a long time, spirometry solutions have been associated with clinical environment, whereas in the homecare cheap and functionally limited peak flow meters were recommended to patients for measuring lung function. With the advent of handheld spirometers, the situation changed: They have largely democratized spirometry, opening opportunities for lung function management to a wide range of clinicians, general practitioners, and patients.

Manufacturers of connected handheld spirometers offer API opportunities for potential partners, as well as their own mobile app solutions. Companies from this category include NuvoAir, Medical International Research (MIR), Sparo Labs, etc. NuvoAir is currently the only spirometer company that offers a vertically integrated patient monitoring solution, which include devices, apps, and a clinical dashboard.

Pharmaceutical companies and generic drug manufacturers are both clients of connected inhaler technology companies and potential connected inhaler service providers. The pharma sector is currently the major driver behind the adoption of connected inhaler solutions. As it is very challenging to increase revenues within existing drug franchises, pharma companies are looking for new ways of protecting their market shares, including the digital update of device-drug combinations. On the other hand, supporting adherence by using connected inhaler solutions results in improving the performance of inhaler drugs and thus increasing revenues from their sales. Currently, several leading pharma companies are engaged in developing connected inhaler solutions either via partnerships with connected inhaler manufacturers (AstraZeneca, Novartis, Boehringer Ingelheim, GSK) and connectivity vendors (Novartis, Boehringer Ingelheim) or via direct acquisitions (Teva).

Manufacturers of drug delivery systems include traditional suppliers of hardware components for inhaler medication, such as Aptar Pharma, HT Presspart, Vectura and 3M. Looking for value-adding opportunities, these companies are engaged in developing embedded sensor solutions for drug delivery systems, cooperating with connected inhaler technology companies and pharma companies.

Connectivity vendors are not yet widely represented in the digital respiratory market, with Qualcomm Life, a subsidiary of Qualcomm being the only example. Since 2016, Qualcomm Life has partnered with Novartis and Boehringer Ingelheim to develop the new generation of connected inhaler drugs, without radically changing their existing design.

Further growth of the digital respiratory market should attract new types of players to join the value chain, such as service providers (both in-app and external ones), AI enablers, and big data solution providers. In the medium term, provided that the market keeps its momentum, it is expected to attract big internet companies, looking for opportunities to diversify their portfolio and create new value streams.

The Global Digital Respiratory Solutions Market 2009-2023, a new report by Research2Guidance, describes in detail the current respiratory market status, digital service offerings, connected devices, service offerings, perceived strategies of key market players, key trends, market barriers and future revenue streams.

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