According to the Global Alliance against Chronic Respiratory Diseases, more than 1 billion people in the world suffer from chronic respiratory diseases. Chronic obstructed pulmonary disease (COPD) and asthma are the two most common airways diseases that make breathing difficult. With more than 250 million cases of COPD globally and no cure, COPD is one of the leading contributors to the burden of non-communicable diseases.
Today, there are more than 250M cases of COPD globally. According to the WHO’s prediction COPD will become the third leading cause of death worldwide by 2030. Many cases of COPD and asthma can be prevented and / or treated, if people are diagnosed earlier on. Because breathing is so natural, it is taken for granted. The shortness of breath, for example, might not be seen by the sufferers as a sign for a serious medical condition. Thus, asthma and COPD can go undetected and misdiagnosed until it is too late.
One of the key and most reliable ways to diagnose and monitor COPD is through a spirometer – a device for measuring the volume of air inspired and expired by the lungs. Spirometry also assists in guiding the personalized patient therapy. Being able to measure their lung health in the comfort of their home and share the information with the doctor in real-time via an app could help COPD sufferers and respiratory patients in general maintain a better quality of life.
However, a closer look at the COPD digital solutions shows that far less than 1% of the 250M addressable target group use COPD apps. At present, majority of the COPD apps are not meeting the needs and demands of the sufferers, nor the market potential. COPD publishers struggle to achieve a significant reach and have little impact on the mHealth app market. The gap between the demand and supply presents an untapped market potential for innovative digital health startups and traditional healthcare stakeholders.
So, why do COPD apps capture far less than 1% of the addressable market? Is it lack of awareness amongst GPs and COPD sufferers, app quality issues, time consuming data input, failure to motivate behavior change and engage users, usability limitations, and / or outdated design?
To share his view on the reasons behind the low success rate of apps aimed at COPD sufferers, as well as the concept and business model behind NuvoAir, one of the novel health tech market players, we talked to Lorenzo Consoli, CEO.
The company’s Air Smart Spirometer is the first ultra-portable spirometer connected to a smartphone that lets users understand their health in seconds, anytime and anywhere.
Enjoy the interview.
Research2Guidance: As a short introduction to NuvoAir, could you please explain what your role is and what your company is offering?
Lorenzo Consoli: I’m the CEO and co-founder of NuvoAir. In a nutshell, NuvoAir combines hardware, software and data to improve lives of people suffering from respiratory conditions and to enable more precise clinical decisions.
Through Air Smart, our award winning digital spirometer and our software patients can perform a spirometry test comfortably sitting at home and monitor how their lung health develops over time.
Our Platform allows patients to share seamlessly the results with their caregivers, who will have a unique, accurate and timely data when they see their patients face-to-face. In fact, healthcare providers can follow their respiratory patients’ lung health anytime and have immediate access to personalized data, so they can focus on most critical patients, reducing costs and improving outcomes.
Finally, our AI engine is combining data from a variety of sources, including environmental data, and soon we will be able to provide much more personalized insights to our users.
Eventually, we want to demonstrate that our solution provides better outcomes in a cost-efficient manner.
Research2Guidance: How do you differ from other asthma/COPD solutions on the market?
Lorenzo Consoli: At NuvoAir, we care about empowering patients to monitor their own health and helping physicians make better clinical decisions. Contrary to many other solutions on the market, our solution includes a CE certified class IIa medical device, which provides an objective measurement about how an individual’s lung health develops over time. Patients and caregivers can take data-driven action when things are worsening.
In addition to our innovative technology, soon we will be releasing an important product aimed at providing much more personalized feedback to our users under the umbrella of a digital health coach.
Design and user experience is also a central pillar of our strategy. We believe that great user experience increases adherence thus supporting better outcomes. The Red Dot Award, the Design-S award and the award at the Medica App competition are a testament to this commitment.
Pricing is also a differentiation point for us. We believe that healthcare should be affordable and our solutions, whether hardware or software, are priced very competitively, without compromising on quality.
Research2Guidance: What is your business model?
Lorenzo Consoli: Given that the healthcare landscape in Europe is very fragmented, our pricing, distribution model and priorities change depending on where we operate.
Generally speaking, with regards to our distribution channels, we work with a variety of customers ranging from hospitals, physicians, telehealth platforms, insurance and Pharma companies.
Our revenue model is a combination of hardware, software and data. For example, in some instances, customers are mainly interested in our hardware, while in other cases they are interested in a full remote care solution. We are happy to provide both options.
Finally, I like to underline that although we are a small company whenever we have the chance we love to give back to the community. In more than one occasion we gave away for free Air Smart to patients in need, hospitals and research organizations.
Research2Guidance: Which countries are you concentrating on and why?
Lorenzo Consoli: At present, our focus is mainly on Europe. Our spirometer is CE Marked as class IIa medical device, hence we can market and sell our technology in Europe and few other countries around the world where the CE Mark is accepted.
Our international expansion strategy includes entering into the US and later on into Asian markets. Both regions represent a tremendous opportunity to reach hundreds of thousands of patients suffering from respiratory conditions.
Research2Guidance: Are you interested in expanding your business in the future to serve and help improve the lives of patients’ with other chronic conditions?
Lorenzo Consoli: We do not have any plans to enter into other disease areas at the moment. Things may change in the future, but as a startup it is important that we remain focused and we move one step at a time.
Research2Guidance: Today around 300 million people are suffering from asthma, yet less than 1% of them are actively using asthma apps. Unfortunately, the COPD situation is no better: 250M global cases and far less than 1% of addressable market is using COPD apps. In your opinion, what are the reasons behind this extremely low asthma/COPD sufferers’ adoption rate?
Lorenzo Consoli: Yes, I agree in general the adoption rate is quite low. When that happens, it means that those products are not creating enough value for users or not solving specific pain points. User engagement is also very important and perhaps still lacking in the medical space.
In my opinion, many solutions are still requiring users to input lots of data. Rather, solutions should be designed to invisibly monitor patients’ health or collect relevant health data. For one unit of input users expect to get more than one unit of output. Digitalizing a diary or a symptom questionnaire is not enough anymore. Systems need to get smarter about how they collect, analyze and provide insights back to users.
Research2Guidance: On September 7th 2017, NuvoAir announced its partnership with Novartis Pharma AG to distribute NuvoAir’s spirometry technology to physicians worldwide. What is the market response and physicians in which countries are more open to recommend it to their patients?
Lorenzo Consoli: The collaboration with Novartis is a stepping-stone in our journey. As you are correctly mentioning, the objective of that partnership is to help physicians perform more effectively spirometry for the correct diagnosis and re-assessment of respiratory patients.
Now we are seeing that physicians are spontaneously willing to recommend our technology to their patients for home monitoring. This is happening homogeneously across markets because physicians have been both very satisfied with our solution and also more exposed to digital health solutions in general.
Research2Guidance: Currently you have a few partnerships, what challenges are you facing?
Lorenzo Consoli: It is important that the objectives of both parties are clear, and the incentives are aligned before starting any partnership. If this is done correctly, we see more opportunities than challenges. Having said that, given we are a small company, we face operational challenges every day, but this is part of the game.
Research2Guidance: Do you see digital therapeutics as a key part to effectively manage chronic diseases, including asthma/COPD?
Lorenzo Consoli: Absolutely. I think a digital intervention can play a key role specifically where lifestyle changes are needed to improve the condition. This is certainly true in many chronic conditions including COPD. Secondly, a digital intervention can play a fundamental role in preventing an acute event to occur. In COPD and Asthma patients can have exacerbations, which could lead to hospitalizations. Technology can help patients and caregivers prevent and/ or manage these episodes. In general, I think a drug in combination with a digital therapeutic solution will be considered standard of care for the management of a chronic condition.
Research2Guidance: In your opinion, how far in the future are the entirely AI based coaching services?
Lorenzo Consoli: If driverless cars will be here by 2020, I don’t see why we should not have entirely AI based health coaches over the next couple years. The question is whether the regulatory bodies will be fast enough to adapt to the changes that fully AI driven healthcare services will demand.
Research2Guidance: Where do you see the main barriers for the asthma/COPD apps and what needs to be changed for this market to take off?
Lorenzo Consoli: First of all, I think we should not work with the assumption that a patient would use a medical app regardless just because he / she has a disease. We should spend enough time to think hard about the value that the solution brings to that person and about the barriers of adoption.
Secondly, it is about trust. We should generate evidence that the solution designed brings medical value and, more importantly, make sure that physicians are included in the solution.
Finally, having the right business model plays a crucial role too. I think legislators need to create enough incentives for individuals, payers, and providers to use mobile health solutions or digital solutions in general, granted that the medical value and/or cost efficiencies have been demonstrated.
Research2Guidance: What is next for NuvoAir?
Lorenzo Consoli: 2017 has been an incredible year for NuvoAir, but 2018 will be even more exciting. As an organization, we are very R&D driven and have built a strong product roadmap for the future. We will be releasing soon new products both on the hardware and the software side and we are confident that these solutions will further improve the lives of people with respiratory conditions.
We are also working on exciting collaborations and partnerships that will allow us to reach more patients and strengthen our value proposition.
Finally, we have hired an incredible team over the last 12 months and in 2018 we are planning to grow the team with more talented people committed to make a difference in the healthcare space.
Research2Guidance: Thank you, Lorenzo, for your answers. We wish you all the success!
About NuvoAir AB
Founded in 2015, NuvoAir AB is a Stockholm-based digital health startup focused on empowering respiratory patients to live more active lives and enabling more precise clinical decisions. In 2016, NuvoAir launched Air Smart, the first portable spirometer connected to a smartphone that lets patients measure lung health in seconds, sold at a fraction of the price of standard spirometers. Early in 2017, NuvoAir closed a seed round from a major venture fund in Europe to finance product development and commercial expansion.