Patient over product

Improving the clinical adoption and engagement of digital health

solutions starts by focusing on patient-centricity

PwC | Patient over product 1

 Table of contents

03 Co-foreword

04 A focus on patient-centricity

05 Why is patient-centricity important

across all stakeholders?

08 What opportunities and momentum are

there for digital therapeutics (DTx)?

What are some examples of best

11 practices in patient-centricity?

PwC-NUS’ 3 Es framework for evaluating

14 patient-centricity in digital health
solutions

Recommendations for stakeholders

19 to be enablers of patient-centricity

PwC | Patient over product 2

Co-foreword

As a practicing clinician, This position paper by PwC in collaboration with

I would like to think that I National University of Singapore’s (NUS) Institute
and every other of Digital Medicine (WisDM) aims to redefine
stakeholder in the patient-centricity, in a holistic manner that
healthcare ecosystem involved seeking input from more than 100
have always been patient- individuals and across all stakeholders. By
centric. However, the highlighting and quantifying not only the
question is, "What is opportunities from an academic, business and
patient-centricity?" While clinical perspective but also the challenges faced,
we would all agree that this paper proposes a patient-centricity framework
being patient-centric and best practices that can be applied to digital
means placing the therapeutics each step of the way, starting from
patient’s (and their conceptualisation through to commercialisation.
families', too) Regardless of our role in any health system, let us
individual needs and preferences first, definitions all work together towards being truly patient-
vary across the globe. Furthermore, in today's centric, or perhaps even better, patient-driven as
healthcare ecosystem, with all health systems a recent article I came across stated. In the words
globally facing time and resource pressures, is it of a large hospital group CEO, “If you look after
reasonable to expect that we stop and ask what your patients, the business will look after itself.”
each of our patient’s needs and preferences are?
And take a completely holistic approach? I believe
it is. Dr. Zubin J Daruwalla
Asia Pacific Health Industries Leader,
PwC Singapore

If digital health solutions (DHS) have the potential to for patient-centricity.

disrupt healthcare, there is still a long journey ahead Additionally, a framework
before these solutions can benefit and be used every for patient-centric best
day by clinicians, patients, and their family members. practices is introduced,
Among the numerous critical challenges that DHS designed as a
need to address is the question of patient-centricity comprehensive tool for
and how best to address the needs of patients to evaluating patient-
ensure that these solutions are used in a real-world centricity in DHS. We
environment beyond the traditional few weeks of a hope this framework will
clinical trial. As the World Health Organisation (WHO) be used as a roadmap to
and numerous others have emphasised, there is a enhance patient values of
critical need for the development of DHS to solutions by empowering
meaningfully involve the patients and communities patients to actively
they impact, particularly concerning the applications of engage in their healthcare journey as equal partners.
artificial intelligence (AI).

For this reason, using digital therapeutics (DTx) as a Prof. Dean Ho

use case, this white paper defines what patient- Director,
centricity means, outlines effective ways to involve The Institute for Digital Medicine (WisDM),
patients in technology development, identifies key NUS Yong Loo Lin School of Medicine
stakeholders to engage, and presents best practices

PwC | Patient over product 3

A focus on patient-centricity
How is patient-centricity currently such enhanced and personalised experiences for
defined? patients often include a greater sense of
empowerment, engagement, and trust in the
Patient-centricity means prioritising patients' needs healthcare system to care for their unique needs. Such
and preferences, not just when it comes to healthcare positive patient experiences can in turn be used to
innovations but in general, too. One major way to be promote greater uptake of the digital health solution.
more patient-centric is to enhance their participation at
every stage of the digital health solution (DHS) A case in point: Perx Health1 reported a remarkable
lifecycle, from inception to clinical validation and 96.8% implementation adherence using a digital
implementation. Yeoman et al. defined patient therapeutics (DTx) mobile app over a six-month period.
centricity as ‘putting the patient first in an open and Their multicomponent adherence management
sustained engagement of the patient to respectfully intervention, incorporating reminders, educational
and compassionately achieve the best experience and components, incentives, gamification, and social
outcome for that person and their family.’ It is thus community components, demonstrated the success of
crucial to emphasise patient engagement in all stages this approach in maintaining optimal medication
of development of DHS. adherence.

This position paper aims to present various Improved patient outcomes

stakeholders' perspectives and interpretations of By centring on the individual needs and preferences of
patient-centricity, incorporating both ground-up patients, patient-centric solutions contribute to better
perspectives and from existing literature. Additionally, treatment adherence1, reduced hospital
it proposes a framework for evaluating patient- readmissions2,3, and overall enhanced health
centricity in digital therapeutics (DTx) solutions. outcomes4—essential benchmarks for any healthcare
solution. Moreover, we can argue that improved
patient outcomes, or initial data indicating that patients
What are the benefits of patient-centric are progressing positively in terms of their conditions
digital health solutions? and/or symptoms—a data-driven approach—will also
This section explores why pursuing patient-centricity bolster patient adherence.
provides benefits to both patients and a broad range of A case in point: In the pharmaceutical industry, which
stakeholders, including clinicians and healthcare faces similar challenges to digital healthcare solutions, a
systems. Two key categories of benefits stand out: research report by Parexel5 for The Economist
Enhanced patient experience, and improved patient Intelligence Unit revealed that drugs developed using
outcomes. patient-centric clinical trials, involving patients in design
or execution, were 19% more likely to be launched
Enhanced patient experience successfully. Such case studies support that patient-
Patient-centricity prioritises the individual needs and centric methods are more likely to yield successful health
preferences of patients, encouraging their active innovations with superior outcomes for patients.
involvement in the development process of healthcare
solutions. When patients are engaged in the design
process, they are more likely to access online
healthcare resources, participate in studies to
understand their conditions better, and engage with
online patient communities. Establishing the norm
where patients are closely involved in healthcare
research advocates for healthcare which aligns with
their needs. Patient-centric care emphasises empathy,
communication, and collaboration between patients
and healthcare providers, resulting in a more positive
and satisfying healthcare experience. The outcomes of

PwC | Patient over product 4

Why is patient-centricity important
across all stakeholders?

Medical professionals Patients

• Increased efficacy: Patient-centricity leads to • Personalisation: Patient-centricity offers
better patient outcomes and disease tailoring of the best experience for end-users,
management6, rendering the efforts of medical empowering patients to make informed
stakeholders more effective. decisions about their healthcare.
• Engagement: Patient-centricity offers medical • Cost: Patient-centric DTx solutions, done right,
professionals the chance to learn from patients7, can be associated with lower costs. (e.g.,
who can be extremely knowledgeable about Sleepio users had 28% lower healthcare costs,
their own health condition(s). decreasing by US$1677 on average per
person8).
• Ethos: Patient-centricity is a core tenet of
healthcare, as patients form the driving • Engagement: Enables patients' involvement in
motivation for medical professionals. the research process9, where they can provide
meaningful feedback on potential DTx solutions.
• Partnership: Therapies and treatments are
decided on in partnership with the patient, for
the patient.

Regulators and developers Academics

• Tackling non-adherence: When DTx solutions • Equity considerations: Patient-centricity is
are patient-centric, they are more likely to be well- crucial in academia to ensure research and
received by patients, thus providing a new avenue healthcare innovations address diverse patient
to enhance patients’ health effectively and address needs, experiences, and outcomes, ultimately
longstanding issues of non-adherence, which can promoting equitable access to effective
cost between US$949 and US$44,190 per treatments and improved health for all
person10 annually11. populations.
• Cost-effectiveness: In drug development, early • Real-world validity: Much of the academic
investment in patient input on drug design is research within DTx ultimately aims to be
more effective for recruiting and retaining applied to real scenarios. Patient-centricity
patient participants, which saves downstream offers a means of applying academic theories
costs over its future development. Research has with better uptake, i.e., truly going from bench
found that investing US$100,000 to gather to bedside.
patient input on drug design and improve
participant recruitment and retention can save
an estimated US$60m over the drug’s lifetime12.
• Market demand: Patients can be drivers of new
innovations that best meet their needs which
can limit market failures due to low demand.

PwC | Patient over product 5

Survey methodology and stakeholder results
In order to determine how medical stakeholders viewed patient-centricity, in January 2024 we conducted a survey
of 118 stakeholders worldwide, the majority of whom were from the Asia Pacific region. Countries represented
included Australia, New Zealand, Singapore, Indonesia, Malaysia, Philippines, Thailand, Vietnam, China, India,
Japan, Taiwan, United Kingdom, France, Germany, Brazil and the United States of America.
The survey was designed to capture the stakeholders' perspectives on patient-centricity. Participant responses
were collected through the researchers’ professional networks. Each respondent was asked to identify up to three
stakeholder positions they most identified with, which was designed to acknowledge how individuals frequently
contribute across various professional domains.
Digital therapeutics were used as a case study to capture the perspectives of stakeholders within the healthcare
community on the concept of patient-centricity.

The proportion of stakeholder representation within our sample was as follows:

• MedTech – 39%
• Clinical providers – 31%
• Investors – 27%
• Technology providers – 27%
• Patients / Patient advocate groups – 18%
• Government agencies – 14%
• Institutes of higher learning – 12%
• Healthcare administrative staff – 9%
• Pharma – 9%
• Regulators – 3%
• Economists – 2%
• Insurers – 2%

The top five stakeholder groups represented were: (1) medical technology, (2) clinical providers, (3) investors, (4)
technology providers, and (5) patients / patient advocate groups.
The next section summarises the key insights from the participants’ responses and support the operationalisation
of patient-centricity and help establish patient-centric best practices.

PwC | Patient over product 6

How did our survey respondents define patient-centricity?
Through thematic analysis of responses, seven complementary characteristics of a patient-centric solution were
identified.

Characteristics of
Qualifying explanation
patient-centricity

1 Meeting patients’ Meeting patients' needs involves various approaches, such as catering to patients’
needs technological proficiency levels, addressing genuine and unmet needs, and
comprehensively understanding the patient beyond their disease parameters.
Embracing a patient-centric design approach means ensuring that all aspects,
from treatments to clinical trials and technology, revolve around the patient and
prioritise their needs and interests.

2 Prioritising and Enhancing patients' quality of life, ensuring an effective intervention by producing
achieving improved the desired health outcome, addressing their pain points, improving their
patient outcomes condition, and providing a clear value proposition for patients by giving them
access to outcomes which improve their quality of life.

3 Respecting patient Understanding and respecting patients’ personal values and preferences
values throughout the healthcare solution’s development. Any healthcare solution should
prioritise the problems which patients determine to be of highest importance and
delivered in a manner which respects their personal and moral values.

4 Providing an Accessibility means ensuring that there are minimal barriers to treatment for
accessible solution patients, which include equitable access to technology, convenience of obtaining
care, and affordability.

5 Providing a simple The technology’s user interface should be simple, intuitive, user-friendly, facilitate
and intuitive user the ease of patients’ access to healthcare, and be easily integrated into patients’
experience everyday lives.

6 Involving patients Actively seeking and integrating patients' input by directly engaging them as equal
stakeholders in every stage of healthcare technology
development. It signifies adopting a patient-driven approach
towards providing healthcare solutions.

7 Empowering patients Encouraging patients to take ownership over their health by

providing them with the education, tools and resources they
need to make informed decisions or take the initiative to
manage their health. Empowerment also involves
actively engaging with patient voices and making
meaningful change based on their experiences.

PwC | Patient over product 7

 What opportunities
and momentum are
there for DTx?
Clinical

Number of clinical trials by DTx ventures YoY

A total of 567 clinical trials have been conducted or are
currently underway by digital health ventures focusing
on digital therapeutics. As of September 2024, 39
clinical trials had been logged, which was below the
101 clinical trials recorded in 2023.

<2019 121

2019 53

2020 72

2021 97

2022 71

2023 101

2024 39

2025 13
(YTD)
Source: ©2025 by Galen Growth

Business Academic

Number of scientific publication by DTx

US$5.66bn ventures YoY
2023 More than 4,412 scientific publications were published by
digital therapeutics ventures since 2010. In 2023, the annual
US$36.47bn number of publications reached 849, down 9% YoY.
2032. CAGR 23% 1065

849
Source: ©2023 by Astute Analytica 716
513

314
119 180 221 255
97
56
27

<2015 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
YTD

Source: ©2025 by Galen Growth

Without certainty, the observed reversal above of an increasing trend over preceding years with a decline of clinical
trials and academic publications in 2024 may be reflective of uncertainties in (1) securing funding representative of
investor hesitancy, and (2) navigating market access, regulatory approvals, and potential reimbursement as
governments have slowly started establishing DTx-specific frameworks.

PwC | Patient over product 8

How should patient-centricity be How best can we involve patients in the
measured? development of DTx?
118 participants’ responses to the question of
measuring patient-centricity were coded and the five Our survey results showed that
most recurring points for evaluating patient-centricity in
DTx solutions included (1) Ease-of-use, (2)
Affordability, (3) Quality of outcomes, (4) Accessibility,

1
and (5) Engagement. These results Usability studies,
re-emphasise that, beyond ensuring clinical efficacy,
DTx technology must engage with patients as they followed by
are. To be patient-centric, a DTx technology should working with
remain accessible to patients regardless of their
technological familiarity, financial, or social
backgrounds.

2
Survey of stakeholder opinions on the best patient advocate
parameters for assessing patient-centricity groups/patient
(N=118)
ambassadors
40 35
Number of times parameter

35
was suggested

30
25
23 22
19 were thought to be the best means of involving
20 15 14 14 12 patients in DTx development over in-app feedback
15
9 channels, clinical trials, patient surveys, and
10
community patient forums.
5
0
What the results tell us
Stakeholder responses imply that patients should be
actively engaged in iterative usability studies, allowing
them to provide continuous feedback during the
development process of DTx technologies. In contrast,
clinical trials require a DTx to be sufficiently mature
before undergoing medical testing with patients, which
usually occurs later in the development process.
There is, therefore, a gap between stakeholder
opinions on when it is most beneficial to involve
patients, and when patients are actually involved in
DTx development. Involving patients earlier, rather
than later, would provide more avenues for patient
input and set the basis for more patient-centric DTx
development. Moreover, existing literature suggests
that patient focus groups, conducting patient advisory
panels and patient advocate group involvement are
initiatives with the lowest cost and highest impact on
the patient, relative to other patient-centric practices13.
A co-creation approach is needed to genuinely
address the needs and preferences of its users,
primarily patients and healthcare providers. Taking an
interdisciplinary approach towards engaging patients
and stakeholders in the concept, design and
development process enhances the relevance,
usability, and effectiveness of health solutions,
resulting in improved patient outcomes, higher
adoption rates, and ultimately, enhanced
healthcare delivery.

PwC | Patient over product 9

Who should be involved in the easily adopted and used by the consumer at a cost-
development cycle of a patient-centric effective price. Early engagement allows developers to
understand and comply with regulatory requirements
DTx? from the outset, thereby reducing the risk of costly
Unsurprisingly, patients! Across the development, delays or rejection during the approval process.
clinical validation and implementation stages, patients Regarding regulators, some countries have issued
are continuously cited as the most important guidance on developing patient-centric digital
stakeholder to involve. The support and involvement of measures, emphasising the importance of patient
family members and caregivers are vital for the centricity. For instance, in the US, the Food and Drug
physical, emotional, and practical well-being of Administration (FDA) has created a series of four
patients, contributing to better outcomes and quality of patient-focused drug development guidance
life during illness or recovery. Consequently, they documents. These documents guide stakeholders on
should also play an integral role in the development gathering and submitting patient experience data and
cycle of patient-centric digital therapeutics (DTx). other relevant information from patients and
caregivers for medical product development and
Secondly, healthcare professionals with the closest regulatory decisions. While not strictly limited to digital
contact with patients in treatment contexts are also health, many of these approaches, tools, and best
thought of as warranting the greatest involvement in practices are relevant for DTx. The FDA guidance, for
developing patient-centric DTx. 85% of survey example, references the ‘Digital Measures That
respondents selected doctors, and 62% selected Matter' framework, which provides a hierarchical
nurses as the health professionals thought to have model for establishing the meaningfulness of such
greater involvement in the DTx development cycle digital measures.
compared to C-suite, healthcare administrative staff or
other allied health professionals. The results from this In addition to regulators, a crucial stakeholder
survey corroborate with results from a previous study potentially missing from our respondents’ answers is
conducted by PwC and Singapore’s National Health the payor. The monetisation of DTx presents one of
Innovation Centre (NHIC) that similarly found doctors’ the most intricate and complex challenges
and nurses’ perspectives were perceived as the most organisations currently face. Engaging and consulting
highly sought after and valuable ones. with payors (including insurance companies,
Finally, whilst regulators are mentioned ‘only’ once in employers, and government agencies) during the DTx
the top three throughout the DTx lifecycle, we would development is therefore imperative. This involvement
argue that early engagement with regulators is crucial is essential for validating the solution's value
for the successful development, validation, and proposition, ensuring market suitability, understanding
eventual approval of DTx solutions. This ensures that reimbursement landscapes, facilitating market access,
they meet regulatory standards while delivering safe and determining the scale of adoption beyond the
and effective healthcare interventions which can be clinical trial.

Top three stakeholders who should be involved throughout the DTx lifecycle
according to survey respondents

Development Clinical validation Implementation

• Patients • Patients • Patients
• Clinical providers • Clinical providers • Clinical providers
• Tech. providers • Regulators • Tech. providers

PwC | Patient over product 10

What are some
examples of best
practices in
patient-centricity?

In technology development An example of involving individuals in the early

• Patient engagement technology development and testing phase. Image
depicts the swallowing of a camera embedded in a pill to
- For example, consider MedRhythms, a US seek early user feedback.
based company that utilises neurotherapeutics
to aid patients with neurological diseases or
injuries in enhancing their functional mobility
through music. Incorporating the patient
perspective into daily decision-making was at
the heart of MedRhythms' inspiration in forming In clinical validation
the first-of-its-kind Digital Therapeutics Patient
Advisory Board14, alongside the typical scientific • Decentralised clinical trials
advisory board. Patients are deeply engaged - Decentralised clinical trials are randomised
and consulted from the inception of control trials made patient-centric by organising
MedRhythms' product development and trial activities around participants instead of
consistently provide input on product investigator sites, increasing the convenience
innovation. for participants. For example, trial activities can
• Interdisciplinary and mixed-methods approaches take place at or near participants’ homes using
operational approaches like telemedicine visits,
- The Institute for Digital Medicine (WisDM) at directly delivering study drugs (or in this case,
NUS is committed to seeing its DHS DTx products) to participants’ homes.
implemented in real-world settings. To achieve Decentralised clinical trials aim to increase
this, their research engineers, clinicians, participant engagement, retention, and
implementation science experts, and other recruitment, whilst decreasing barriers like the
professionals collaborate closely with their in- burden of travel — which may result in more
house dedicated behavioural team. Together, diverse clinical trial samples. Accommodations
they conduct ongoing usability and feasibility need to be made to effectively engage a
studies, actively listening to end-users and representative cohort of consumers.
incorporating their feedback into the
requirements for improved (and more relevant) - For every additional 48 kilometres patients have
design and user engagement. to travel, it was found that enrolment and
retention rates would decrease by 10%15,
- Mixed-methods approaches, combining suggesting that reducing participants’ travel
quantitative and qualitative approaches, offer a burden could make them more inclined to enrol,
comprehensive understanding of patient or less inclined to drop out of trials. Another pilot
perspectives and help assess the study suggested that decentralised clinical trials
generalisability of observations. delivered 300% greater enrolment rates and
higher rates of retention (89% as opposed to
69%)16.

PwC | Patient over product 11

• Patient partner collaboration the standard care pathways for adult patients
with major depressive disorder. These patient
- The Patient-Centered Outcomes Research representatives were instrumental in
Institute (PCORI) in the US has established a challenging and verifying assumptions made by
‘patient co-investigator’ role for their studies. the model and were able to point out unique
These patients, often referred to as ‘non- limitations. The study noted that the final model
scientists’ or ‘lived experience experts', and are was stronger as a result of diversity in the
not merely ‘study participants,’ they also serve modelling team, and raised new research
as advisors, actively engaged throughout the questions based on patient partners’ lived
research process from the concept stage experiences. The success of their approach in
through to implementation, by sharing their own including patient partners provided the impetus
lived experiences. This involvement helps in for other teams to consider when modelling
effectively designing new DTx solutions that are issues in healthcare.
relevant and impactful.
- Other key advantages of utilising patient
- A study conducted by Parry et al17. indicates partners include:
that patients show increased engagement when
provided with high-quality decision-aids. These o Their ability to test new DTx objectively and
aids enhance their comprehension of how to provide valuable feedback, ensuring new
engage as patient-partners with clinical DTx is relevant and prioritised for
research, defining their priorities, and the consumers.
perceived benefits vs. risks of participating in
clinical trials. These decision aids serve to o Ensuring independent and diverse
inform patients about clinical research, provide perspectives are included in product
them with actionable opportunities to collaborate development19, evaluation and
with investigators, and patients to consider their implementation, which improves access and
priorities, readiness (including benefits and equity to technology and healthcare.
risks), and the next steps they can take. o Keeping DTx development companies
Feedback from patients suggests that these accountable and transparent in their
decision aids are user-friendly, relevant and processes.
beneficial, offering knowledge and support that
facilitates patient-oriented research. o Ensuring DTx is effective for the end user
and meets their needs.
- Patients can also be involved as partners. A
research study conducted by Bunka et al18. o Involving patient partners from the concept
exemplified this practice by including two patient stage improves trust in new DTx, and can
partners on the team responsible for modelling assist new technologies in coming to market.

PwC | Patient over product 12

In implementation
• Ensuring equal access to digital healthcare and
equal outcomes
- DTx should be designed within an equity
framework, which might incorporate the
considerations of several interrelated factors,
such as socio-economic and cultural contexts,
digital determination of health or resourcing and
quality of care – to name just a few. As Hadjiat20
(2023) highlighted, a DTx, ‘can make a
difference to health inequity, IF fit for purpose’.
• Ensuring accessibility and affordability of DHS
- A patient-centric solution allows patients to
access solutions comfortably and should be
available for use by patients regardless of their
background. Accessibility can be ensured by
providing multi-language support for diverse
communities, user-friendly interfaces that cater
for different degrees of digital literacy, providing
digital literacy programs and robust customer
support. Accessibility is further enhanced
through stable internet connectivity and offline
functionalities. Furthermore, affordability can be • Providing individualised support to patients
ensured with cost-effective technology and - Welldoc, a platform that helps patients manage
insurance or welfare services coverage. These chronic conditions like diabetes, hypertension,
solutions can work together to ensure that heart failure and behavioural health, provides
patients of all backgrounds are able to interact users with individualised treatment
with healthcare professionals with confidence recommendations based on their activity21.
and ease and across care pathways. Patients can not only access their healthcare
information (e.g., weekly glucose levels), but
also receive AI insights into the factors
influencing their health (e.g. attributing higher
glucose levels to poor medicine adherence, or
dietary reasons etc.). Welldoc’s AI can
recognise patterns in user’s behaviours and
give appropriate recommendations. These
trends are passed on to the patient’s healthcare
providers to assist in optimising care pathways.

PwC | Patient over product 13

A framework for evaluating patient-centricity
in digital health solutions
Patient-centricity in health technology is about designing, developing, and implementing innovations with a primary
focus on addressing patients’ preferences, improving their well-being and experiences, and ensuring accessibility,
affordability and ultimately, a positive impact on clinical and non-clinical outcomes. The results from our survey
corroborate this definition, which provides the basis of a new and holistic definition of and framework for patient-
centricity. The following patient-centric framework is designed to serve as a comprehensive tool for assessing the
degree of patient-centricity, using DTx as a use case. Its primary goal is to empower DTx developers to prioritise
patient-centredness throughout the design, development, and implementation phases. By leveraging this
framework, developers can systematically evaluate the level of patient-centricity embedded within their innovations
and utilise it as a roadmap towards achieving maximum value for the patient.

Value

Equity Experience
Ensuring equal access to Providing a personalised
digital healthcare and experience catering to
equally improved individual needs,
outcomes to all preferences, cultural
nuances, and health
conditions to maximise
likelihood of achieving
Efficacy positive outcomes
Improving patients’ clinical
outcomes, and so overall
health and quality of life in
real-world environments,
while potentially reducing
healthcare costs through
effective management and
treatment of medical
conditions relevant to the
individual

The patient-centricity framework is built around three key dimensions: Equity (Accessibility, Affordability),
Experience (Education, Engagement, Empowerment, Empathy, Ease-of-use), and Efficacy (Quality and safety,
Clinical trial efficacy, Effectiveness, Relevance)

PwC | Patient over product 14

How to evaluate each framework dimension
for your organisation
In the table below, we have taken a fictional organisation to demonstrate how the proposed patient-centric
framework above can be utilised for conducting a self-assessment of your organisation and outlining a pathway
towards excellence and patient-centricity. Please note that this example is not intended to be comprehensive or
exhaustive in the selection of certain features, nor is it representative of any specific organisation. It is purely for
illustrative purposes.

Patient-centricity (PC) framework evaluation tool

Aspects of PC Low Medium High

(definition) levels levels levels

Equity

Accessibility Limited availability of the Following FDA and

DTx across various Conformite Europeenne
The ease with which devices, platforms, and (CE) clearance, the DTx
patients can physically channels restricting is now available in
access, and in a timely access not only for multiple countries, and
manner, the DTx. patients lacking specific accessible across
devices, operating various platforms and
systems, or sufficient channels. Importantly, it
internet connectivity but ensures accessibility for
also for patients who may all individuals,
lack the necessary digital regardless of their level
health literacy to utilise of digital health literacy,
such technological device preferences, or
solutions (e.g. pilot trial internet connectivity
with a potential status.
commercial partner such
as an insurer or
employer).

Affordability In a market where Availability of Availability of

individuals pay out of (government) subsidies to reimbursement
Patients should have the pocket, the cost of the lower income group users mechanisms or complete
economic capacity to DTx could be a (e.g. cost neutral (government) subsidy of
purchase the solution, considerable expense compared to current gold DTx (e.g. cheaper than
and/or it should be cost- compared to patients' standards, and/or current gold standards
effective for a healthcare income or the available standard of care). and/or standard of care).
system to justify potential budget and resources of
reimbursements or potential payors (e.g.
subsidies. more expensive than
current gold standards,
and/or standard of care).

PwC | Patient over product 15

Patient-centricity framework evaluation tool (cont’d)

Aspects of PC Low Medium High

(definition) levels levels levels

Efficacy

Quality and safety No ‘system of controls’ A high reliability

(including manufacturing) and associated framework adopted and
processes to provide implemented as a
Does not cause harm to confidence over key precursor to any
users (e.g. mechanical, clinical risks in place. potential regulatory
electrical, and chemical submissions.
safety) while ensuring data
security, patient privacy,
and adherence to
regulatory standards.

Clinical trials efficacy Expert opinions, case Case control study, Randomised controlled
reports and case series. retrospective cohort trials. Beyond evaluating
The extent to which the study, prospective the DTx's performance in
DTx demonstrates clinical comparative study. terms of its intended
validity and achieves its medical purpose and
intended health outcomes. ensuring it does not
cause adverse effects or
harm to patients, post-
market surveillance and
monitoring of adverse
events are required for
maintaining clinical
safety.

Real-world effectiveness DTx intervention shows Conduct pragmatic Conducting an economic

effectiveness primarily in clinical trials, which are evaluation, which is often
Produces the desired specifically defined designed to determine the overlooked but critical,
health outcomes when scenarios, such as in pilot effectiveness of alongside pragmatic
implemented in real-world studies conducted with interventions in real-world randomised trials is
settings but also considers employers, which might clinical settings. crucial for assessing the
the significance of these lack generalisability cost-effectiveness of the
outcomes (e.g. in weight across the wider DTx intervention under
management, a clinically population. real-world conditions.
significant amount of weight
loss is defined as ≥5% of
baseline body weight.
Anything below this
threshold may be
considered a low level of
real-world effectiveness,
despite potentially high
statistical significance).

PwC | Patient over product 16

Patient-centricity framework evaluation tool (cont’d)

Aspects of PC Low Medium High

(definition) levels levels levels

Efficacy

Relevance Target audience research Actual user research,

such as secondary conducting usability
Appropriateness of the DTx market research on the studies, with a
to patients, to address an Total Addressable Market combination for example
unmet need, to the (TAM), Serviceable of in-depth interviews
Healthcare Professionals Addressable Market and focus group
(HCPs) to address a clinical (SAM) and Serviceable discussions. This
need, but also to the health Obtainable Market approach aims to
system broadly speaking (SOM), as well as of the explore patients' interest
and government. clinical relevance and and perspectives as well
clinical benefits of the as potential challenges
DTx intervention. and concerns, in utilising
DTx to support the
management of their
medical conditions, with
the goal of enhancing
overall outcomes.

Experience

Education DTx created with what Key considerations are

designers presume given to the health
Process of equipping patients would literacy and digital health
individuals with the require/need. literacy of targeted
knowledge, skills, and users, identifying
competencies needed to potential gaps and
effectively navigate and addressing them through
utilise a DTx intervention. hyper personalised, bite-
sized content,
interactions, and
engagements.

Engagement General engagement Develop comprehensive A dynamic patient

mechanisms that offer personas based on engagement system
Level of active involvement minimal personal previous study findings uses various
and sustained participation interaction with the user. and observations, communication channels
of individuals in using DTx identifying key and touchpoints
to manage their health. touchpoints and according to patient
interactions for each preferences and
patient, as well as integrates these
important features to channels through
foster engagement (e.g. omnichannel
peer support groups and engagement.22
community support).

PwC | Patient over product 17

Patient-centricity framework evaluation tool (cont’d)

Aspects of PC Low Medium High

(definition) levels levels levels

Experience

Empowerment Pre-determined Users have access to Users have extensive

interventions based on essential health control and
Providing individuals with basic patient data (e.g. information and tools that comprehensive access
the tools, information, and height, weight or gender), support self-management to their health
resources they need to take with users having minimal and informed decision- information and a range
control of their health, make control and access, making, such as rule- of tools, enabling full
informed decisions, and/or limited ability to based algorithms that self-management,
manage their conditions manage their health facilitate shared decisions informed decision-
effectively, and actively information or make (e.g. ‘Would you like to making, and active
participate in their informed decisions, often fast in the morning, participation in their
healthcare whilst respecting relying heavily on afternoon, or evening?’). healthcare (e.g.
their values in how they healthcare providers. incorporating
want to receive healthcare. patient‐reported outcome
measures (PROMs),
improves doctor-patient
communication,
promotes shared-
decision making, and
enables patients' quality
of life concerns to be
addressed). 23

Empathy Top-down approach with Slight personalisation in Use of generative

respect to communicating artificial intelligence
Ability to understand and information/intervention information or (GenAI) in DTx
address the emotional and delivery. administering intervention to enhance
personal experiences, interventions to patients, empathy by providing
needs, and concerns of targeted at a specific personalised and
users, thereby fostering a patient profile (but not at contextually relevant
sense of trust and support. the individual patient interactions with users,
level). providing compassionate
and hyper personalised
experiences at the
individual patient level.

Ease of use DTx involving extensive One-time consultation Co-created DTx with
patient onboarding, with patients to assess patients considering
How easily users can including training for both their requirements/needs elements such as colour
understand, and use a DTx patients and physicians, and subsequently develop choice, language,
to meet their needs without as well as ongoing patient a DTx based on the convenience, and
extensive training or support from healthcare collected data. simplicity, resulting for
support. professionals like nurses. example in user-friendly
and intuitive interfaces,
leading to improved DTx
‘uptake’.

PwC | Patient over product 18

Recommendations for stakeholders
to be enablers of patient-centricity

If you are a… ...you should consider the following:

Patient • Learn about the potential benefits and risks associated with clinical trials, and if
appropriate, join research efforts to provide detailed, valuable feedback on what aspects of
a DTx are successful or unsuccessful from an end-user’s perspective.
• Join patient advocacy groups, patient forums or other equivalent groups and raise your
concerns and perspectives when opportunities arise.

Researcher or • Proactively seek advice from patient stakeholders early in the process of creating new
academia digital health solutions, rather than asking for patient feedback retroactively. This could be
done by first asking patients what pain points they experience, then co-designing a
targeted digital health solution.
• Actively engage patient advocates and support groups in clinical trials and other feedback
channels, allowing consumers to assess whether healthcare solutions align with their
lifestyle and values. Ensure these solutions are relevant, appropriate, and accessible.
• Consider mixed-methods approaches, combining quantitative and qualitative approaches,
which offer a comprehensive understanding of patient perspectives and help assess the
generalisability of observations.

Payor • Ensure digital health solutions reach diverse patient populations, including underserved
communities, and address health disparities effectively.
• Focus on solutions that emphasise outcomes that matter to patients and can be tailored to
individual needs and preferences.
• Move from volume-based to value-based reimbursement structures that reward solutions
based on their effectiveness in improving patient outcomes.

Regulator or • Involve patients in policy development and include them in committees that evaluate and
legislator select digital health solutions for coverage.
• Allow healthcare providers greater liberties to propose a research project with low-risk
patient-centric DTx technologies, by reducing the bureaucratic processes or waiting times
associated with obtaining regulatory approval to participate in trials.
• Design specific legislative pathways for DTx technologies that have demonstrated
sufficient effort to engage with patients.
• Consider creating and expediting the regulatory approval and potential reimbursement of
DTx through ‘fast-track’ processes, such as the Digital health applications (DiGA) in
Germany or La prise en charge anticipée numérique (PECAN) in France.

Clinical • Clinical providers should consider better understanding patients’ needs and preferences
provider, based on their unique and individual circumstances. They may also wish to consider
including allocating allotted time to evaluating the suitability of new healthcare technologies and
hospital innovations to determine and ensure they are fit for purpose for their patients.
administrator
• Consider feedback/complaints from patients, no matter how small. This will ensure a more
patient-centric approach and that more DTx and other solutions are explored.
• Be willing to constantly and proactively learn about promising new technologies and
potentially adopt them if they are shown to significantly improve patients’ treatment
experiences and health outcomes.
• Inculcate an environment where the opinions of all clinical stakeholders (doctors, nurses,
healthcare administrative staff, C-suite etc.) are given due consideration, especially if the
perspective can be used to enhance patient-centric practices.

PwC | Patient over product 19

 If you are a… ...you should consider the following:

Technology • Promote the cultivation of multidisciplinary skill sets within your teams. This will ensure that
provider they have the technical expertise to develop healthcare technologies and understand how
to design innovations that best meet patients’ needs.
• Involve patient or lived experience partners from the concept stage of new technology and
iteratively throughout the technology developmental process. It is recommended that
diverse patient population groups be consulted through surveys, focus groups and other
consultation methods to ensure a wide range of views are represented.

Pharma, Life • Consider incorporating patient feedback into the research and development processes.
Sciences and All new technology developments and research projects have patients or people with lived
MedTech experience of targeted health conditions, as members of their research or development
team to ensure health outcomes are addressed.
• Focus on creating intuitive, accessible interfaces that cater to diverse patient populations,
including those with limited tech literacy.
• Prioritise robust data protection measures and be transparent about data usage to build
patient trust.

Investor • Focus on funding healthcare technologies that have taken measurable steps toward
patient-centricity, using established frameworks to evaluate their potential for maximising
value to patients and their families.
• Emphasise patient outcomes and engagement. Make investment decisions based on
solutions that demonstrably improve patient outcomes and quality of life, while also
considering key performance indicators such as user adoption rates, patient satisfaction
scores, and long-term engagement.
• Support evidence-based impact assessment. Allocate resources for real-world evidence
studies to evaluate the actual impact of digital health solutions on patient outcomes post-
launch, ensuring that investments truly deliver on their promise to improve patient care.

PwC | Patient over product 20

References

1. Wiecek, E., Torres-Robles, A., Cutler, R. L., Benrimoj, S. I., & 13. Stergiopoulos, S., Michaels, D. L., Kunz, B. L., & Getz, K. A.
Garcia-Cardenas, V. (2020). Impact of a Multicomponent (2019). Measuring the Impact of Patient Engagement and
Digital Therapeutic Mobile App on Medication Adherence in Patient Centricity in Clinical Research and Development.
Patients with Chronic Conditions: Retrospective Analysis. Therapeutic Innovation & Regulatory Science,
Journal of Medical Internet Research, 22(8), e17834. 2168479018817517.
https://doi.org/10.2196/17834 https://doi.org/10.1177/2168479018817517
2. Fadol, A., Estrella, J., Shelton, V., Zaghian, M., Vanbenschop, 14. MedRhythms. (2020, April 23). MedRhythms Assembles First
D., Counts, V., Mendoza, T. R., Rubio, D., & Johnston, P. A. of Its Kind Digital Therapeutics Patient Advisory Board.
(2019). A quality improvement approach to reducing hospital Retrieved December 9, 2024, from
readmissions in patients with cancer and heart failure. Cardio- https://www.prnewswire.com/news-releases/medrhythms-
Oncology, 5, 5. https://doi.org/10.1186/s40959-019-0041-x assembles-first-of-its-kind-digital-therapeutics-patient-
advisory-board-301045919.html
3. Fadol, A. P., Adornetto-Garcia, D., Shelton, V., Durand, J.-B.,
Yeh, E. T. H., & Summers, B. L. (2015). Heart success 15. Moore, E. G., Roche, M., Rini, C., Corty, E. W., Girnary, Z.,
program: An interdisciplinary patient-centered approach to O’Daniel, J. M., Lin, F.-C., Corbie-Smith, G., Evans, J. P.,
cancer patients with concurrent heart failure. Progress in Henderson, G., & Berg, J. S. (2017). Examining the cascade
Pediatric Cardiology, 39(2, Part A), 99–105. of participant attrition in a genomic medicine research study:
https://doi.org/10.1016/j.ppedcard.2015.10.007 Barriers and facilitators to achieving diversity. Public Health
Genomics, 20(6), 332–342.
4. Hibbard, J. H., & Greene, J. (2013). What the evidence shows https://doi.org/10.1159/000490519
about patient activation: Better health outcomes and care
experiences; fewer data on costs. Health Affairs (Project 16. Sommer, C., Zuccolin, D., Arnera, V., Schmitz, N., Adolfsson,
Hope), 32(2), 207–214. P., Colombo, N., Gilg, R., & McDowell, B. (2018). Building
https://doi.org/10.1377/hlthaff.2012.1061 clinical trials around patients: Evaluation and comparison of
decentralized and conventional site models in patients with
5. The Economist Intelligence Unit. (2018). The Innovation low back pain. Contemporary Clinical Trials Communications,
Imperative: The Future of Drug Development Part 1: 11, 120–126. https://doi.org/10.1016/j.conctc.2018.06.008
Research Methods and Findings.
https://druginnovation.eiu.com/wp- 17. Parry, M., Bjørnnes, A. K., Toupin-April, K., Najam, A., Wells,
content/uploads/2019/05/Parexel-innovations-in-drug- D., Sivakumar, A., Richards, D. P., Ceroni, T., Park, M., Ellis,
development-part-1_V14.pdf A. K., Gilron, I., & Marlin, S. (2020). Patient Engagement
Partnerships in Clinical Trials: Development of Patient Partner
6. Yu, C., Xian, Y., Jing, T., Bai, M., Li, X., Li, J., Liang, H., Yu, and Investigator Decision Aids. The Patient, 13(6), 745–756.
G., & Zhang, Z. (2023). More patient-centered care, better https://doi.org/10.1007/s40271-020-00460-5
healthcare: The association between patient-centered care
and healthcare outcomes in inpatients. Frontiers in Public 18. Bunka, M., Ghanbarian, S., Riches, L., Landry, G., Edwards,
Health, 11, 1148277. L., Hoens, A. M., & Bryan, S. (2022). Collaborating with
https://doi.org/10.3389/fpubh.2023.1148277 Patient Partners to Model Clinical Care Pathways in Major
Depressive Disorder: The Benefits of Mixing Evidence and
7. Fix, G. M., VanDeusen Lukas, C., Bolton, R. E., Hill, J. N., Lived Experience. Pharmacoeconomics, 40(10), 971–977.
Mueller, N., LaVela, S. L., & Bokhour, B. G. (2018). https://doi.org/10.1007/s40273-022-01175-1
Patient‐centred care is a way of doing things: How healthcare
employees conceptualize patient‐centred care. Health 19. Søndergaard, H. (2024). Patient Involvement in the Design of
Expectations : An International Journal of Public Participation an Innovative Clinical Study to Compare the Palatability of
in Health Care and Health Policy, 21(1), 300–307. Anti-Hyperkalemia Medications. Patient Preference and
https://doi.org/10.1111/hex.12615 Adherence, 18, 1059–1064.
https://doi.org/10.2147/PPA.S445399
8. Big Health. (2020, May 12). Digital Therapeutic SleepioTM
Yields 28% Lower Healthcare Costs. Big Health. Retrieved 20. Hadjiat, Y. (2023). Healthcare inequity and digital health–A
December 9, 2024, from bridge for the divide, or further erosion of the chasm? PLOS
https://www.bighealth.com/news/health-economic-evaluation- Digital Health, 2(6), e0000268.
of-sleepio https://doi.org/10.1371/journal.pdig.0000268
9. Meskó, B., & deBronkart, D. (2022). Patient Design: The 21. Quinn, C. C., Clough, S. S., Minor, J. M., Lender, D., Okafor,
Importance of Including Patients in Designing Health Care. M. C., & Gruber-Baldini, A. (2008). WellDoc mobile diabetes
Journal of Medical Internet Research, 24(8), e39178. management randomized controlled trial: Change in clinical
https://doi.org/10.2196/39178 and behavioral outcomes and patient and physician
satisfaction. Diabetes Technology & Therapeutics, 10(3),
10. Cutler, R. L., Fernandez-Llimos, F., Frommer, M., Benrimoj, 160–168. https://doi.org/10.1089/dia.2008.0283
C., & Garcia-Cardenas, V. (2018). Economic impact of
medication non-adherence by disease groups: A systematic 22. Blasiak, A., Sapanel, Y., Leitman, D., Ng, W. Y., De Nicola,
review. BMJ Open, 8(1), e016982. R., Lee, V. V., Todorov, A., & Ho, D. (2022). Omnichannel
https://doi.org/10.1136/bmjopen-2017-016982 Communication to Boost Patient Engagement and Behavioral
Change With Digital Health Interventions. Journal of Medical
11. Levitan, B., Getz, K., Eisenstein, E. L., Goldberg, M., Harker, Internet Research, 24(11), e41463.
M., Hesterlee, S., Patrick-Lake, B., Roberts, J. N., & DiMasi, https://doi.org/10.2196/41463
J. (2018). Assessing the Financial Value of Patient
Engagement: A Quantitative Approach from CTTI’s Patient 23. Damman, O. C., Jani, A., de Jong, B. A., Becker, A., Metz, M.
Groups and Clinical Trials Project. Therapeutic Innovation & J., de Bruijne, M. C., Timmermans, D. R., Cornel, M. C.,
Regulatory Science, 52(2), 220–229. Ubbink, D. T., van der Steen, M., Gray, M., & van El, C.
https://doi.org/10.1177/2168479017716715 (2020). The use of PROMs and shared decision-making in
medical encounters with patients: An opportunity to deliver
12. Astute Analytica. Digital Therapeutics Market Size & Share. value-based health care to patients. Journal of Evaluation in
(2024). https://www.astuteanalytica.com/industry- Clinical Practice, 26(2), 524–540.
report/digital-therapeutics-market https://doi.org/10.1111/jep.13321

PwC | Patient over product 21

Contacts
Dr. Zubin J Daruwalla Prof. Dean Ho
Asia Pacific Health Industries Leader Director
PwC Singapore The Institute for Digital Medicine (WisDM)
NUS Yong Loo Lin School of Medicine

Dr. Devanathan Raghunathan Mr. Yoann Sapanel

HealthTech and MedTech SME Head, Health Innovation
PwC Singapore The Institute for Digital Medicine (WisDM)
NUS Yong Loo Lin School of Medicine

Ms. Rhea Joshi Ms. Avelle Wong Shi Ying

Senior Associate Research Fellow
PwC United States The Institute for Digital Medicine (WisDM)
NUS Yong Loo Lin School of Medicine

PwC | Patient over product 22

 Acknowledgements
We extend our heartfelt gratitude to all survey participants and contributors, whose invaluable
insights and expertise gathered through surveys and interviews have been instrumental in the
development of this report. We would especially like to thank Mr David Xi from the N.1 Institute for
Health for his valuable research contributions, along with the following individuals and/or
organisations whose inputs significantly helped shape its content.

Mr. Amer Fakhouri, MPH

Director
Patient Navigation and Business Services, UCLA Health,
United States of America

Ms. Heather Renton

Founder - Syndromes Without A Name
(SWAN) Australia, and Consumer Health and
Disability Engagement Consultant, Australia

Dr. Chew Han Shi Jocelyn

Assistant Professor
Alice Lee Centre for Nursing Studies; Behavioural
and Implementation Sciences Interventions (BISI),
National University of Singapore, Singapore

Ms. Ngan KN MacDonald

Chief of Data Operations
Institute for Artificial Intelligence in Medicine,
Northwestern University, United States of America

Dr. Purav Gandhi

Strategic Advisor
C4IR Telangana, Life Sciences Government of
Telangana

Dr. Yacine Hadjiat

Director
Innovation in Health Science & Digital
Health, Dubai Health, United Arab
Emirates

PwC | Patient over product 23

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Please see www.pwc.com/structure for further details. This content is for general information purposes only, and
should
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| Patient be used
product as a substitute for consultation with professional advisors. 24