What Do Startups Bring to the Table Over Bigger Companies?
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What Do Startups Bring to the Table Over Bigger Companies?

Photo by:   Maria Salido
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By María Jesús Salido Rojo - SocialDiabetes


The health sector is highly regulated, conservative and accustomed to slow time-to-market periods, for obvious reasons. But the last few years have been a challenge for all players in the ecosystem: the pressure the system is under to cope with the three revolutions we face — demographic, technological and epidemiological — means that we need to take advantage of any dynamic that generates agile, safe and sustainable innovation to deliver new formulas to the market.

To remain competitive and respond to market expectations, organizations in the healthcare industry must move from a commercial strategy of commodity and product price pressure toward a data-driven service-oriented approach. The industry is fully aware that digital health is not only changing the way drugs are discovered and clinical trials are run, but it is also changing the relationship between health providers and patients or healthcare personnel (HCPs). Those patients (citizens, actually, in general and in any sector) are becoming more active in their healthcare decisions and are demanding digitally integrated solutions. 

It is not easy to combine a hyper-regulated and, by nature, slow market with the speed at which innovations must develop, the necessary digital transformation of all processes, the financial pressure from payers and the demands of users. And no one can do it alone.

We have seen more than ever in this past year how both digital health startups and big corporations are working together to create added value beyond the product and provide the industry with significant innovation leverage. These are strategic alliances that combine robustness and agility, rigor and speed, security and innovation, long-time experience with foresight into consumption and behavioral dynamics. Some examples are:

  • Integrate digital health into strategic therapeutic areas

  • Broadly integrated digital health across the research organization 

  • Digitalization of patient HCP journey

  • Decision-making support tools (for both patients and HCP)

  • Consumer loyalty/evidence of adherence/outcomes (PSP)

  • Commercial omnichannel strategies

  • Time to market speed by co-developing optimal solutions for targeted patient populations or focus area

  • Strategic business use of digital data:

    • Market insights based on real-world data

    • Patient and HCP behaviors

    • Dynamic HCP segmentations (salesforce)

    • Population risk management plans

    • Negotiation with payers (EPS, IPS, OS, HMOs, PHI, Public)

But these alliances are not easy for either party. Differences in size, speed, processes and culture make it challenging for large companies and startups to partner.

At SocialDiabetes, 2022 was the busiest year in terms of partnerships with major industry players on strategic projects, ranging from the digitization of patient programs to the provision of connectivity and interoperability services.


Some of the lessons learned for the future include:

  1. Save the gap in culture and work style between pharma/corporates and startups: Big companies are complex organizations that operate via endless and baroque internal processes. Startups are the exact opposite. They are small and nimble and can focus on developing innovative solutions without inter-departmental politics or complex infrastructure. A good practice is for startups to incorporate into their teams profiles with experience in consultancy and management at large companies.On the other hand, we have seen how it has helped corporates to create project-based liquid teams on the fringes or transversal to the formal structure.

  2. Real partnership role mode:  If you treat startups just like a supplier you will receive cost-control-based delivery. Excellence requires commitment with common goals. Startups need to understand what drives pharma/corporates (beyond the project delivery) and pharma must understand the startup dynamics and challenges. It requires sensitivity regarding the negotiation loops, agility on business decisions, operational requirements and invoicing periods.

  3. Complementary approaches to market access. Large companies have years of experience and data on which to segment and design market-entry strategies. But startups can offer a better end-user experience (they are closer to the ground). The explanation is simple: they start with a blank canvas, imagining the ideal experience for their target customers, and then build it.

They test, measure quickly and improve. By not having to deal with antiquated technology with high account values, functional silos and competing corporate agendas, they focus like a laser on the simple, impactful experience.

The combination of these two visions can be very powerful in designing-rewarding products and services.

  1. Talent management: I am often asked by clients, how do we transform our  culture; how do we incorporate in our employees a vision that is aligned with the digital world? My answer is always the same: immerse them in the experience. Let's learn by doing, and involve your employees in real projects. The mere contact with new ways of working will gradually permeate like invisible waves. 

There is an implicit training of the staff assigned to these projects that the company must recognize, enhance and take advantage of. 

  1. Leadership: The involvement of top management and the commitment from middle management are essential in promoting these alliances. Strategic vision, understanding the difficulties, actions to overcome them, and high doses of empathy on both sides must be embedded in  leadership along with  a strong awareness of the challenges and benefits involved.

We have not seen a successful project in our entire history without clearly identifying strong, visionary and courageous leadership to push these innovative initiatives.

In short, what a startup can bring to the healthcare industry is:

  • Applied innovation

  • Patient/professional orientation

  • Ability to generate synergies/ecosystems

  • Knowledge transfer to the client

  • Flexibility in the offer

  • Open systems/radical interoperability

  • Speed of execution

  • Adaptability to changing needs

  • Low overhead costs

It is difficult, but believe me, it is possible. We have experienced it, we have learned and we have even enjoyed it.

Photo by:   Maria Salido

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