Unlocking the £100 Billion Opportunity: How Continuous Respiratory Monitoring is Transforming Pharma Economics
Co-authoured by Dr Steve Arlington, previously PWC, IBM and President of Pistoia Alliance
April 29th, 2025
Executive Summary
The respiratory therapeutics market represents one of healthcare's largest commercial opportunities, projected to reach £44.1 billion by 2027 across COPD, asthma, and ILD segments. Despite this substantial market size, respiratory care remains constrained by outdated monitoring approaches that fail to capture the dynamic nature of these diseases. Traditional spirometry—typically performed just once annually per GOLD recommendations—provides only periodic snapshots rather than the continuous insights needed for optimal management and commercial success.
This episodic approach creates significant blind spots for pharmaceutical companies: 60-86% of COPD cases remain undiagnosed globally (representing 150-220 million people and over £100 billion in untapped potential); only 22-35% of eligible COPD patients receive appropriate triple inhalation therapy; and medication adherence across respiratory conditions averages merely 30-40%. These gaps translate directly to missed revenue opportunities and suboptimal returns on therapeutic investments.
Forward-thinking pharmaceutical executives now have an opportunity to transform this landscape through lungDx technology—a smartphone-based continuous respiratory monitoring system with clinical-grade accuracy. This breakthrough solution enables real-time disease monitoring & progression, treatment response tracking, and evidence-based therapy adjustments that directly impact commercial performance across the respiratory portfolio.
Accelerating Commercial Performance Through Digital Intelligence
For pharmaceutical leaders focused on driving revenue growth and market dominance, lungDx offers three primary value drivers with substantial impact on commercial metrics:
1. Accelerated Revenue Growth
The lungDx platform directly addresses key revenue constraints in the respiratory market by:
Expanding diagnostics through accessible at-home screening, potentially increasing the addressable market by approximately 10% through earlier identification of undiagnosed or undertreated patients
Driving therapy optimisation by providing objective evidence supporting appropriate treatment intensification, potentially increasing triple therapy adoption and biologic utilisation by 5% within existing diagnosed populations
Improving persistence through regular engagement and early intervention, potentially enhancing one-year adherence rates by approximately 5%
While we do not yet have compliance numbers specific to this therapeutic class, improvements of this magnitude have been commonly achieved in successful monitoring and engagement programs across other chronic conditions. For products like Trelegy (currently achieving £2.7B in annual sales), these improvements could generate approximately £135M in incremental annual revenue—far exceeding implementation costs and creating compelling ROI.
2. Reduced Time-to-Market for New Therapies
The platform significantly accelerates clinical development timelines by:
Decreasing trial durations by 15-25% through continuous endpoint measurement and reduced site burden
Reducing required sample sizes by 20-30% through enhanced statistical power from longitudinal monitoring
Accelerating regulatory submissions with richer datasets demonstrating real-world effectiveness
Enabling novel digital biomarker development for future pipeline differentiation
These efficiencies translate directly to faster market entry, extended effective patent life, and accelerated revenue generation for both existing and pipeline products.
3. Sustainable Competitive Advantage
By creating an integrated therapeutic and monitoring ecosystem, pharmaceutical companies can establish structural barriers to competition through:
Ecosystem integration combining medication and near real-time monitoring in a holistic solution
Data advantage from longitudinal patient insights unavailable to competitors
Clinical differentiation supported by proprietary real-world evidence
Positioning transformation from product supplier to comprehensive disease management partner
This approach mirrors the successful paradigm established in diabetes management, where the integration of insulin delivery systems and continuous glucose monitors has transformed care delivery and created powerful ecosystem advantages for participating companies.
Overcoming Barriers to Adoption
While the opportunity is compelling, we recognise that several significant barriers to adoption must be overcome for successful implementation:
Internal Pharmaceutical Barriers
Large pharmaceutical organisations often face structural challenges in implementing digital health solutions:
Organisational silos between traditional pharmaceutical operations and digital initiatives
Complex decision-making processes involving multiple stakeholders across commercial, medical, regulatory, and legal functions
Risk-averse culture prioritising established approaches over innovative solutions
Investment prioritisation that may favor traditional promotional activities over digital ecosystem development
Our implementation approach addresses these challenges through structured partnership models with dedicated cross-functional teams, milestone-based deployment, and shared risk/reward arrangements aligned with existing commercial incentives.
Healthcare System Barriers
The conservative nature of medical practice presents additional adoption challenges:
Physician scepticism toward new technologies and monitoring approaches
Workflow integration concerns regarding data management and clinical decision support
Reimbursement uncertainty for digital monitoring components
Evidence requirements from both providers and payers
Our solution overcomes these barriers through extensive clinical validation (studies with over 600 patients demonstrating 95% correlation with gold-standard spirometry), seamless workflow integration, and a growing evidence base supporting improved outcomes and healthcare economics.
Embracing Evidence-Based Medicine as a Strategic Imperative
Despite implementation challenges, evidence-based medicine has become a necessary reality that all stakeholders must embrace. Payers, providers, and regulators increasingly demand robust evidence of clinical and economic value—not merely marketing claims. While this evidence burden may appear challenging, forward-thinking companies recognise it as an opportunity to create sustainable differentiation & resulting value through superior data insights.
The lungDx platform transforms this regulatory requirement into a strategic advantage by generating continuous, objective evidence that validates therapeutic value in ways that episodic monitoring cannot. Companies that embrace this evidence-generation capability will secure preferential formulary positioning, optimise pricing potential, and establish defensible market leadership.
Conclusion: The Time for Digital Transformation is Now
The respiratory care landscape is at an inflection point, with increasing pressure on pharmaceutical companies to accelerate clinical R&D and secure sales growth for both established and newly launched products. Traditional approaches to respiratory monitoring no longer suffice in an increasingly competitive and value-driven healthcare environment.
lungDx technology provides a unique opportunity for forward-thinking pharmaceutical executives to overcome these limitations and establish dominant market positions through digital intelligence. By expanding diagnosed populations, optimising therapy utilisation, enhancing medication persistence, and generating compelling real-world evidence, this platform directly addresses the core commercial challenges facing respiratory portfolios today.
The companies that act decisively to integrate continuous monitoring capabilities will define the next generation of respiratory care—creating sustainable competitive advantages and unlocking billions in previously unrealised commercial potential.
About the Authors:
Dr. Bipin Patel is the founder and CEO of electronRx, a respiratory health technology company developing clinical-grade continuous monitoring solutions for respiratory diseases. Dr Steve Arlington previously PWC, IBM and President of Pistoia Alliance.
