Pharma Digital Health Programs: A Behavioral Science Approach to Global Frameworks and Local Adaptation

This article is based on our recent webinar, Pharma Digital Health Programs: A Behavioral Science Approach to Global Frameworks and Local Adaptation, featuring Martin Peters, Head of Patient Experience & Solutions, Novartis, and Sean Gill, Director of Behavioral Science, S3 Connected Health.

The webinar opened with a crucial question that sits at the heart of many digital health initiatives: If global teams strive for consistency and local teams strive for relevance, how do you determine what should remain standardized and what genuinely needs to be adapted?

There is often an assumption that global programs inevitably require extensive local adaptation. In fact, many digital health programs contain a core foundation that can be applied consistently across markets. Approximately 70–80% of a program's underlying strategy, behavioral objectives, and value proposition often remain universal, while a smaller proportion requires local tailoring. The challenge lies in identifying which elements genuinely need adaptation and which can remain standardized.

It is important to distinguish between patient challenges and healthcare system challenges. Many patient behaviors and barriers are remarkably consistent across geographies. Concerns such as treatment uncertainty, fear of side effects, or difficulties establishing new routines often transcend national borders. In these situations, the same core solution may work effectively across multiple markets. By contrast, challenges related to healthcare access, reimbursement, or service delivery are often shaped by local systems and may require greater adaptation.

This was the central topic explored by the panel, who shared their experiences of balancing global frameworks with the realities of local market needs. Read on to discover four key takeaways from the discussion.

Adaptation without diagnosis leads to reinvention

Many localization efforts are driven by assumptions rather than evidence. Instead of diagnosing what is different between markets, teams often jump straight into adapting, rebuilding, or re-briefing programs. This can duplicate costs, slow launches, and fragment learning across markets.

The consequence is reinvention rather than localization.

Markets may redesign assets, redefine objectives, or measure success differently, even when they are attempting to solve the same underlying problem. When different markets or teams change the objective, the solution logic, or how success is measured, it's difficult for the organization to tell what's working, what should be reused, what can be built upon, and how to avoid reinventing the wheel time and time again.

The question should not be whether a market is different, but rather what specifically is different. Is the challenge rooted in patient behavior? Healthcare professional behavior? Or is it driven by environmental factors such as care pathways, reimbursement systems, regulation, or access?

"Often we frame it in the wrong way. We get lost in asking whether something is different, rather than how different it is, in what ways it is different, and whether we actually need to change the solution or the program at all. Or maybe it's just the way it's rolled out or the execution, or maybe it's some of the content or the framing, etc."

Sean Gill, Director of Behavioral Science, S3 Connected Health

When teams focus on these specific variables, conversations become less political and more evidence-based. Rather than negotiating over opinions, global and local stakeholders can work from a shared diagnosis of the problem and make more informed decisions about where adaptation is genuinely required.

Globalize the behavioral backbone, localize the environmental fit

The global backbone comprises elements that should remain consistent across markets. This includes the program’s objective, the behavioral friction it aims to address, the logic by which the solution drives change, and the way success is measured.

What often varies, however, is the environment in which that solution is delivered.

“One thing to keep in mind is patients are usually the same, systems differ”

Martin Peters, Head of Patient Experience & Solutions, Novartis

Healthcare systems differ in terms of care pathways, reimbursement models, regulations, social norms, stakeholder influence, and communication channels. These factors may affect how a program is implemented, who delivers it, how patients access it, or how healthcare professionals engage with it.

Instead of relying on opinion or hierarchy, discussions can focus on diagnosing whether a difference stems from behavior, environment, or both.

If both the behavioral challenge and the environment are similar across markets, a solution can often be deployed with little or no modification.

If the behavior remains the same but the environment differs, adaptation may be needed around channels, workflows, stakeholders, or implementation approaches while keeping the core solution intact.

If the behavioral challenge itself changes, a different intervention may be required. Only in the relatively rare cases where both the behavior and the environment are fundamentally different does a fully localized solution become necessary.

Most markets fall somewhere in the middle, requiring targeted adjustments rather than complete redesigns.

Success depends as much on implementation as design

Digital health programs can fail not because the solution is wrong, but because implementation is weak. Too much attention is often placed on designing the asset itself and not enough on ensuring it is adopted by field teams, healthcare professionals, and patients.

"We may have developed something that both global and local teams see value in, but it fails to get traction because you haven't fully operationalized how it fits in."

Martin Peters, Head of Patient Experience & Solutions, Novartis

Adoption rarely happens automatically. For many programs, healthcare professionals play a critical role in introducing solutions to patients, whether directly or through nurses and support staff. That means organizations must think beyond the asset itself and consider practical questions. These include when a sales representative should introduce the program, how much time should be allocated to discussing it, what messages should be communicated, and how it fits alongside other priorities competing for attention during a healthcare professional interaction.

Even the most carefully designed program can struggle if healthcare professionals are unaware of it, do not understand its value, or are not equipped to introduce it to patients. This means implementation planning should begin much earlier in the process. Field teams, sales leaders, and local stakeholders need to be involved alongside brand and strategy teams. Organizations must think not only about the solution itself, but also about the behaviors required to make that solution successful.

Diagnose behaviors, not markets

Rather than starting with markets, channels, content, or healthcare systems, begin with behavior itself. Identify the key moments where patients or healthcare professionals struggle to take a desired action. These can be described as "moments of friction".

A moment of friction occurs when a behavior breaks down. A patient may delay starting treatment because they feel uncertain about whether it will work. They may discontinue therapy because side effects create anxiety. A healthcare professional may fail to recommend a support program because it does not fit naturally into their workflow. By focusing on these behavioral barriers, organizations can begin to understand the real problem they are trying to solve.

Many of these underlying frictions are surprisingly consistent across markets. Patients around the world experience uncertainty, fear, information overload, declining motivation, and difficulty forming new habits. While the specific circumstances may differ, the fundamental behavioral challenge is often the same.

This is where behavioral science becomes particularly valuable. Instead of treating every market as completely unique, it helps organizations distinguish between the underlying friction and the local circumstances in which that friction occurs. For example, uncertainty may manifest differently in different countries. In one market, a patient may need reassurance from a specialist. In another, they may need clarity around reimbursement or insurance coverage. The surface-level challenge looks different, but the underlying behavioral barrier remains uncertain.

It is also important to separate the person from the environment when analyzing behavior. Human behavior is influenced by factors such as motivation, confidence, habits, and beliefs, as well as being shaped by environmental influences, including healthcare systems, regulations, social norms, family dynamics, and access to care. Understanding the interaction between these factors allows organizations to determine whether a challenge is truly behavioral, environmental, or a combination of both.

From this perspective, behavioral science becomes a practical decision-making tool rather than simply an academic discipline. It helps teams identify which behavioral drivers are universal and can therefore support global scale, while also highlighting where local environmental differences require adaptation.

“What I'd recommend going into your next meeting: ask, "What's universal here?" What's local? Where does evidence actually justify adapting and in what ways? And is the behavior different or is it only the environment or is it a bit of both?”

Sean Gill, Director of Behavioral Science, S3 Connected Health

To dive deeper into these insights and gain expert guidance, access the full webinar now. Hear from our panelists who provide a pragmatic framework for scaling digital health programs with greater confidence, consistency, and effectiveness across regions.