By Karen Taylor, Director, Centre for Health Solutions
Last week we provided an update on the three health care predictions from our November 2017 report - The future awakens: Life Sciences and health care predictions 2022. As promised, this week’s blog reviews developments during 2018 on the three predictions that are more life sciences focused and what we might expect to see in 2019.
Prediction - The life sciences industry is industrialised: advanced cognitive technologies have improved the productivity, speed and compliance of core processes
Until recently, in comparison with other industries, pharma have been slow to integrate digital technologies into their routine systems and processes. However, in 2018 many large companies set up innovation groups and allocated budgets to various pilot initiatives. For example, companies were increasingly leveraging real-world evidence for better trial design, began collecting novel endpoints via sensors and using natural language processing to automate the writing of clinical study reports. However, most of the solutions have been piecemeal, bringing incremental improvements to existing processes. One example of a more transformative approach that is starting to change the way clinical trials are conducted is the use of telemedicine and sensors to conduct trials virtually, enabling patients to participate with minimal disruption to their daily lives.1 In 2019, AI is likely to help pharma re-purpose existing drugs, find new targets and optimise enterprise efficiency. It is also likely to improve the efficiency and security of systems and processes along the life sciences value chain, from the supply chain to marketing and launch to regulatory compliance.
For the medical technology industry, some medical devices are now ‘made to order’ based on specific patient geometry, using technologies such as additive manufacturing (3D printing). There has also been a significant increase in the number of connected medical devices that are able to generate, collect, analyse and transmit data. These data, along with the devices themselves, are creating the Internet of Medical Things (IoMT) – a connected infrastructure of medical devices, software applications and health systems and services – helping improve efficiency of healthcare delivery. In 2017, MarketsandMarkets valued the IoMT market at $41.2 billion and expects it to rise to $158.1 billion in 2022.2 Moreover, voice technology is being adopted faster than any previous technology. During 2019, big data, AI, mobile applications, 3D printing, advanced sensors and other technologies will continue to create new business opportunities for medtech companies.
Prediction - Data is the new health care currency: artificial intelligence and real-world evidence are unlocking value in health data
In 2018, health care data was recognised as a national infrastructure priority. Biopharma companies accelerated the use of real-world evidence (RWE), not only to demonstrate the value of products but increasingly to address regulatory requirements, drive drug development, support outcomes-based contracts, and reduce products’ time to market. Deloitte’s 2018 benchmarking survey of leading biopharma companies found that the volume and variety of RWE being generated has continued to expand. Furthermore, the technology platforms and analysis tools available to manage and derive insights have continued to evolve, with the application of real-world data (RWD) across the enterprise increasing. In 2019, regulatory bodies are expected to provide guidelines around the use of RWE. While patients are increasingly recognising the value in their own data, as yet the companies buying patient data generally have far more insight into its value than the patients selling it. This is likely to change in 2019 as appropriate checks and balances are put in place to enable both sides to get equivalent value.
AI is now beginning to transform many systems and processes across healthcare. Key examples are in access and diagnostics, including increasing access to diagnostics in places where radiologists are inaccessible (most developed countries are facing a shortage of radiologists, and many developing countries have limited or no access to radiologists).4 Today, AI has the potential to enable anyone with a smartphone to have access to healthcare, transforming care for people in the developing world and those working in remote environments. AI is also increasing levels of accuracy in detecting and diagnosing disease. Various studies show that automated assessments, done by computer algorithm, are more reproducible and less subjective and could therefore reduce variation and alleviate subjectivity and inconsistency in disease diagnosis. AI algorithms can also read images in less time (minutes vs. hours), usually with higher accuracy (up to 99 per cent in some cases).5 During 2019 most medical imaging machines will be connected to the cloud with AI algorithms analysing data and helping doctors screen, assess, and diagnose patients.
Prediction - The future of medicine is here and now: exponential advances in life-extending and precision therapies are improving outcomes
In 2018, insights from human genomics programmes and the development of more precise and personalised medicine heralded a momentous year for science and medicine, with the approval of a number of genome-editing (CRISPR) treatments and the expectation that a newly synthesized form of the antibiotic teixobactin could be at the frontier of battling drug-resistant bacterial strains.6 2019 is shaping up to be just as notable, with advances in gene editing and phage therapy coalescing, and progress in the quest for improved influenza vaccines.
During 2018, advances in in-vitro 3D culture technologies, such as organoids, have opened new avenues for the development of novel, human cancer models. Organoids, grown from embryonic and adult stem cells, display essential aspects of the organs they are derived from. Genetic modification of organoids allows disease modelling in a setting that approaches the physiological environment, potentially enabling patient-specific drug testing and the development of individualised treatment regimens.7 In 2019, tumor organoids are likely to be used in clinical settings as avatars for identification of effective, personalised therapies, as well as tools to facilitate patient selection for specific trials.8
During 2018, advancements in the field of diabetes included the FDA’s approval of the extension of the hybrid closed-looped system for glucose measurement and insulin delivery (‘artificial pancreas’) to include children with type 1 diabetes. Indeed, the artificial pancreas gained significant momentum, with its market value anticipated to reach $390.4 million by 2024.9 In 2019, we expect to see the approval of the world’s first glucose measuring smart watch, able to continue to measure glucose levels in real-time, providing results when needed and eventually triggering alarms to warn users of abnormal levels.10 In the race to find a cure, hopes are being pinned on cell therapy, especially for type 1 diabetes, while other areas include immunotherapy and microbiome-based treatments.11
Advances in our understanding of science are continuing at an exponential pace, driven by insights from genomics. Scientific data and research are proliferating, augmented by AI and machine learning. New therapies are transforming health care and dramatically improving patient outcomes in specific areas. As a result, some of our predictions are coming true earlier than anticipated, although but others are still some way off. Nevertheless, we continue to believe that 2022 will be a world where new innovation, collaboration and automation have improved the cost effectiveness of service delivery and people’s health and wellbeing. As was the case with our three healthcare predictions, which was the subject of last week blog,12 each of our predictions shares three key enablers that are critical to the realisation of the prediction and will impact the pace of change:
- wide scale adoption of new digital and cognitive health technologies
- recruitment and retention of new skills and talent
- a new approach to regulation.
As 2019 gets under way, the future of health is more challenging and the possibilities more exciting than ever before. In 2019, as health care costs continue to increase, pharma pricing will become a major issue, especially given the expected improvements in price transparency. Two specific questions that will need to be addressed in 2019 are to what extent will:
- collaboration and cooperation between pharma, biotech, regulators and health technology assessments lead to new, more affordable innovations
- industry, payers and providers start to gain more control over costs through wider scale adoption of new ways of working?