PHARMA FUTURE: Is Pharma Geared Up for the Future?

There was a man named Vasculo D’mage who lived life like there was no tomorrow. So much the better, since Vasculo did not have too many tomorrows.  His king-sized lifestyle caused Vasculo to develop high blood pressure. After bouts of dizziness and headaches, Vasculo was hauled off by his wife, to a doctor who pronounced him a hypertensive and prescribed medicines that Vasculo had to take for the rest of his life. The thought scared and depressed him and like any scared man Vasculo made his way straight to the bar to contemplate. And he contemplated long and hard – with whisky and red meat. All this led to nothing much apart from accommodating copious quantities of cholesterol into his blood. The fat-thickened blood raced through his arteries (vasculature) and  over many years, eroded them causing – you guessed it – vascular damage! Slowly but surely, Vasculo D’Mage ate up his tomorrows and finally succumbed to a massive heart attack one morning leaving behind a grieving and helpless wife.

This is how things would end up for most people who suffer from chronic diseases like heart disease, diabetes etc. One of the reasons is that these diseases are asymptomatic – or simply – without symptoms. People who suffer from these diseases do so silently – not because they are resilient, but because they feel nothing unusual. This makes them pay less attention to their doctors’ advice, ignore taking medicines on time or in the recommended doses and not heed advice on lifestyle modification. This, in turn, leads to aggravated illness and often premature death.

A fact that the pharmaceutical industry – and others who profit from all things healthcare – take solace in, is that as long as people fall ill, everyone makes money! Sad but true. Yet.

Yet, what if? What if the sun rises on a day when technology overpowers such things that are taken-for-granted and makes them obsolete? And such a day shall come. The ‘Pharma Future’.

Today, a challenge for  pharmaceutical companies is to ensure that patients suffering from chronic disease listen to their doctors’ advice on taking medicine and other precautions. This would, along with improving the health of patients, also increase the duration of patients on the medicines manufactured by these companies. While it seems unethical, it isn’t if its done with the patients’ best interests in mind. Non-compliance leading to worsening illness or even premature death is clinically proven. While doctors know this, they are often helpless given the sheer number of patients they manage in the limited time they have.

Often, pharmaceutical companies step into this sphere to assist doctors to manage their patients better. As long as product promotion programs are not disguised as compliance programs – this is a good thing, since most people need constant reminders about taking medication and following medical advice. Now this is what we already know. The ‘taken-for-granted’ part here is that as long as people fall ill, all things healthcare make money. The doctors, the hospitals and the pharmaceutical companies.

What if this wasn’t to be in the future. Who knows what technology is already evolving? Technology (nascent or otherwise) that has the potential to disrupt health and healthcare delivery!

What if Vasculo D’Mage lived in the future? Vasculo’s doctor would then diagnose him as suffering from high blood pressure. On a hunch he would run Vasculo’s DNA through a routine genome test mapped with the biometrics captured in his unique identity number and find out that he has a high familial (genetic) risk of developing coronary artery disease and diabetes. A software program in the doctor’s computer would rapidly calculate the time it would take for Vasculo’s blood vessels to be damaged, accumulate lumps of cholesterol, cause this lump to obstruct blood flow to his heart or brain and lead to a heart attack or stroke.

In short, technology would accurately predict the hour of Vasculo’s death! The doctor would also determine the chances of Vasculo listening to his health improvement advice through a simple, user-friendly probability model. The computer would calculate that the chances of adhering to medical advice for Vasculo’s personality types is very less. This would provide invaluable information to the doctor to decide the exact course of treatment that he would adopt for Vasculo. Since the doctor would personalize his advice to suit Vasculo – and not simply dole out routine advice and prescription – Vasculo (and his wife) would listen with rapt attention and even ask a few questions. All of this in under 30 minutes!

Next, the doctor would give Vasculo just one pill to swallow. This one pill, which is actually an implant created through nano-engineering, would possess the capability to deliver medication for chronic diseases (high blood pressure and diabetes that Vasculo suffers/will suffer in the future) at the required doses. This implant would last Vasculo till the end of his life injecting medicine straight into receptor sites providing superior efficacy and eliminating chances of side-effects and drug-drug interactions. This targeted delivery would also optimize the quantity of medicine while maximizing therapeutic efficacy. This would mean that Vasculo would need very little medicine in each dose to keep him healthy therefore allowing him to use the drug implant longer. Nano-engineering would also develop methods of regenerating the drug inside his body for use therefore not requiring him to refill the implant in his entire life. Micro-sensors in the ‘drug-bot’ would analyze Vasculo’s biologics and send back reports on his health status to his doctor at stipulated frequency. This would allow Vasculo to carry on with his life even while he remains under constant medication and medical supervision!

If all this sounds like science fiction to you, then imagine the chaos it can instill into the existing business models of healthcare providers. A patient will have to buy a medicine only once! He will not be required to come to hospitals more than once in his whole life! How would hospitals, doctors and pharmaceutical companies continue to make money?!

Is the healthcare delivery model geared up for this future? How can pharma play a role to shape the future of healthcare delivery?

A few decades ago most medicines had to be consumed twice or thrice a day to create therapeutic efficacy inside the patient’s body. The creation of extended release (XL) or modified release (MR) systems made it possible for the same medicine to be consumed only once a day and yet produce the required therapeutic effect. Open source drug delivery (OSDD) research will soon create Life Time Release Systems (LTRS) thus allowing once-in-a-lifetime implants as embedded in Vasculo’s body. This would signal the death of conventional drug therapies over the next 25-40 years as costs fall for LTRS making the technology affordable to a majority of health consumers.

This change in modality of healthcare delivery and the nature in which health and healthcare is consumed in the future will also undoubtedly require doctors and hospitals to develop different capabilities focusing on building better services and service models since patients will not have to visit hospitals as regularly as used to. Therefore, while consumption of products will reduce, opportunities will abound in the services sector. Healthcare will have to develop a consumer service model like the white consumer goods industry beginning with the equivalent of annual maintenance contracts (AMCs) to home delivery of healthcare services such as diagnostics, reports, consultations and medicines.

The pharmaceutical industry currently positions itself as an important stakeholder in the healthcare value chain. Being a common thread that runs through the chain, the importance of the industry is set to increase multifold. The life and health of people such as Vasculo D’Mage is set to change for the better with the developments that the future holds. These developments will create scores of opportunities for all stakeholders, especially the pharmaceutical industry. How large a role the industry wants to carve out for itself depends on how well it reads the future of healthcare. The question to ask is how well is the industry geared up for the future? The pharma future.

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