Are we about to enter a new “golden age” of medical innovation?

Thursday, October 31, 2019

After decades of rapid progress, advances in medical technologies have slowed in recent years. But there are reasons to be hopeful, according to the Global Innovation Index 2019, with artificial intelligence, genomics, and mobile health applications all poised to transform global healthcare.


GENEVA, 31 October 2019 - In the context of the joint technical symposium by the World Health Organization (WHO), the World Intellectual Property Organization (WIPO) and the World Trade Organization (WTO), GII Co-Editor Sacha Wunsch-Vincent presented the results of the GII 2019 Theme Chapter on Creating Healthy Lives -- The Future of Medical Innovation, answering the question: “Are we about to enter a new “golden age” of medical innovation?”


Over the last century, improvements in healthcare have doubled life expectancy in developed and developing countries, resulting in an expanded workforce, greater economic growth and improved quality of life. Driving those improvements has been healthcare innovation, both in technologies, such as chemotherapy and joint replacements, and in processes, such as better hygiene and enhanced public health planning.


Much of that progress came between 1940 and 1980, a 'golden age' of medical innovation that has not been matched in recent decades. This is one of the topics explored in the Global Innovation Index 2019, the report from the World Intellectual Property Organization and its research partners Cornell University and INSEAD.


The theme of this year’s GII is Creating Healthy Lives – The Future of Medical Innovation, and the report outlines numerous challenges healthcare innovators face today, from lack of access to quality healthcare in parts of the developing world to rising costs of new technologies. Innovation can be slow and difficult, with a fragmented network of stakeholders, increasing development costs and complex approval processes to be navigated. It can take more than a decade to bring an Alzheimer's drug to market, for example.


The demand for medical innovation is high, but declines in major medical advances each year, drug approvals and research productivity raise concerns that the golden age has passed. Nevertheless, there are reasons for optimism.


Changing the landscape of health


The financial crisis of 2009 led to a five-year slump in pharmaceutical research and development (R&D). Worldwide R&D spending was around US$135 billion in 2013 but has been growing since then, reaching US$177 billion in 2019. Meanwhile, medical technology patents are among the five fastest-growing technology patent fields since 2016. There are now around 100,000 medical technology patents worldwide - similar to the number of pharmaceutical patents. Biotechnology patents are about half that number but that area, too, is rapidly growing in influence.


Source: The Global Innovation Index Report, 2019


Another positive is that the geography of innovation is expanding from Europe and the US to not only large emerging economies such as China and India, but also Mexico, Viet Nam, Indonesia, South Africa, Nigeria and many other regions. Levels of R&D expenditure are increasing outside Europe and the US, as are investment levels and the number of patents granted. Mexico and India, for example, are increasingly specialising in pharmaceutical patents.


Since 2015, the number of drugs in Phase I and Phase II clinical trials has grown substantially. Although Phase III totals are not yet matching those of 'golden age' levels, innovation is burgeoning in other increasingly health-related sectors such as medical technologies or IT and software applications. Process and organizational innovations in healthcare delivery are also taking place due to automation and efficiency. Lastly, there is increasing “adapted” use of existing technologies in developing countries with considerable impact in low-resource contexts.


Source: The Global Innovation Index Report, 2019


Forthcoming breakthroughs in medical and health innovation


A range of new scientific breakthroughs, treatments and cures promise the possibility of vaccines for cancer and HIV, pre-symptomatic diagnosis of Alzheimer's and swallowable nanotechnology devices. New implants and bionics are being made possible by 3D printing, regenerative medicine is shedding light on tissue engineering and personalised medicine is at last looking achievable.


However, significant breakthroughs are not limited to drugs and treatments - digital technology is having an impact, too. Artificial intelligence and big data can change how research is carried out and how healthcare is delivered. Quality data will make it easier for the healthcare sector to shift from the current 'react and revive' model to a 'predict and prevent' model, changing the focus from illness to wellness. These tools will also make it easier for policy makers to pursue a data-driven health policy.


Telemedicine, remote patient monitoring, portable diagnostics and the delivering of medicine via drones are all solutions that could expand the reach of healthcare in developing countries and will play a role in improving services in the rest of the world too. The most powerful disruption is likely to come from the convergence of digital and biological technologies.


Opportunities and policy imperatives


These new technologies will require investment. Without it, we risk increasing the divide between the healthcare haves and have-nots across the world. With no legacy technology to unravel and replace, developing countries have an opportunity to use medical innovations to close the healthcare gap. But innovation relies on stable, predictable funding, often for long periods of time.


Government money is still the primary source of R&D investment in healthcare because the benefits for society are so great. However, it must be prioritised so that development can be maintained. Funding discontinuities can lead to 'brain drain', as top talents go elsewhere, training gaps that affect the ability of healthcare professionals to deliver the latest treatment, and obsolete equipment.


For some countries it makes sense to specialise, and government investment helps to create expert clusters, such as the Thai Center of Excellence for Life Sciences or the Brazilian SENAI Innovation Institute. More can be done to promote international collaboration, so that these clusters can make the greatest contribution.


New funding models will be necessary, too. For example, the stage between prototype and final product is an area where more funding is needed. It's possible that public-private partnerships, prize competitions, crowd-funding or some combination of those could provide an answer.


Another area that will need to be addressed is staffing and skills shortages, which are an issue in developed and emerging markets. In particular, more medical professionals are needed with experience in research and training in advanced research technologies, such as 3D modeling. Workforce planning is needed to ensure the right mix of skills. It also needs to be easier for researchers and medical professionals to move more easily between research and business contexts so as to better spread knowledge.


Building medical innovation systems


Greater collaboration is necessary across the sector. Research has traditionally been led by pharmaceutical firms and academics in university hospitals but there is a greater role to be played by technology firms, insurers and even patients. Creating mechanisms that enable this cross collaboration is imperative but doing so will also create new risks.


Increased data sharing will be vital but this brings security and privacy risks. System and data security principles must be established for healthcare institutions. Regulators and other agencies may not be ready for the problems that this will cause, especially in developing countries.


New technology brings new risks and international cooperation will be needed to prevent countries from adopting the lowest common safety or ethical level. Technology is not always the answer. In Mali, for example, the availability and training of nurses to go door-to-door examining children for common diseases has had a widespread and sustainable beneficial effect on health. Evidence-based decision making is essential to ensure that money is not wasted on unnecessary technology.


Healthcare innovation has the power to disrupt business models, lower costs and improve efficiency. The policies and institutions created by national and global actors will determine how effectively that is accomplished. Maximising future health innovation potential requires collaboration across key actors, increased funding, a skilled health workforce and careful cost-benefit assessments.


For more information about the trilateral WHO/WIPO/WTO meeting, see this link.


The Global Innovation Index 2019: Creating Healthy Lives—The Future of Medical Innovation is the result of a collaboration between Cornell University, INSEAD, and the World Intellectual Property Organization (WIPO) as co-publishers, and their Knowledge Partners, Confederation of Indian Industry, Dassault Systemes, Sebrae, Brazilian Micro and Small Industry Support Services, and Brazilian Confederation of Industry.

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