The medical industry is put to the test in all its dimensions: screening, prevention, the efficiency of the health system, the research and manufacture of treatments, its financing, …
Over the past 20 years, the health professions have changed little
Compared to other industries such as Retail or Banking, to name but a few, the digital transformation of the pharmaceutical industry and the healthcare sector in general is still emerging.
The WHO World Health Assembly has been held since yesterday in the midst of the Covid-19 turmoil. What used to be an inconspicuous meeting of experts has suddenly become the high-voltage theatre of a geopolitical battle between countries.
How does this heavy industry, which is highly regulated and complex to transform, absorb this shock? How is it seizing opportunities for acceleration to benefit, on the one hand, its own business but also to benefit human health?
An update on dormant trends in this industry:
- HealthTech, AI, Digital Transformation
- Emergence of new business models
- Reducing medical gaps in developing countries
What does Covid-19 really change in patient management?
The Covid-19 crisis has boosted dormant opportunities that were struggling to materialize
Before Covid there was still a great reluctance to develop telemedicine. And yet in the space of two weeks, the rate of adoption of teleconsultation by general practitioners rose from 20% to 70% on Doctolib.
In the field of patient care, in oncology for example, Health Tech has mobilized to provide solutions to ensure the continuity of treatment for patients outside hospitals.
Pharmaceutical companies are focusing their efforts on research and development of a treatment as quickly as possible, as well as the production and supply of emergency drugs for intensive care units. On this last point, the use of data and the analysis of weak signals on social networks have enabled some, such as MSD, to anticipate curare needs even before countries’ requests and to accelerate production accordingly.
The crisis has also highlighted the importance of the network of pharmacists and has given them, at least during this period, an increasingly important role, particularly by allowing them to extend the renewal of chronic treatments (by order of 15 March 2020 until the end of May).
Artificial intelligence is expected to be at the turning point, especially in research
The technology is ready and opens up an immense field of possibilities.
Can we predict which patients will go to the ICU? Can we sort them in advance? Can we predict which patients will be considered symptomatic? What are the associations of signs that are symptomatic?
Artificial intelligence is a powerful predictive tool that increases the diagnostic and analytical capabilities of the researcher or physician.
In particular, it makes it possible to identify sub-groups of patients that cannot be seen in clinical trials, however well-structured they may be. To characterize them, combinations of biomarkers are needed that are sometimes radiological and inaccessible via conventional computer systems.
Thanks to a better stratification of patients, a better quantification of lesions on scanners, a better combination of biomarkers and artificial intelligence, the effectiveness of clinical trials can be improved.
The discovery and understanding of these new subgroups of patients and new mechanisms of response to a treatment can accelerate not only development but also therapeutic research, through predictions made on patient data.
Another under-exploited area of application is the analysis of post-marketing data to understand how different populations respond to treatment.
The pharmacist network also provides signals on patient behaviour, on dangerous co-prescription data to predict the risk of ambulatory mortality for example.
Publish or Perish! I’ll share my data later
The big issue of Artificial Intelligence in health care is access to data. For artificial intelligence to be able to keep all its promises, especially in research, you need the right data training sets.
The Covid-19 crisis has created big research silos all over the place because everyone wants to make a discovery. The number of scientific publications has exploded since the beginning of the pandemic (5 per day).
How to make the data available? How to manage confidentiality? How to aggregate them? So many questions that push the actors of HealthTech to innovate in order to get around the brakes:
Owkin, for example, has created a European open source data sharing consortium COAI, and developed a federated learning solution that allows access to data sets without extracting them from medical institutions and thus preserving their confidentiality (Data does not move, only algorithms travel).
Doctors and patients discover new practices and behaviours change very quickly
There are things that are thought to be unthinkable in one country and yet exist in others.
In Italy or the United States it is possible to get tested or vaccinated at your pharmacist. In Brazil it is possible to have medication delivered to your home.
Doctors and patients in emergency situations have realized that there are new practices that have proven to be effective.
It is not necessary to travel to see your doctor every 3 months, or to simply return for a prescription renewal. This can be done over the phone without having to pay for a consultation again, which the social security will have to reimburse again.
The patient quickly gets a taste for these new uses and it will be very difficult for him or her to give up an innovative experience that has worked.
These innovations raise the question of disintermediation and the issues of reduction, cost transfer and redistribution of value from the historical players to new entrants:
- Do you need a pharmacist to dispense drugs safely? Not necessarily.
- Do you need an expensive laboratory to diagnose? Not necessarily.
It is therefore becoming urgent for health actors to identify strategic impasses and come up with ideas to disaggregate the traditional value chain.
- Digitalisation of product/service design within a value chain: how to eliminate costs perceived as superfluous? “I am willing to pay my doctor as long as I am healthy. I stop when I get sick because he hasn’t done his job”.
- Dematerialization: how to acquire and value data more efficiently?
- Disintermediation: once the product/service has been designed, which non-value-added intermediaries should be eliminated?
Is the crisis leading to the emergence of new, more resilient business models?
The health industry is highly regulated and carries the weight of a powerful history, its lobbies, its resistance to change, the protections of oppositions inherited from the past and which are as many brakes on the large-scale adoption of a certain number of innovations in access to care.
Today, 2 billion human beings do not have access to health care. The world spends 10% of its wealth on health, including 5% in Africa (Source World Bank). There are 2 doctors per 10,000 inhabitants in Sub-Saharan Africa, whereas there are 32 doctors per inhabitant in Europe.
By 2030, 100% of humanity must have access to healthcare
The sooner this goal of providing access to basic health care for all is achieved, the better off humanity will be in both rich and poor countries.
In the image of the global mobilization for the preservation of biodiversity, will this crisis be able to sustain new forms of solidarity and collaboration for the preservation of human health and access to health care for all?
Will health systems, health policies and investments by health actors align and prioritize the achievement of this sustainable objective, just as all industries align with climate-related objectives?
The economy of life is not just a cost but often an investment
Today the Pasteur Institute in Dakar is able to produce respirators for $60 and a Covid test for $1. And yet few investors are rushing to invest in the scale up of this innovation in order to flood the world market.
The choice has not been made to invest in these countries as a factor of economic development and a factor of human development.
The crisis reinforces the importance of creating local ecosystems but also international collaboration to avoid falling into a discourse of withdrawal.
There is a need to create frameworks that apply and allow local initiatives to emerge.
On the other hand, we must not wait for states to move internationally to move forward, otherwise in 20 years time we will still be there.
Companies in the sector have a fundamental role to play, as they are the ones making this transition
This requires a rethinking of the notion of corporate responsibility, which is becoming broader than the mere pursuit of profit.
They also have a responsibility to raise the legal limits that weigh on them to the State.
It is preferable to create coalitions of companies, by rallying to a cause 25% of the actors who weigh the most to reach a tipping point and therefore a more effective negotiating lever towards the remaining 70% and the states.
Without falling into Lifewashing, it is a question of setting up a kind of extended Responsibility Pact with the aim of :
- save money
- respond to social and sustainable development challenges
Thus, collectively the private sector, the pharmaceutical industry, Health Tech, the major international donors, and local governments are making the choice to invest to ensure that the health system in these countries evolves rapidly to the benefit of greater resilience for all in the event of a new crisis.