By Robert Hickson 23/10/2018


Following on from my last post, the UK has just released its Future of healthcare policy paper. It’s essentially a fluffy digital health information policy. No timelines and no systems-level thinking (apart from IT systems). Just add digital and other technological bits, encourage innovation, and it’s sorted is the short version.

I found it a dispiriting read. It could have been written by a large consulting company. Some of the short case studies provide useful indicators of emerging digital approaches. TechCrunch was also critical of aspects of the paper, and has comments from others involved in healthcare. They also pointed out that the current UK Health Minister was previously the digital Minister, and it shows.

New Zealand has its own vision for health technology. It name checks digital technologies du jour – AI assistants, 3D printing, an internet of medical things. Although drones and blockchain don’t get a mention. Whether it survives the latest restructuring with the Ministry of Health remains to be seen. It probably will, since digital strategies are still all the rage.

However, you don’t need a digital (health) strategy (or vision). You need a strategy where it is clear how technologies enable that strategy to be realized, rather than having lots of strategies and visions.

This is important here because a review of the health system is underway. The UK’s future of healthcare policy paper seems like rearranging some deckchairs and adding some fancier seating devices, rather than considering whether they need a different vessel upon which seating can be organised.

 

The future of the pharmaceutical sector

In addition to the community-focus initiatives I wrote about in my last post, what’s overlooked in many discussions about the future of healthcare is the US$1 trillion gorilla in the room – the future of the pharmaceutical sector. The ability to develop safe and reasonably priced medicines (and medical devices) is critical to any healthcare system, but the assumption is that they will be available.

Some now compare “Big Pharma” to the oil industry. Both in the sense that it is getting ever harder and more expensive to find a profitable prospect.  And also that they are in some ways toxic, spending as much or more on share buy-backs as on research and development, and stifling innovation through aggressive patent protection and a focus on creating “me too” medicines rather than meeting “what about me?” needs.

The price of medicines also often don’t have any relation to research and development costs, and there are no controls on what are reasonable prices.

There is a widespread view (at least outside of the industry) that the current model for pharmaceutical production seems unsustainable. Like democracy being the best of a bad set of choices, some don’t see what a better model could be.

However, a recent report from University College London proposes a more values-based approach. This includes “mission-oriented” challenges like DARPA uses for defence-related innovation, greater collaboration and transparency in drug development, and disconnecting the R&D costs from the drug price (as we are starting to see in initiatives like DNDi).

Change in healthcare can be slow. Nine years ago Pwc confidently predicted what healthcare would look like in 2020. There still a long way to go, and a shift in perception is required. We often seem to bring a microscope to an astronomy fight  – too focused on what’s close at hand and not taking a longer and broader view.

 

Featured image by Lucas Vasques on Unsplash