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Thailand: Innovation and the pharmaceutical industry
In this series of articles we have been discussing various aspects of innovation in healthcare and how advances in technology have been transforming the field. We have focused mainly on computer and communications technology but in this final article we will look at the role and significance of innovation in the pharmaceutical industry.
Drugs play a pivotal role in our everyday lives and in the provision of healthcare across a very wide spectrum of conditions, everything from medicines to treat a common cold or a headache through to antibiotics, therapies for cardiovascular, cancer, central nervous system, respiratory disorders, and myriad other conditions.
We take drugs and their availability for granted. They provide cures for millions, avoid the need for visits to doctors and hospitals, and provide relief from pain and suffering. Some of the greatest innovations of the 20th century were advances in pharmacology, from anaesthesia to antibiotics and everything in between.
The pharmaceutical industry is international, knowledge-based, capital-intensive, highly regulated and offers high risk and high reward. Continuous innovation is one of its most defining characteristics. Investment in R&D probably exceeds that of any other industry.
New drug development is extremely difficult and risky, characterised by uncertainty of success, expense and long lead times. The odds of success are prohibitive: only one in more than 5,000 compounds investigated ultimately becomes an approved drug. Typically, about 30% of candidates fail because of associated toxicity, another 30% from lack of efficacy, and the rest due to a range of factors including rate of action, duration of effect, and problems with absorption, metabolism or excretion.
The industry is subject to constant public scrutiny and frequent critical and unflattering commentary, not all of it fair or balanced. Sometimes it is simply wrong and misinformed.
Perceptions of the industry can change quickly. Several years ago there was alarmist talk of “patent cliffs” and empty product “pipelines”, with dire predictions of the demise of the industry. How things have changed. Today the industry has a wealth of new drugs under development. We will discuss a few of these and some digital innovations.
Immunotherapy: Cancer immunotherapy (also called “immunoncology” or I-O) is one of the most significant breakthroughs in many years. The objective of I-O is to stimulate the body’s immune system to identify and attack tumour cells. This innovative therapeutic tool adds to the traditional means of treating cancer such as surgery, radiation and chemotherapy. A number of companies are racing to develop new I-O drugs for a wide range of cancers and finding existing I-O drugs that are efficacious for additional cancers.
Genome sequencing and precision medicine: Genome sequencing, which converts DNA into data, can be used to identify specific gene abnormalities (“biomarkers”) in individual patients. Identification of biomarkers can assist in understanding for which types of patient a drug will be most effective and to minimise any side effects.
These “targeted therapies” or “precision medicine” applications involve the use of genomic testing to tailor-make drugs suitable for the genetic makeup of an individual patient, heralding an era of “personalised medicine”. The relationship between an individual patient’s genes and a particular drug can assist doctors in identifying the right drug and dosage, leading to improved outcomes and fewer side effects.
Artificial intelligence: Computers with learning capabilities (such as IBM’s Watson) can assimilate, interpret and cross-reference vast amounts of data and thereby assist in the pursuit of new drugs and additional indications for existing drugs. Watson has demonstrated an ability to discover previously unknown or undetected connections between diseases and to make recommendations. Within minutes it can scan and assess millions of pages of text in journals, clinical trials and medical records.
Nanotechnology: This microscopic technology uses nanoparticles to travel inside the human body and bloodstream, assisting with things such as the delivery and absorption of drugs and the monitoring of patient adherence.
3D printing: 3D-printed drugs could change not only the way in which drugs are manufactured but also their administration. For example, in the future hospitals may be able to make slight adjustments to software before printing and adjust dosages for individual patients, a process of personalisation that might otherwise be too expensive. The US Food and Drug Administration has already approved a 3D-printed drug that is made by creating layers on top of one another until the correct dosage is achieved.
Conclusion: The above are only a few examples of how the pharmaceutical industry continues to innovate. The industry attracts more than its share of critics and pundits, including those who say it is not adapting to the “digital revolution” quickly enough or accepting the inevitability of “digital disruption”. In fact, we believe the industry is very conscious of the potential of digital technology.
However, the reality is that digital technology does not of itself produce new drugs. Digital technology is a valuable tool but only one of many. Successful drug innovation depends on many factors including state-of-the-art life science, cutting-edge advances in information optimisation, discipline, persistence, good management and not a little old-fashioned good luck, to name but a few.
We have sought to emphasise that neither we nor Thailand as a whole can hide from advances in technology. We all need to work together and welcome innovation and change. Adaptation and disruption can be positive experiences. Thailand’s healthcare system has to find the right balance between cost-effectiveness, quality, efficiency and accessibility. In the longer term an emphasis on cost containment alone is unlikely to provide an optimal solution.
Source: https://www.bangkokpost.com/business/news/1339255/innovation-and-the-pharmaceutical-industry