I suspect that by the end of this decade, we will
look back upon the next two to three years as the
most defining period of time for the future of the
pharma industry.
It won't happen overnight, but sooner than you
probably realize, we will witness a transformation that
will impact every stage of the pharma development
process.
One fundamental output of this transformation will
be something we call Comprehensive Treatment
PackagesSM:
individualized "bundles of
services" that take a patient-centric — rather
than drug-centric — approach to healthcare.
When this shift inevitably happens, the winning
companies will be those that have organized
themselves around this new and exciting
paradigm.
Two Big Changes
As discussed in our November 2006 bulletin ("Pfizer
Announcement… Big Changes for Big
Pharma"), the industry is moving from its
traditional mass market (one size fits all), "small
molecule" focus to a more targeted, "large molecule"
biologic approach.
As a result, more and more drugs will address
disease cause as well as symptom; the
development process will be more predictive, leading
to higher success rates; and the FDA approval
process will shift from its current focus on a single
snapshot in time, to one that monitors post-market
safety and efficacy over a period of years (as a given
drug is dispersed to millions of patients in the
commercial marketplace).
That's big change number one — a
transformation in the type of drugs that are developed
and the way that they are brought to market.
Big change number two relates to technological
connectivity.
Just as the conversion from paper to electronic
claims in the mid-nineties led to massive
improvements in the nation's healthcare payment
and reimbursement systems, treatment connectivity
— the seamless electronic interconnection
between patients, doctors, data centers, support
services, electronic medical records (EMR) and more
— will yield enormous communication and
cost saving benefits to the provision of
healthcare itself.
When that happens, when targeted, biologic
drugs work in concert with integrated, real time
information, the need to offer more personalized,
Comprehensive Treatment Packages will
increase.
What are Comprehensive Treatment
Packages?
As we shift to a "disease-driven" approach to drug
discovery — one which understands the
intricacies of disease at a molecular level —
we will target subsets of patients with a particular
ailment in a very personalized manner.
Five distinct pieces make up this shift, all of which,
taken together, will lead to a new way of caring for
patients:
- Diagnostics. If you have a particular
predisposition for which you can be tested (a genetic
inclination towards breast cancer, for example), you
will be given a specific treatment — a
treatment that someone else with the same disease
may not receive. A better understanding of
the
disease itself will allow you to take the drugs you
need to take, and not take the ones you
don't.
- Drugs. Once we know which drug and
dosage is best for you, given your particular disease,
biologic makeup and circumstance, the drug will be
prescribed. Note that today, this is where the
pharma industry devotes its resources, almost
exclusively. In this new order, however, the drug
itself is just one piece of a much greater whole.
- Devices. These will monitor the patient's
condition or the therapeutic level of the compound.
Real-time evaluations and adjustments will lower
cost, reduce side effects and increase treatment
success, a result which we are already
witnessing in certain areas, such as diabetes and
hypertension.
- Services. Good examples of new
services include patient education and
physician feedback. On a larger scale, there
are already medical professionals placing calls and
making visits to patients, supporting the sickest 20%
who account for 80% of healthcare costs. This
will continue and grow — more personalized
therapies require more interactive services —
with the net effect being a lowering of overall
healthcare costs. Pfizer's arrangement with the state of
Florida to manage its Medicare program is just
one example of how this can work.
- Databases. Today's isolated databases
will aggregate and evolve. Practice management
information; de-identified, electronic medical records;
prescription data; patient outcomes and even claims
data (to name but a few) will all be stored in
centralized clearing houses.
These databases will make it possible to monitor the
relevance and effectiveness of services, treatments
and practices to improve health outcomes. (Note how
this contrasts with today's focus on individualized
drug outcome data.) Health plans, physicians,
hospitals, employers, and pharma manufacturers will
all benefit in this networked, collaborative
results-driven environment.
The next generation of healthcare is almost
here
As these forces come together in the next few years,
we will witness an entirely new paradigm. New
kinds of drugs, leading to Comprehensive Treatment
Packages… all tied together with information
systems that interconnect the players, services,
institutions and data.
This isn't hypothetical psychobabble either. Many of
the pieces are already in place, and it's time for us as
an industry to make today's decisions in the context
of this emerging model.
In doing so, we've got more than just a chance to
regain the mantle of leadership, credibility and trust
that we've let slip away in recent years. We've
also got an unprecedented opportunity to drastically
improve the health of every single American.
Too many lives are at stake for anything less.
