There is something about a new year that gives us a clearer vantage point on the trends that might lie ahead. A new year might be an artificial demarcation point, but I use it to reflect on where the health care and innovation market is now, and where it could be headed.
The exponential promise that exists in the life sciences and health care sectors is unprecedented. It used to sound trite when industry leaders would expound on this golden era of science, but now it feels like we are on firm ground. The impact of tools and techniques—such as nanotechnology, artificial intelligence (AI), and user-centered design—are being interrogated to advance innovation in health. Novel approaches are now met with less skepticism than in the past, and there appears to be an understanding that a novel concept can survive and re-enter the market even if the startup that came up with the idea fails.
Deloitte recently launched some powerful perspectives on the overall Future of Health where our thought leaders imagine what the health care, life sciences, and research sectors will look like in 2040. But how about the near term? What are some trends to watch in 2019?
I see five key trends to watch. We’ve been discussing and witnessing some of these trends for years, while others have cropped up and matured more quickly. Some trends are positive and others are not. Some are clear while others are still murky.
- All things digital: The integration of wearables and digital devices into medicine and research has been a long time coming, and there has been some exciting progress. Apple Inc.’s* Series 4 Apple Watch, for example, includes an EKG sensor that can alert the wearer to irregular heart rhythms. Fitbit recently announced a partnership with the National Institutes of Health’s (NIH) All of Us cohort to examine how health indicators such as sleep, activity, and heart rate can be part of personalized health. This is just the tip of the iceberg. Can data generated by wearable devices be welded to other scientific methods to give real-time and longitudinal feedback to clinicians, patients, and scientists? Paying attention to the entire spectrum of approaches could lead to new pathways forward in the development of new digital medical devices.
- Patient centricity: I had a front-row seat to the evolution of patient centricity. It almost feels like the term has become mainstream for federal agencies, life science companies, and patient organizations. For pharmaceutical companies, 2019 could be pivotal for allowing the science of patient input to grow stronger roots for enhancing research and development (R&D). But infusing patient perspectives into the entire research continuum can take considerable effort and internal buy-in. Some patient organizations are forging ahead to create voice of the patient repositories and are hosting patient-focused drug-development convenings. But moving forward takes commitment, resources, and know-how. R&D departments and federal regulators are beginning to connect the dots between different patient populations. But are pharmaceutical companies seeing a return on investment from patient centricity? We should be candid about how it is working to ensure it continues to be part of the way research is conducted.
- Federal agency appropriations: On January 25, the White House and congressional leaders agreed to end the 35-day partial shutdown of the federal government and fund it until February 25. Without federal funding, the Food and Drug Administration (FDA) had to tap into user fees to pay for product reviews. If the shutdown hadn’t ended, FDA Commissioner Scott Gottlieb indicated that those fees could have kept product reviews moving until February 8. During the shutdown, leaders from FDA and NIH were not able to fully participate in all public meetings, some advisory committees were rescheduled, and federal workers (who play a vital role in health care and medical research) faced financial uncertainty. The shutdown illustrated the enormous (and perhaps underappreciated) impact federal funding has on the agencies and people that drive and manage large biomedical research and health programs.
- Patient data sets and data platforms: The sands of data collection and analysis are shifting. Roche’s acquisition of Flatiron Health last year is an indication that the industry understands the importance of big data, analytics, real-world evidence (RWE), and personalized medicine. Deloitte’s report on the future of real-world evidence found that leading biopharmaceutical companies are investing more in RWE capabilities. The quantity and diversity of real-world data has evolved and expanded beyond electronic health records (EHR) and claims data. Increasingly, we are understanding where patient data lives, how it can be aggregated, and what we can learn from it. Will there be a major disruption in this space in 2019, or a steady drip of more use and prominence of RWE?
- Opioids and addiction challenges: The impact of addiction is a vexing problem that has attracted a great deal of attention because of the opioid epidemic. Across our nation, we lose more than half a million people annually to addiction and substance abuse. Last year, we saw our nation’s life expectancy decline in part because of overdose deaths from addictive substances. The challenges brought on by the opioid epidemic has affected how our health care system manages pain and how we provide relief in the near and the longer term via science, new approaches to pain reduction, and strategies to help people who are addicted. Can we use a systems-level approach to help those who need help? This epidemic has shone a spotlight on the silo-ization of our health care services. It is clear that we should improve our scientific understanding of pain and addiction, and become more effective in managing it.
From systems level issues to real diseases impacting people today, we have much to do to advance solutions for people across our nation and indeed the world. We have 11 months left in 2019, and I will be watching these trends closely.