I remember that medicinal chemists felt that ‘real drugs’ were necessarily small, orally-administrable, organic compounds (“small molecules”). The general consensus was that at best biotechnology might occupy a niche making large peptide hormones (“biologicals”) such as insulin (which previously had to be extracted from swine) to growth hormone (previously extracted from human cadavers), that were too difficult or expensive to make synthetically.
How things have changed…
Today the world’s bestselling drug is a biological, Abbott’s Humira, with 2012 sales expected to exceed US$10 billion. A recent Forbes article lists the top 19 drugs of all time – seven are biologicals. As the article notes:
“Tellingly, each of the products in the list above best positioned to record an increase in peak annual sales over the next five years is a biologic; Humira, Enbrel, Rituxan, Herceptin and Lantus being the chief candidates.”
Long-time industry analyst Steve Burrill has predicted that by 2020 all of the top will be biologics.
What does this have to do with Digital Technologies and Health?
Technological advances disrupt markets. Small molecule pharmaceuticals have been a key tool in physicians’ armamentarium since their development in the early 20th Century. But they have now been eclipsed by biologicals. And beyond drugs, biotechnological advances such as tissue engineering are starting to be applied in clinical practice. Pharmaceutical companies are struggling to adapt to rapidly changing market conditions that are a result of the biotechnology revolution started over 40 years ago. It is not clear that they will survive in anything like their current form.
Patients are demanding greater engagement in the delivery of healthcare. Thanks to the Internet they are better informed. With mobile devices they can monitor and manage their own health and the effects of therapies in real-time. And with social media they can share their experiences with others like themselves.
Most current applications of digital technologies to healthcare have been extensions of past practices. But I believe that the greatest impact of digital technologies will be when they enable completely new practices. We are in for some surprises, and a lot of fast-paced change. There will be disruptions, but over the long-term we will all benefit, not just when we are patients, but throughout our lives.
I hope that this site, Digital for Health, will chronicle the journey while hopefully offering a few insights along the way.