How can we continue to monitor the landscape for future disruption. Moreover, one of our interviewees suggested that physicians of the future might be writing prescriptions for healthy food18 and walks outside.19 This increased awareness of well-being, combined with digital therapeutics, could help consumers stay healthy. Life at Deloitte Podcast. Tom Yang is a principal and assists biopharma and biotech executives deliver growth strategies that adapt to the ever-evolving life sciences and health care landscape. A future marked by greater access to needed Innovation starts with insight and seeing challenges in a new way. By 2040 (and perhaps beginning much before), streams of health data—together with data from a variety of other relevant sources—will likely merge to create a multifaceted and highly personalized picture of every consumer’s well-being. For example, diabetes digital programs combine a blood-glucose monitor with actionable insights and personalized coaching. The pharmaceutical industry discovers, develops, produces, and markets drugs or pharmaceutical drugs for use as medications to be administered (or self-administered) to patients, with the aim to cure them, vaccinate them, or alleviate the symptoms. What are some examples of disruption already happening in the market, and how quickly is change likely to occur? MyMee: The three-year-old digital care program focuses on chronic autoimmune disorders. Companies will likely need to develop sophisticated methods for monitoring post-treatment patients to help shape the value story. has been saved, The future of biopharma Sam is known for writing work that brings value to industry professionals and the generally curious – as well as an occasional smile to the face. Proof of this are the current pipelines of the top 20 companies, … enhancements in the operations of these organizations and patient efficacy. This data could help companies develop customized treatment regimens for specific types of patients. This had had a more mixed result. Change isn't just coming. Most could benefit from developing a business model that focuses on more customized treatments. Get the Deloitte Insights app. medicines among the patient population could result.”, “The future of Pharma is digitization and consolidation. The proliferation of fitness trackers, smart watches, and other wearables that track activity and sleep has moved quickly from early adoption a few years ago to the mainstream. Here's what they have to say: “The future of pharma is about embracing technology and a much broader definition of  medicines’, which includes greater focus on prevention (driven by the growth of personal diagnostics via smart devices), digital health and digital medicines / therapeutics (for example, use of cognitive behavioural therapy chatbots for managing depression or apps that help diabetes patients monitor and manage their blood sugar levels). when the acquirer's market power is large due to weak competition or distant patent. The concept of pharmacogenomics has been around for a long time, but little progress has been made when it comes to using this information to determine effective dosing. He’s written extensively on the individuals and companies shaping the future of tech, working directly with many of them to advance their vision. The five forces described above should push biopharma companies to ask themselves some hard questions about the markets they are in and how the threat of disruption could impact them. While there have been notable successes often offset by the premium prices typically paid for these companies. Pharma currently spends, on average, $1.3 billion bringing a new medicine to market with an attrition rate of 90 percent. A podcast by our professionals who share a sneak peek at life inside Deloitte. There will be increased attention to cost and abrupt cost increases. Digital therapeutics deliver evidence-based interventions to patients through software programs that help prevent, manage, or treat a medical disorder or disease. Scientists at the Broad Institute also recently published a study that demonstrated that another enzyme called Cas13 could be programmed to kill three different kinds of single-stranded RNA viruses.14 However, one CRISPR leader pointed out that gene editing might only address part of the problem for multifactor diseases. The authors would like to thank Neal Batra, Tom Fezza, Mike Delone, Hanno Ronte, Anand Parikh, Claire Cruise, Ramani Moses, Laura DeSimio, and the many others who contributed their ideas and insights to this project. There will be more open dialogue and in the same token, scrutiny, on pricing and fairly, the middle-men or pharmacy benefit managers. The most publicized form of ACT (CAR-T) uses the patient’s own immune system to destroy cancer cells. Our US Health Care practice helps clients transform uncertainty into possibility and rapid change into lasting progress. Today, for example, clinicians can detect the early stages of melanoma much earlier than in the past, and early treatment can eliminate the disease completely. View in article, Global Wellness Summit, 2019 Global wellness trends, accessed February 25, 2020. Biopharma companies should be at the forefront of understanding heterogenous patient populations. Early detection of other types of cancer could reduce or eliminate the need for future therapies. A 2012 paper published in the trade journal Sleep determined Sleepio to be more effective than a placebo and helped 76 percent of users achieve healthy sleep levels.20 In a 2018 JAMA Psychiatry paper, about 75 percent of Sleepio users saw an improvement in sleep after going through the company’s six-week program.21 These results spurred the United Kingdom’s NHS to pay for the use of the app.22, Livongo: Livongo, founded in 2008, is a digital health management app for chronic diseases. It allows users to input and track their daily activities, and then make sense of any patterns in the data that might be impacting their health. He's a trained journalist with experience in the field of disruptive technology. Company leaders should develop strategies to counter potential threats and take advantage of the short- and long-term opportunities that emerge in this changing environment. Project team: Steve Davis was an instrumental part of the team, assisting with interview outreach, conducting interviews, and writing and editing the paper. View in article, Deloitte, “Top 10 health care innovations,” accessed February 25, 2020. Since the outbreak, retail of over-the-counter drugs spiked before lockdowns in March 2020 as consumers stockpiled these drugs. As we move toward the future of health, biopharma incumbents should consider new strategic investments to position themselves for success. While these too are vaccines, they bear no resemblance to vaccines that prevent an infectious agent. By 2050, there will be two billion people that are 60 years or older globally. These industry insiders and keen observers share their insights on where the future of pharma lies. Reports indicate that by 2020 the global pharmaceutical market will more than double to around US$1.3 trillion, with Brazil, China, India, Indonesia, Mexico, Russia and Turkey accounting for 1/5th of global pharmaceutical sales.. We can already see these trends taking shape as the pharma industry is expected to see annual compound growth of over 6% and reach $1.2 trillion in 2024, with R&D spending at 16.9% ofprescription sales in 2024.”, “Pharma will become increasingly reliant on digital tools and data-driven strategies from drug development through commercialization. It aims to close gaps in care, provide refill deliveries, and personalize care through both its digital offering and access to real-time health specialists and coaches. Research methods are evolving and we have many promising prospects on the horizon – from the possibilities offered by personalised medicines, to the potential offered by harnessing the power of big data. Gene Therapy is the introduction, removal, or change in the structure of a patient’s genetic code to treat or cure a disease. View in article, Beth A. Helmink et al., “The microbiome, cancer, and cancer therapy,” Nature Medicine 25 (2019): pp. In 2018, the global human microbiome market was valued at US$351.81 million,7 and over 100 companies are investing in analyzing data related to the microbiome.8, The estimated 38 trillion microorganisms that exist within our bodies can have an impact on physical and mental health, which gives new meaning to the phrase “you are what you eat.” A better understanding of the microbiome could lead to more effective ways to prevent disease. Then the odds changed, Grail’s liquid biopsy test shows high sensitivity in early cancer detection, Global human microbiome market analysis & forecast, 2020—The market was valued at USD 351.81 million in 2018, Big investments for human microbiome research, Gut microbiome in type 1 diabetes: A comprehensive view, The microbiome, cancer, and cancer therapy, The battle against drugs—3D printing drugs: The latest advancements, How cellular immunotherapies are changing the outlook for cancer patients, Good food is medicine: A smart ‘farmacy’ program for diabetes patients, A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application, Effect of digital cognitive behavioral therapy for insomnia on health, psychological well-being, and sleep-related quality of life: A randomized clinical trial, Big Health wants you to cure your insomnia with its app, then delete it—and some investors hate that idea, Case study: Livongo demonstrates cost savings, Nanosponges sop up toxins and help repair tissues, A research team builds robots from living cells, Tissue-engineered human pancreatic cells successfully treat diabetic mice, Showing cybersecurity's value to health care leadership, Creating a treasure trove of data for health plans. Pharmaceutical companies that are able to reimagine their traditional business model may be most likely to succeed in a future built around prevention, early detection, and personalized therapies. Copy a customized link that shows your highlighted text. Most of these therapies target diseases driven by a single or a few genetic mutations. The changes that we see on the horizon will likely require biopharma companies to consider new types of markets, alternative business models, or a complete change in how they define what work they do. “Using pharmaceutical industry data, we show that acquired drug projects are less likely to be. We expect that over the next 20 years, we will be able to detect some diseases—and prevent them from advancing—possibly even before symptoms surface. Genetic testing: Whole-genome sequencing is a powerful and revolutionary tool. He received his PhD in cell and molecular biology from the University of Pennsylvania School of Medicine, and his BA from Cornell University. Shifts in how diseases are identified, prevented, treated, or cured may lead to fundamentally different business models for traditional biopharma companies and new entrants. According to Deloitte’s 2019 Global Health Care Consumer Survey, 42 percent of US consumers rely on technology to measure their fitness levels and set health-improvement goals (figure 5).17 Patients are also increasingly interested in trying out homeopathic methods before turning to pharmaceuticals. At a 2019 conference, California-based Grail presented data that it said confirms its ability to detect early-stage cancer with a single blood test. Considerations: A proliferation of real-world data sources could help health care stakeholders understand which drugs work best for which patients and under which circumstances. Digital therapeutics: Increasingly effective and scalable nonpharmaceutical (digital) interventions—including those focused on behavior modification—might also reduce or eliminate demand for medications. In recent times the industry has been less successful at discovering innovative new molecules. Over the next 20 years, more vaccines could be developed that prevent more types of cancer. For example, many digital therapeutics rely on cognitive behavioral therapy (CBT), a psychological treatment that has been shown to improve patient outcomes across a range of mental health diseases. For example, data on how a patient metabolizes a drug could be used to ensure he/she gets the precise dose that will optimize effectiveness and minimize toxicity. Advanced cognitive technologies could be developed to analyze a significantly large set of parameters and create personalized insights into a consumer’s health. In response, they were able to change their diets and lifestyle habits to avoid those triggers. Pharmaceutical companies may deal in generic or brand medications and medical devices. Case in point: In December 2019, the Wall Street Journal reported that seven women from the same family underwent major surgeries after a genetic test determined they all had an elevated risk of developing breast cancer.5 Since then, we’ve learned the increased risk associated with this particular gene is not quite as high as previously thought. Giving each patient a personalized dosage, or the optimal combination of drugs, could lead to better outcomes. Developing, marketing, and pricing these curative treatments could require the biopharma sector to adopt new capabilities. Our interviewees also cautioned that higher socioeconomic classes are more likely than lower classes to use these technologies, which could further widen health disparities. How might these unfold over time? Some of our interviewees suggested that as these technologies become more sophisticated, they could lead to dramatically improved outcomes in cancer, infectious disease, inflammatory conditions, and chronic pain. Advances in early detection will likely enable interventions that halt diseases in the earliest stages—before they progress to more serious conditions. Biopharma companies working in impacted disease areas should consider adopting some of these technologies, or risk operating in a much smaller market in the future. Digital therapeutics, for example, might use an app-based platform to target modifiable chronic diseases such as diabetes, depression, anxiety, and heart disease. It’s actually a set of discrete diseases, and some variations of Parkinson’s look different than others. Unlike some high-cost therapies that treat a small portion of the population, the generic-drug business model is based entirely on high-volume treatments that target large populations. Tailored dosing: Predictive analytics and the ability to analyze longitudinal and integrated data sets for diverse patient populations could help biopharma companies determine optimal dosing levels for patients, who is most likely to respond, and under what conditions. With the benefits and detriments of pharmaceuticals well-documented, one question remains: where does Pharma go from here? He also suggested that we might be able to use gene and cell therapy to reprogram our bone marrow/immune system, but noted that it would be a “longer, harder road with weird speed bumps.”. Then, Covid-19 happened and threw us a curveball that will likely impact all existing forecasts. The Pharma industry as a whole is moving toward consolidation with more and more manufacturers, PBMs, pharmacies merging with one another to achieve control over data and market share. The cells may originate from the patient (autologous cells) or a donor (allogeneic cells). Digital therapeutics that reduce the need for pharmaceutical intervention: Digital therapeutics are increasing access to medical providers, which could reduce the need for drug treatments. “In the future, we might be able to extract bone marrow from a young patient, store it, and use it to cure an autoimmune illness that we know is likely to develop in that person as they reach their 40s,” he predicted. In the face of these five forces, biopharma companies should ask themselves: By 2040, some diseases will be prevented, cured, or managed with nonpharmacological interventions. For example, cancer patients who have hard-to-reach tumors have historically been treated with systemic therapies and radiation. Plan • Past and Present of the Pharmaceutical Industry • Futuristic Look of the Three Levels of the Pharmaceutical Industry • Inner level: Pharmaceutical … “We’ll be able to fix it, regenerate tissue, or grow replacements, perhaps through xenotransplantation,” he predicted. Based on emerging technology, we can be reasonably certain that digital transformation—enabled by radically interoperable data, AI, and open, secure platforms—will drive much of this change. Two other examples of virally transfused cancers include the human T-lymphotropic virus type 3 (HTLV-3) and the hepatitis B and C viruses, which can cause liver cancer. 21–30. Share your feedback and we'll consider adding it to the piece! Certain services may not be available to attest clients under the rules and regulations of public accounting. I predict that the pharma company of the future will not be a single company but rather a decentralized family of companies akin to Alphabet or Tencent, building innovative biotech companies from scratch while making long-term investments in a shared technology platform—harvesting economies of scale where appropriate, but also maintaining entrepreneurial focus at individual companies.”, “The future I see with the pharmaceutical industry is individualizing care. 2: Personalized or customized treatment. Biopharma companies might be able to develop or target therapies to the unique characteristics of each subpopulation. Curative therapies—time-limited treatments that remove symptoms of a disease through the permanent (or semipermanent) correction of the underlying condition—have the potential to reduce the incidence and prevalence of many diseases. Her research focuses on R&D and innovation, the impact of the ongoing health care transformation to life sciences companies, and value-based care. Several of our interviewees predicted that diseases driven by single genetic mutations (e.g., certain cancers, sickle cell anemia, and some rare diseases) are likely to be among the first ones treated by curative therapies. View in article, Alliance for Regenerative Medicine, “Clinical trials: Q3 2019,” accessed February 25, 2020. At the time of publication, academic and biopharma researchers were increasing data transparency, leveraging accelerated regulatory pathways, and setting up adaptive trials to develop and test drugs and vaccines to address the pandemic. Some interviewees were skeptical of the long-term adoption, or stickiness, of digital therapeutics. For example, researchers at the Western University in London, Ontario, successfully used a CRISPR-associated enzyme called Cas9 to eliminate a species of Salmonella using E. coli bacteria. As one interviewee pointed out, “There is no way to determine why some people develop rheumatoid arthritis and some people don’t.” But the groundwork is already being laid for a world with a greater ability to detect and prevent disease. Interviewees noted that disruption is already taking place in the industry, and they tried to project where those threats might lead over the next 20 years. We are already seeing advancements in the ability to detect the early stages of cancer. The growth of pharmacogenomics will become a critical need. He has worked extensively with clients to develop and commercialize breakthrough products in oncology, immunology, and liver disease. Companies who run from one quarterly financial report to the next, ignoring the future, will not survive. 769–81. 1 (2019): pp. View in article, Knvul Sheikh, “Is Crispr the new antibiotic?,” New York Times, October 28, 2019. “We’ll better understand where the immune system has been programmed up and learn to program it down using CAR-T,” he said. View in article, Colin A. Espie et al., “Effect of digital cognitive behavioral therapy for insomnia on health, psychological well-being, and sleep-related quality of life: A randomized clinical trial,” JAMA Psychiatry 76, no. See Terms of Use for more information. developed when they overlap with the acquirer's existing product portfolio, especially. Explore what the future of the pharmaceutical industry holds and how health interventions may impact business models in life sciences. Instead of making medications for diseases, they will make medications that work for the individual patients taking us and our specific needs into account. The future of health that we envision in 2040 will be a world apart from what we have now. Systematic evaluation of how patients metabolize drugs by evaluating the expression of liver enzymes (CYP450) or kidney function could enable more optimal dosing to get patients into therapeutic ranges. View in article, Livongo, “Case study: Livongo demonstrates cost savings,” accessed February 25, 2020. One interviewee said, “Pharmacogenomic data will become part of the electronic medical record.”. Considerations: The future of digital therapeutics depends on user adoption, the ability to demonstrate impact, and optimization of pricing/reimbursement. View in article, Science Daily, “Tissue-engineered human pancreatic cells successfully treat diabetic mice,” May 8, 2018. Non-negotiable, however, is that these technologies need to demonstrate results. Precision intervention: Increasingly sophisticated medical technology—such as precise medical intervention enabled by robotics, nanotechnology, or tissue engineering—could reduce the need for pharmaceutical intervention. She conducts primary and secondary research and analysis on emerging trends, challenges, and opportunities within the health care system. Customized treatments: Personalization in medicine—driven by data-powered insights—could effectively match patients with customized drug cocktails, or design therapies that would work for just a few people, or even a particular person (i.e., “n of 1”). These bio-medications will take into account the .03% DNA difference in each of us that accounts for why one option works better for a person. shrikant.py2011@gmail.com INTRODUCTION: The Pharmaceutical industry in India is the world's third-largest in terms of volume and stands 14th in terms of value. 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