As the holidays approach and the office parties commence, we undoubtedly pontificate and reflect on what is to come in the year ahead. Here’s my list of the most important themes of 2017 that will influence and guide us in the year ahead.
Let’s start with an obvious one: prices and price increases. The hangover effect of Martin Shkreli and Valeant Pharmaceuticals in 2015 continued to haunt the industry along with new dramas like that of Mylan and Epipen in 2016 and this theme is poised to continue for the foreseeable future. Our collective ‘Where’s Wally’ moment seems to be focused on finding the companies in our industry that don’t rely on egregious and shameful price increases to drive topline revenue growth but, rather, focus on innovation and drug discovery.
And on the subject of controversies, the second theme of 2017 will surely be that of Donald J Trump and the degree to which his policies impact the ACA, the role of the FDA, the lowering of corporate tax rates to prevent inversion deals with companies setting up shop in Ireland as a tax haven and various other key cabinet appointments. Has there ever been a president-elect whose incoming views on healthcare are more closely watched? Probably not. Unless Hillary had won.
CRSIPR, CAR-T and Cancer Moonshot. Some fancy words and acronyms but a lot of current and unrealised potential in all of them. The year 2017 looks to be the first in which humans are treated with CRISPR technology and where, despite Juno’s misstep in CAR-T, Kite Pharma and Novartis could take the field to new heights. It truly is the most exciting time to be part of this industry when you sit back and think about the brilliant minds that are working on these projects. Hang on tight.
The promise of mobile health lies not in recording information but in promoting behaviour change
Just a few weeks ago, the WHO declared that the Zika Public Health Emergency was over. Really? Well, I’ll take their word for it and certainly they know more about it than I do. Let’s hope that the absence of international urgency and focus doesn’t reduce vigilance and ongoing research funding leading to a cure. But more interestingly, let’s see what 2017 brings in terms of new (old) emerging infectious diseases. The last few years have seen the (re)emergence of dengue, ebola, measles, West Nile virus, avian influenza and MERS. What’s next in 2017?
Speaking of public health emergencies and emerging illnesses, you can’t pick up a newspaper in North America without seeing a headline about opioid overdoses and the increasing effects of this crisis. Where will governments go with their response? Forget about who’s to blame. The next year needs to be about arming our primary care physicians with the tools to address this scourge at the front lines of care. And about making it more difficult to distribute fentanyl and oxycodone-based drugs. And about a coordinated global response that recognises that this is a public health emergency.
How long have we heard about value-based pricing and risk-sharing as possible panaceas to the unsustainability of health system costs? Will 2017 be the year where wide-spread adoption of both comes to fruition? Can we finally get the leading reimbursement bodies, HTAs and manufacturers to develop a meaningful blueprint for the reimbursement of therapies that recognises society can no longer afford to pay for products that don’t work? And can manufacturers propose surrogate markers for efficacy that are widely-accepted by the clinical community and both public and private payers? For the sake of everyone involved, let’s hope so.
We have been sitting on the cusp of game-changing developments in mobile health for at least five years. The adoption and application of various software and hardware systems designed to interface at the patient level and provide data to the clinician are tantalising. But it’s not enough to measure A1c levels or cardiac enzymes, blood pressure or caloric intake, or the number of steps taken in a day unless we can also change behaviour. The promise of mobile health lies not in recording information but in being able to take recorded information and juxtapose it with behaviour change.
To our industry: a wish that 2017 becomes a seminal year in which we address this list of items (and many more). To all the readers: a wonderful holiday season and a year ahead filled with joy and happiness.