Biomedical Engineering Reference
In-Depth Information
Table 7.
Barriers to innovation.
The drug industry will continue to compete for investment in a competitive, capitalist
environment
Blockbuster drugs drive profit — niche products are unattractive in today's market
Personalised therapies are difficult for today's industry machine
Surrogate endpoints will be essential to register new drugs
Novel providers will emerge providing both diagnostic and therapy services
Payers will seek robust justification for the use of high cost agents
that patients who gave their consent for tissue to be used for a certain purpose did
not mind if it was used for another. Patients do not like to be reminded of their
cancer years after they have been cured. In order to overcome these constraints,
regulators who approve therapies will have to accept surrogate markers, rather than
clinical outcomes. Outcome studies might move to a post-registration surveillance
of a drug's efficacy, similar to cholesterol lowering agents today.
The rise of personalised medicine will mean that the temptation to over-treat will
disappear. Doctors and patients will know whether or not a particular treatment is jus-
tified because the evidence will be there to support their decisions. Therefore, treat-
ment failure, along with its associated costs, will become less common (Table 7).
Patient's Experience
Two separate developments will determine a patient's cancer care experience in
future. The increasing expectations of patients as consumers will cause health ser-
vices to become more responsive to the individual, similar to the way other service
industries already are. Targeted approaches to diagnosis and treatment will individ-
ualise care. People will have higher personal expectations, will be less deferential to
professionals, and will be more willing to seek alternative care providers if they are
dissatisfied. As a result, patients will be more involved in their care. They will take
more responsibility for their health decisions, rather than adopt a paternalistic “doc-
tor knows best” attitude. These changes will partly be fuelled by the internet and by
competitive provider systems. By 2025, the majority of people in their 70s and 80s
will be adept at using the internet to access information (Institute of Medicine, 2001).
As patients begin to have access to all this health information, they will need peo-
ple who can interpret the huge amounts of information available, help them to assess
risks and benefits, and determine what is relevant for them. These patient brokers will
be compassionate, independent advocates who will act as patients' guides through
the system. They will be aided by intelligent algorithms to ensure that patients
understand their screenings and the implications of early diagnosis. They will spell
out the meaning of genetic susceptibility, and they will guide patients through their
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