DEVELOPMENT AND INNOVATION IN CANCER MEDICINE - Innovation in the Biopharmaceutical Industry - page 63

SOCIETY

INNOVATION

willingness to pay
expectation
economy
selfishness
spirituality
family integrity
ethics
political ideology

prevention
screening
diagnosis
surgery
radiotherapy
drugs
supportive care

THE CANCER
FUTURE DELIVERY

FINANCE

hospital
hotel
specialist
primary care
DTC
professionals role
public vs private
globalisation

self pay
co-payment
voluntary insurance
mandatory insurance
state insurance
HMO
NHS
charity

Fig. 6. The four building blocks of cancer's future — innovation, society, delivery and finances
(DTC = Diagnostic and Treatment Centres; HMO = Health Maintenance Organisation; NHS =
National Health Service).

increasing divorce, greater international mobility and the increased selfishness of a
consumer driven culture will leave many isolated with little support at the onset of
serious illness. There will be a global shortage of caregivers, who are the unskilled,
low paid but essential component of any health delivery system and an invaluable
human capital resource, for which there will be increasing competition.
New financial structures will emerge with novel consortia from the pharmaceu-
tical, financial and healthcare sectors, which will enable people to buy into the level
of care they wish to pay for. Cancer, cardiovascular disease and dementia will be
controlled and join today's list of chronic diseases such as diabetes, asthma and
hypertension. Hospitals will become attractive health hotels run by competing pri-
vate sector providers. Global franchises will provide speciality therapies through
these structures similar to the internationally branded shops in today's malls. Gov-
ernments will have long ceased to deliver care. By the end of this decade, Britain's
NHS, one of the last centralised systems to disappear, will convert to UK Health, a
regulator and safety net insurer.
The ability of technology to improve cancer care is assured, but it will come at
a price — namely, the direct costs of providing it and the costs of looking after the
increasingly elderly population it will produce. New ethical and moral dilemmas
will arise as we seek the holy grail of compressed morbidity. Living long and dying
fast will become the mantra of 21st century medicine.