100 objects that shaped public health

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An amazing article posted on the website of the Johns Hopkins Bloomberg School of Public Health details the 100 objects that changed our life, in positive or negative way.

As you will see, you could spend hours discovering those objects and, one by one, you will either discover something you ignored or confirm what you already know. But basically, each one will relate to one aspect of your health.

From Aerosol Cans to Cigarettes, from Airbag to Gin Tonic, from the Horseshoe Crab to the Hard Hat.

This article really deserve a blog post as it will really inform us on the historical background of each of those objects.

 

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Can U.S. Drug Prices be Justified? A U.S. vs. E.U. Comparison

Extremely insightful – a must read

Regulators and payers have raised major concerns over recent spikes in drug prices. Unjustified high drug prices (see Valeant case) have triggered not only political comments from U.S. presidential candidates in the previous U.S. elections (see Hillary Clinton’s statement) but also a broader discussion on how drug prices can be regulated and whether the European drug pricing model (reference pricing) should be adopted.

In this article, I will discuss the differences between U.S. and E.U. drug prices based on the case of CNS drugs. Prices have been drawn from various sources including reported Wholesale Acquisition (WAC) prices as well as from a number of journal articles.

The following indications will be analysed: Multiple Sclerosis, Neuropathic Pain and Parkinson’s Disease. These disorders account for ~50% of the global CNS market (excl. psychiatric disorders such as depression, schizophrenia anxiety or eating disorders).

Multiple Sclerosis (MS)

Disease Description: MS is a neurodegenerative disorder in which the insulating covers of…

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Top 15 Pharma companies – FY 2016 performance review

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The 2016 earnings season is nearly over and some companies gave really excellent performance reports like Bristol-Myers Squibb with 17% organic revenue growth and AbbVie with 13.3% sales growth.

Negative performance for some players like Gilead (suffering base effect linked to a very strong 2015 performance) and AstraZeneca (struggling with a fragmented portfolio unable to drive growth).

In the PDF document (q4-2016), I computed the 2 ratios (operating margin and R&D in % of sales), I also added a column for 2017 guidance follow-up and made some comments on the results, especially the main products and whether I could see any growth driver.

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Top 15 Pharma companies – Q3 2016 performance review

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The earnings season for Big Pharma is now over with Teva publication yesterday.

As usual, a table summarizes the main figures and key points from each publication. Worth noting that some companies like Gilead suffered from a basis effect after a stellar performance last year. Among top performers, Bristol-Myers Squibb, Pfizer and GSK held well during the last quarter. The bottom performers were Gilead, AstraZeneca and Novartis with the last two companies experiencing negative impact from generics.

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Biomimetics – How Nature can help us in solving complex problems

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Biomimetics are fascinating as, very often, nature is better skilled than humans to solve complex problems. Historically, humans started to look at birds to be able to develop airplanes to fly themselves. Biomimetics applications are extremely wide, especially because of the complexity of biological systems and, also probably, for the reason that scientists have not yet uncovered all the mysteries of Nature itself.

Life sciences would strongly benefit from more Nature-inspired innovations like spider web silk used for artificial ligaments thank to their strength and robustness. Other amazing examples come from the virus world: most viruses have an outer capsule 20 to 300nm in diameter, which are remarkably robust and capable of withstanding temperatures as high as 60 °C; they are also stable across the pH range 2-10. Viral capsules can then be used to create nano device components such as nanowires, nanotubes, and nanomaterial. Last but not least, viruses (in their inactivated form) are very often used as carriers for other molecules and allow the delivery of drugs to very precise locations in the human body.

Biomimetics as innovation method is characterized by interdisciplinary information transfer from the life sciences to technical application fields aiming at increased performance, functionality and energy efficiency.

Before jumping in the library or clicking on the links shown below, have a look at the TED Talk Playlist on Biomimetics or Biomimicry. You’ll discover stunning examples and fascinating technologies.

Biomimetics is definitely a field where we need to invest more.

 

More to discover:

Innovations

Biomimetics innovations

14 Smart Inventions Inspired by Nature: Biomimicry – Bloomberg – 2015

Life sciences

Biomimetics: forecasting the future of science, engineering, and medicine – International Journal of Nanomedicine – 2015: biomimetics-forecasting-the-future-of-science-engineering-and-medicine-2015

The state of the art in biomimetics – Bioinspiration & Biomimetics Review – 2012: 2012-bioinspirationbiomimetics-the-state-of-the-art-in-biomimetics

Nanomedicine and biomimetics: life sciences meet engineering: nanomedicine_and_biomimetics_life_sciences_meet_en_2009

Biomimetics: Design by Nature – National Geographic – 2008

Biomimetic Materials for Tissue Engineering – Advanced Drug Delivery Review – 2007

Biomaterials

Living, breathing biomimetic meta materials – MaterialsToday – 2016

Biomimicry: Designing to Model Nature – Whole Building Design Guide – 2014

Biological materials sciences – Max Plank Institute – 2010

Biomimetic Solutions to Sticky Problems – Science – 2007

 

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Novel drugs for depression – The Economist

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The Economist took a deep plunge into mental health research for depression. The article is extremely interesting as it seems that the scientific community understands depression a bit more than before. Despite the lack of interest from the industry, old drugs like ketamine seem to be very useful in treating that disorder. In order to patent their invention, new drugs with the same benefits as ketamine are being developed by pharmaceuticals companies.

Even if we do not yet have a complete picture, we took a step in the right direction.

Article link

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Advances in Oncology Drug Discovery – Sachs Conference Talk by Roche pRED Head of Oncology DTA, William Pao

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A fascinating talk about cancer drug discovery was given by Dr. William Pao, Head of Oncology Discovery and Translational Area (DTA) at Roche Pharmaceutical Research and Early Development (pRED) during the Sachs 16th Annual Biotech in Europe Forum.

He started to explain what is cancer, for us to gain more insights:

  • cancer is a genetic disease: tumors can harbor over 400 somatic mutations
  • cancer is heterogenous: there are more than 200 types of cancers and a single patient tumor displays intra and inter-tumoral heterogeneity
  • cancer can metastasize: once spread, it is virually incurable. Metastatic cancer survival at 5 years is extremely low (between 4 and 28%)

Based on those considerations, treatment is becoming much more complex today with a blend of chemotherapy, targeted medicines and immunotherapies. A right combination could extend survival by several months.

But how to develop drugs with increased efficacy against the smart strategies used by the disease (such as tumor angiogenesis)? According to Dr. Pao, 3 elements are necessary:

  • understanding disease biology as well as druggable targets in the complexity of cancer molecular pathways
  • developing fit-for-purpose molecules allowing to create the right drug with the right format against the right target
  • personalizing healthcare with the administration of the right drug to the right patient at the right time

Beyond a better understanding of the disease, using more than a single strategy to target the cancer:

  • Host directed with cancer immunotherapy. This approach is particularly challenging as some patients do not respond to it (innate or acquired immune escape) and other patients may fully benefit with long term survival
  • Tumor directed with targeted medicines

External innovation, collaborations and partnerships, is fully leveraged in order for Roche to complement existing capabilities in the field (immunotherapy examples: CuraDev, Pieris, BluePrint; targeted medicines: Tensha, C4Therapeutics).

As a conclusion, Roche is well positioned to address the cancer challenges and, since the beginning of innovative cancer treatments, the company has always been perceived as the leader of the therapeutic area.

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Missing points in his talk were considerations of patient’s quality of life (extending life does not always go with good quality of life because of treatment’s side effects) and drug pricing (adding more and more drugs to the treatment cocktail costs a lot of financial resources, not only paid by the health insurance but also by the patient).

 

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DNA methyltransferase 1 has a role in the establishment and regulation of tissue-specific patterns of methylated cytosine residues. Aberrant methylation patterns are associated with certain human tumors. www.enzymlogic.com. Work done with the molecular visualization VMD program developed at the University of Illinois: www.ks.uiuc.edu/Research/vmd/

Top 15 Pharma companies – Q2 2016 performance review

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All the big names published their Q2 results during the summer. After spending some time on the beach, looking at their numbers is a good way to be immersed in the industry again.

During this last earnings season, performances were extremely heterogeneous. AbbVie and BMS had stellar revenue growth while AstraZeneca, Gilead and Sanofi showed poor performance for diverse reasons (explained below in the table – NB: you can click on it to make it bigger).

Comparing the Top 15 each quarter is insightful and allows me to spot pockets of growth and dynamism in the industry as well as challenges and red flags.

Q22016

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E-health Day – Internet of Me: Vision and Challenges

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I had the opportunity to attend the e-health day in Sierre (TechnoArk) on June 3rd 2016. The event was well organized around big players (Boston Scientific, Roche), showing their vision of the technology and its implementation in their own business model, and startups (L.I.F.E. Corporation, Karmagenes) unveiling their innovations in the field. Moreover, other stakeholders like the health insurance Groupe Mutuel and government-financed agency CIPRET presented their real-world experiences. The event was closed by a panel discussion on the relationships between eDoctors and ePatients.

Globally, the vision of health is: health care providers will be able to improve health outcomes by working with digital patients (the data collected by sensors will be integrated and analyze to provide personalized treatments and consequently better outcomes). Several projects are developed: prosthesis control, diabetes management, vital signs monitoring for elderly people…

Below I summarize the key takeaways from the most interesting talks (not all of them).

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BOSTON SCIENTIFIC – MEDTECH : WHICH BUSINESS MODEL FOR THE E-PATIENT ?
By Frédéric Briguet, EU Digital Health Engagement

  • The goal of the presentation was to provide clues on which business model is the most appropriate for digital health companies.
  • Medical technology companies create and develop products for patients but they really have to be aware of their ecosystem and the influences that will drive patients’ behavior.
    Body sensors brought revolutionary tools to life. They are wireless, responsive, use mobile devices and allow data analysis to be performed. However, what is the real impact on health and disease management? Many companies have sensors supported by solid hardware, cloud data collection and a dashboard for mobile phone.
  • Despite the evolution of technology, we are still lacking clinical studies and proofs. In addition, the user dropout rate is pretty high (after 6 to 8 months, users abandon the sensor(s) and the app). Needless to say that, on top of all the previous disadvantages, the amount of data generated is extremely heavy and it is difficult to extract the most relevant indicators to analyze them.
    However, the first digital health products helped open new perspectives and the potential of connections between all the stakeholders. Empowering and engaging healthcare providers is also one of the key benefits of the first digital health initiatives. Beyond those elements, what’s crucial to ensure adoption and reimbursement is to demonstrate the cost savings the technology could bring to the current health care settings. Doctors also have to support it and be convinced of the use and utility for their own patients.
  • All in all, the future of healthcare is expected to improve outcomes, reduce hospital readmission rate and control costs while maintaining care access.
  • The experience of the speaker allowed him to say which business models where the most appropriate to survive and thrive in that new field. He established 4 directions (that can be combined):
    1. The patient is not a consumer. Generally speaking, he is not really willing to know that he’s ill. His main focus is to live. Family and friends are the most concerned about the patient’s health and wellbeing. Creating and developing tools that could ease the burden for the supportive people around the patient is generally well received and adopted.
    2. Understand the business ecosystem. Knowing where to position the company is fundamental to avoid being stuck in a no man’s land. Focusing on lifestyle, coaching or care pathways is different and requirements increase massively for the care pathway segment.
    3. The population is ageing and increasing. The health care system will have to support an additional financial burden with the passing of the years because we know that the majority of the costs is generated toward the end of life. Hospitals are paid today according to their own efficiency (shorter hospital stays as well as improved outcomes will generate higher payments from heath insurances). It is the OPM principle (Other People Money) meaning that the patient (who consumes) is not the payer. It is then crucial to find new solutions to reduce the costs.
    4. Understanding the disease is more than fundamental. Compliance and adherence management and control in order to avoid hospital readmissions is one of the main issues of the whole healthcare system. Beyond that point, enhancing and improving the patient’s experience as well as the quality of care could well trigger new motivations for the patient to be compliant to his treatment.
  • Go beyond sensors-mobile-cloud-dashbord to include blockchain technology, augmented reality, internet of things… + any relevant technology or innovation that can bring value to the system. This value has to be demonstrated and proved as viable for the whole system.
  • The technology has to be integrated in the patient’s experience, nearly invisible, but not less complex.

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PATIENTS LIKE ME – THE POWER OF WE
By Chris Fidyk, Business Development Director Europe

  • Accelerating research and development of new treatment but also allowing patients to support each other and exchange life experience with a disease is the main goal of PatientsLikeMe. That network is maybe the smallest social network but the larger medical registry with more than 500’000 patients. Patientslikeme provides tools for patients to put their disease into context.
  • Today, there is a lot of momentum about patient centricity. It becomes more mainstream. Patients owe other patients their own experience (drugs, symptoms,…). Empowering people to express themselves about their journey in the disease. Then, when all the stories are aggregated, meanings and trends can be extracted.
  • It is also possible to see all people taking the same drug, its perceived effectiveness as well as some conversation analytics allowing to understand which symptoms are the most talked about, the treatment awareness, the barriers to access in addition to the reasons behind their treatment failure or cessation or continuation.
  • Data (experience and discussions) stay online and available even when the patient dies to enrich other patients’ lives. Regular video postings on Patientslikeme Youtube channel show patients sharing their own experience with the website and how it helps them cope with their disease.

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ROCHE DIABETES CARE – EHEALTH: THE FUTURE WE CREATE TODAY
By Horst Merkle, Diabetes Management Solutions Director

  • You can only do something with data when you can access to it.
  • Infrastructure is the foundation for innovation and creativity” – as quoted by a speaker at the Connected Health Conference.
  • How to meet the future? The lack of healthcare staff, the increase in chronic diseases and the rising healthcare costs are the challenges. How to manage them: accountability and empowerment for the patient and the consumer. Mastering your own health with less health and care services.
  • Today, technology-driven health is messy. The solutions have to be easy to use and secure for the patient.
  • The Personal Connected Health Alliance (PCHA) is at the forefront of health and wellness in today’s society, driving advancements in mobile and communications technologies, and the growing use of new devices, health trackers and apps by consumers and healthcare providers.
  • PCHA brings together the critical elements needed to ensure that these technologies are user-friendly, secure and can easily collect, display and relay personal health data. In PCHA’s vision for healthcare, consumers can use readily available technologies to access their personal health data, receive targeted health and wellness education, consult with healthcare providers and gain support from friends and family to improve their health.
  • PCHA focused on engaging consumers with their health via personalized health solutions designed for user-friendly connectivity (interoperability) that meet their lifestyle needs.
  • Business models are the main obstacles for interoperability to work.
  • Accu-Check Connect System from Roche provides an integrated meter, an app, and online tools for better diabetes management. The glucometer can share data in the cloud with the healthcare provider.

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WITHINGS – FROM QUANTIFIED SELF TO PREVENTIVE MEDICINE
By Alexis Normand, Health Development Director

  • The main goal of Withings is to sell connected products to the general public. Those products can be bought in supermarkets and will help the consumer monitor vital signs such as weight, blood pressure,… Without being a doctor, the consumer can create a dashboard for his health. Changes in health are driven by him and, due to the fact that he generates data, he will be at the center of the data collection and analysis.
  • Those tools could also be used to enhance corporate wellness and engage employees through gamification. Employers will offer a connected bracelet and will organize a competition. Employers are however inherently screening employees for health issues and can analyze aggregated data to discover trends. Data around workout and physical activity are enriched by environmental and lifestyle inputs but also by stress management and absenteeism information.
  • In the e-health field, we are in the prevention area and also on new territories like personal health dashboard and employer focus on employees’ health.
  • E-health could be widely applied together with EHRs (Electronic Health Records). Linking EHRs to outcomes allow hospitals to monitor their performance to get more money from payers as they will limit the expenses for the system as a whole.
  • Withings also builds an open health data platform with the implementation of national observatories aggregating data from all the users. Those platforms will support research on connected devices with scientific publication and could stimulate partnerships and collaborations with other data sources.

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GROUPE MUTUEL – IGNILIFE – DAILY HEALTH COACH
By Stéphane Andematten, Marketing Leader

  • Real world business case from concept to realization in partnership with the startup Ignilife.
  • Today more than 165’000 health apps are available with 40% dedicated to medical uses and 60% to wellness.
    Regarding Switzerland, few initiatives have been developed to date. Groupe Mutuel would like to be the forerunner and not a follower in the field.
  • Ignilife is a French startup with a subsidiary in Switzerland. It is the perfect combination of entrepreneurship, medical skills and user experience. Ignilife has a previous experience with Malakoff Médéric, the leader for private health insurance in France.
  • Ignilife is a e-coaching platform based on people. It covers physical and emotional wellbeing. A first auto-evaluation is performed by the user in order to have a broad overview. An assessment is then released by the system with risk factors and advices to manage and lower their impact. Support and follow-up is provided as a selection of programs the user can choose from. He can also connect his devices.
    Close to 300 video and audio plays are available. Each time a contest or challenge is won, it is input in the platform to show the progress and evolution.
  • It is essential to develop a rich, engaging and fun platform to keep the user motivated. The goals set are reasonable and not out of reach. There is a social media component where users can exchange experience and tips. More functionalities will be developed in the next future (health at work, back health, burnout prevention,…)
    Data protection is well managed, as all the data are stored in Switzerland on independent servers.
  • Groupe Mutuel pretends it does not use data collected by user but only on an aggregated basis. The rationale behind the implementation of such a project is the focus on prevention. It will help to keep health expenses at an acceptable level in the longer term.
  • Some stats:
    25’000 Ignilife users (out of more than 1’100’000 insured people)
    Mobile users connect much more than desktop users (2x)
    91% did their auto-evaluation
    61% engaged in a coaching program
    47% changed their habits

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MANAGE MY DATA OR BE MANAGED BY MY DATA
By Stéphane Koch, Expert in Digital Experience

  • People like to measure their own weight, the calories they burnt, their heart rate,…
    There is a real value added in using quantified self.
    However, coherence is not always part of the measures and can distort statistics extracted out of the data. Sensors sometimes lose connection with the app leaving gaps or errors in measures. Improving apps with coherence system would be a big step further or even allowing the user to correct the data himself.
  • Quantified self generally has a positive impact on the user’s wellbeing but it can also generate stress if the progress takes time to emerge or if it stops. Knowing the scope of the technology as well as his body are fundamental.
  • The website DMD (in French) allows the evaluation of digital tools and the sharing of everyone’s user experience.

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CIPRET – 7000 SWISS PEOPLE STOPPED SMOKING THANK TO A FACEBOOK PROGRAM
By Alexandre Dubuis, PhD, CIPRET Valais leader

  • CIPRET is a center for the prevention of tobacco use, recognized of public interest by authorities.
    It launched early 2016 a program to help people stop smoking via Facebook.
  • A real human adventure started and succeeded. The initiative was in 2 phases: recruitment and program on the same platform. It was completely free for the users. They just had to like the page, say they are interested and accept that all the posts written by CIPRET were the first they saw when they opened their Facebook app.
  • 3 pillars of the program:
    – Daily advices (personalized and not always linked to tobacco consumption)
    – Group support (tips and experience sharing)
    – Physical desire to smoke (will only last between 3 and 5 minutes => tips given to avoid relapse).
  • Professional support has been organized at 3 levels : the first one, community managers answer simple questions ; the second one, prevention experts take specific questions ; the third level, medical practioners take care of medical questions.
  • Some stats:
    1’500 posts created
    Support was on call during the whole week from 6am to 11pm
    13’000 messages have been answered in the first weeks
  • Key strengths: no moral scolding, always up-to-date, focus on workouts, nutrition, Sunday evening chats, real meeting groups.

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L.I.F.E – EXPRESS YOUR TRUTH THROUGH YOUR ACCURATE DATA
By Dario Ossola, PhD, Algorithm R&D Coordinator

  • L.I.F.E stands for Live – Inspire – Free – Entertain
  • The project started at the core of The Ark and focused on predictive models for tiredness, exhaustion and strain with the development of a garment.
    That garment is equipped with sensors to monitor vital signs (it is medically accurate and there is no need of a smartphone). It allows total freedom.
    It can be the third platform of communication (with the first 2 being computers and smartphones).
  • The medical accuracy is fundamental and it can be used in medical practice but also in sports. That garment has the same results as the invasive methods to analyze vital signs. It allows real life measurements and expansive communication (data omnipresence, diverse data analysis levels).
  • Two web sites: http://x10x.com/ (for women) and http://x10y.com/ (for men)

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ISYPEM2 – PERSONALIZATION OF TREATMENT DOAGE THANK TO MEDICAL DATABASES
By Séverine Petitprez, Scientific associate, Clinical pharmacology CHUV and Alevtina Dubovitskaya, Research assistant, HES-SO Valais

  • Software for personalized treatment dosage.
    Unique treatment dosage works very well for simple drugs like paracetamol. Unfortunately, for oncology or chronic diseases drugs, which are much more complex molecules, it doesn’t work as well. It can lead to toxicity, side effects or no effect at all.
  • Therapeutic follow-up normally starts with a blood sample, pharmacology experts interact and guide the doctor in order to personalize the treatment.
  • A new software (EzeCHieL) do exactly the same but in a much faster and more practical way. The software can create the patient’s drug metabolism curve based on the EHR (Electronic Health Record) and medical databases. Some genetic characteristics or co-morbidities can lead to changes in drug blood concentration.
  • Interoperability (web interface) as well as confidentiality and data security are guaranteed (pseudonymisation, anonymisation).

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KARMAGENES – BE A GAME CHANGER MEET YOURSELF
By Kyriakos Kokkoris, CEO

  • Karmagenes is a game combining gene profiling and psychological analysis. Integrating genetics with psychology for improved personal development.
  • What defines who you are: what you are (DNA) and where you live (environment & perception).
  • Genetics meet psychology.
  • Human centric approach
  • Could be a network of personalities and connect locally.
  • Personal guide for career development, personal motivation, and physical as well as emotional well-being.

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PANEL DISCUSSION – E-DOCTORS AND E-PATIENTS, AN EMERGING RELATIONSHIP
Moderated by Sébastien Mabillard, Swiss Digital Health coordinator with 5 paticipants: Dr. Jean-Gabriel Jeannot; Dr. Pietro Scalfaro; Pierre-Mikael Legris; Christine Bienvenu; David-Zacharie Issom.

  • The market is not yet mature, a lot of opportunities are waiting to be seized.
    The patient is at the center of all motivations.
  • Despite new technologies, there is a lot to do to reach the patient. Few success stories (the CIPRET is however an excellent example).
  • What about doctors’ digital education? Patients are really driving the trend today; they stimulate doctors to be up to date and they push technology adoption.
    Patients are very often looking for information online. Doctors should be prepared and help patients to use the right web sites in order to find appropriate and correct information. Doctors should also contribute and provide content on website to populate them with correct information.
  • All that information help to start interesting conversations. Information exchange should also be facilitated. The patient could be educated to provide the appropriate amount of information to avoid overload.
  • Patient should take part and be part of medical research. The patient is the least used resource in health care. With patients’ associations, precious information is stored and exchanged. That data can be analyzed.
  • The social component is extremely important for patients. Several of them like to share their experience and find support online. They also feel useful to provide information for other that have been diagnosed recently.
  • By giving access to medical and health information, communication and interactions with doctors will be easier and improved.

Theranos – A recipe for disaster?

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A lot has been said and written about Theranos. My goal in this blog post is not to reinvent the wheel but to guide the reader toward meaningful and relevant web content about this story.

Like everybody else I was fascinated by the rise of Elizabeth Holmes without questioning the technology itself. Why? First, at that time, it was not one of the company I was considering for analysis (and investment opportunity) and, second, because sometimes technical words and concepts are difficult to understand and you do not have the time to dig further.

Needless to say that my interest grew stronger when I saw that the company and its technology as well as its founder were under scrutiny… As I’m very curious I tried to understand.

My first objective was to find the timeline of the events. Interestingly, the fall started in October (2015) like the majority of stock market crashes… Autumn may be the season for distrust or maybe mistrust… (in this case for good reasons!).

Beyond what has been shown and written in the media, it is key to understand the path that led the company in this situation and the potential mistakes made so far. It seems that more experience on board could have helped and maybe avoided misdirection.

Management errors could have doomed the company but the most problematic issue may well be the reputation: not only the company’s one but also the ones of all the other diagnostic start-ups in US and Europe. Investors will be much more skeptical. On the other hand, it also shows that due diligence and analysis (not only financial but mostly technical and scientific) must be done before investing in order to limit and frame the risk.

The media obviously played a significant role in pushing, developing and supporting the hype behind Theranos. The reality of media pressure and the underlying celebrity fame are far from innocent.

Another point, which should have made us raised a red flag, is the fact that none of the big names in biotech investing took a single share of Theranos capital. Well-known investors are generally an excellent benchmark even if they are not immune to failure.

This story is really amazing and I will update this blog post each time I have relevant material to make it easy to follow the case.

So, stay tuned!

 

Relevant sources and articles:

The rise and fall of Theranos – A cartoon history – July 2016

Theranos Doomsday Clock – MedCityNews – February 2016

What Theranos and Elizabeth Holmes Have Always Misunderstood – INC – April 2016

Theranos debacle may scare investors away from diagnostic technology – STAT – April 2016

Theranos’ Lab Problems Go Way Deeper Than Its Secret Tech – Wired – April 2016

The secret culprit in the Theranos mess – Vanity Fair – May 2016

The Theranos Scandal Is Just The Beginning – Fast Company – May 2016

Theranos’ Voided Tests Could Make It a Magnet for Lawsuits – Wired – May 2016

 

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Top 15 Pharma companies – Q1 2016 performance wrap-up

Wall Street

The Q1 2016 earnings season is now over. It is always nice to take a step back and compare the big names of the pharmaceutical industry.

Below you will find the key figures published by the most important companies in the industry.

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Life Sciences Innovation Hotspot

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An event has been organized in Geneva (Campus Biotech) in order to give an overview of funding opportunities in R&D in Switzerland. European as well as Swiss opportunities were explained, each time with insightful success stories and business cases.

That event combined both useful information together with relevant stories of companies having experienced the process, sometimes time-consuming but clearly worth the efforts.

Horizon 2020 was an extremely important topic during the event as Switzerland is now in a partial association framework with EC (Fact Sheet on the Status of Switzerland in Horizon 2020).

Below I summarized the key points and “take home messages” from the event in a MindMap format (much better than taking notes and reading them afterwards).

The event was organized by Inartis and BioAlps.

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The potential for disruption in healthcare by Apple

Port_and_lighthouse_overnight_storm_with_lightning_in_Port-la-Nouvelle

A lot has been said about the role of Apple in healthcare, the disruption it could bring and the need for it. If Steve Jobs was alive today, he would surely help the healthcare industry improve.

There is a lot of work and some progress are currently being made but they are slow to implement because evolution is not always seen as such (we all know about the learning curve…).

Apple is not the only company that could bring change and improvements, even disruption, in healthcare. All the technology companies are interested in this field and they will inevitably contribute to change the landscape.

What could Apple bring?

Analyze and integrate health data

The introduction of HealthKit in June 2014 was the start of a big wave of healthcare initiatives launched by Apple. Data collected via the HealthKit through wearables like the Apple Watch can be shared with the user’s doctor in order to improve the doctor-patient relationship. Data can then be integrated in the EHRs (Electronic Health Records) of the patient in order to enlarge the data collection.

Beyond data collection stands data analysis and it’s done with the help of the partnership with IBM Watson to support this effort.

Improve EHRs and real-time medical data to broaden prevention initiatives

Merging EHR and real-time data could enable the use of predictive analytics to anticipate health issues and diseases spread.

The implementation of EHRs could simplify and quicken the collection, use and consultation of medical data, especially in the case of emergencies. This could dramatically help to avoid medical errors due to the lack of specific retrospective information.

Partnerships

Apple has been and is still extremely smart in building strategic partnerships. 3 main partners worth keeping in mind:

  • IBM Watson: storage and analysis of raw data on IBM Watson Health Cloud for the data collected on HealthKit and ResearchKit.
  • Mayo Clinic: access to over 1 million patients in several countries around the world using dedicated proprietary EHR and communication tools for doctor-patient interactions.
  • Epic Systems: expertise in EHR covering over 100m people in USA.

HealthKit & ResearchKit

The main goal of the HealthKit is to collect data from wearables and other connected devices to better monitor individual health. HealthKit also allows the integration of 3rd party apps and devices.

ResearchKit is an add-on to the HealthKit as it helps create apps to improve clinical trials and medical studies.

Apple Watch v. 2.0 and new wearables

The new versions of the Apple Watch could potentially be developed into more sophisticated health-tracking devices with improved heart rate monitor. Moreover, thank to non-invasive technologies, new vital signs could to be captured and analyzed more accurately.

 

Related sources:

Why healthcare needs a Steve Jobs-like disruptor, STAT, February 2016.

Three More Industries Apple Could Disrupt, re/code, July 2015.

Steve Jobs didn’t disrupt, he adapted. So should healthcare, Becker’s Hospital Review, July 2014.

The Industries Apple Could Disrupt Next, Harvard Business Review, June 2014.

 

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Top 15 Pharma companies – 2015 performance

Oldremedies

Nearly all of the companies already published their 2015 financial results. Performances varied widely and some clearly outperformed others as in any industry.

The 2015 best company is Gilead: what an amazing performance! In less than 2 years, it reached the Top 15 Pharma companies. More than USD 19 billion of sales had been generated from Harvoni and Sovaldi, both disruptive drugs against hepatitis C. 58% of 2015 sales came from those 2 products. Diversification will be the next challenge for the company.

The table below summarizes the main financial data points for 2015:

2015_Top15Pharma

Teva has not yet published its results at the time of my post. I’ll update it later on.

*For Takeda, the company released only its 9-month results and for comparison purposes I extrapolated the 9-month into a 12-month period.

After populating the table, 2 aggregates have been computed:

  • Total sales in 2015 from Top 15 Pharma companies: USD 487 billion
  • Total R&D expenditures in 2015 from Top 15 companies: USD 82.5 billion

All in all, the big names of the industry spent close to 17% of their sales in research and development.

When we look at the 4th column in the table, year over year growth in constant currencies is between 0 and 8% apart for 2-3 companies like AbbVie (linked to the Pharmacyclics acquisition in May 2015), Bristol-Myers Squibb and Lilly.

Generally speaking, the pharmaceutical industry is still a cash-rich and good performing industry. More challenges will probably come from pricing pressures around the world (and this time not only Europe or Japan, but also from the USA).

 

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The opioid pain drug misuse problem solved?

Children's_pain_scale

Today using opioids to treat chronic pain seems quite obvious for a lot of clinicians. This trivialization, beyond the responsibility of both the clinician and the patient, is responsible for the dramatic increase of opioid misuses and overdoses.

An excellent article written by Dr. Daniel Alford in the last issue of NEJM proposed smart solutions. Prescriber education is one of them. It would allow a more specific approach to addressing the opioid-misuse epidemic: benefit-risk assessment of patient’s needs and care individualization. It should be completed with patient close follow-up and monitoring as well as the careful evaluation at each encounter of whether to start, continue, decrease, increase or stop the treatment.

Training should start early in the medical education and students have to be aware of the best practices for that type of prescription. All the options for chronic pain management have to be taught and not only to doctors but to all healthcare providers in order to tackle the lack of awareness and education in the field.

Beyond drugs, other alternatives should be tested and proposed, especially when an opioid-based treatment is stopped. Explanations have to be provided in order to reassure the patient that his/her pain is manageable without this type of drugs.

The whole discussion, and a whole lot of other healthcare themes, are closely linked to the doctor-patient relationship. Trust, collaboration and open discussion are all key in order to have the best outcomes for the patient.

As a conclusion, I would like to invite you to watch the fantastic talk given by Elliot Krane, an expert in chronic pain about how this disease invades the body, what are the treatment options and what’s next.

 

Additional information:

Overdose Death Rates – US National Institute on Drug Abuse

Understanding the Epidemic – US Centers for Disease Control and Prevention

How drug use changes the brain — and makes relapse all too common – STAT – April 2017

The Painkillers That Could End the Opioid Crisis – MIT Technology Review – August 2016

Opioid Prescribing for Chronic Pain — Achieving the Right Balance through Education – NEJM – February 2016

Mortality Trends Among Working-Age Whites: The Untold Story – The Commonwealth Fund – January 2016

Trends in Opioid Analgesic Abuse and Mortality in the United States – NEJM – January 2015

When Pain Kills – AARP – September 2015

Opioid Addiction Facts and Figures – ASAM

Assessment & Management of Chronic Pain – Healthcare Guideline – ICSI – November 2013

 

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Gender-specific medicine is necessary

Couple

What’s gender-specific medicine?

As stated in a well-known article, “Gender-specific medicine is the study of how diseases differ between men and women in terms of prevention, clinical signs, therapeutic approach, prognosis, psychological and social impact. It is a neglected dimension of medicine.” Medical research conducted over the past 40 years has focused almost exclusively on male patients.

How men and women are different?

Differences could lead to wrong diagnosis, symptoms underestimation, and even premature death. Differences appear in a variety of domains such as:

  • PKPD (pharmacokinetics & pharmacodynamics): efficacy and side effects profiles as well as drug-drug interactions.
  • cardiovascular diseases: risk factors for these diseases; clinical manifestations; influence of drugs (see below for more).
  • cancer: incidence; aggressiveness and prognosis.
  • liver diseases: epidemiology and progression.

The main goal

The main goal of gender medicine is focused on understanding the differences of patho-physiology, clinical signs, prevention and treatment of diseases equally represented in men and women.

Advocacy

Advocacy in this field is emerging with amazing women like Marianne Legato, Alyson McGregor and Noel Bairey Merz, whose conference and TED Talks below really show the decisive importance of this discipline.

Conclusion

Traditionally, research has been done almost entirely on men and those conclusions were then applied to both men and women. Even though the law requires that women be included in studies, the gender-different results are almost never analyzed. Instead, they are blended. This is detrimental to both men and women. Perhaps now is the time for everything in research and medicine to be reviewed in the light of potentially significant gender differences.

Additional resources:

The Foundation for Gender-specific Medicine

Why Sex Matters

Women’s Heart Attacks Look Nothing Like Men’s – TIME – 2016

Gender-Specific Medicine in the Genomic Era – Clinical Science – 2015

Sexism In The Doctor’s Office Starts Here – Even actual lab rats are subjected to science’s male bias – HuffPost – 2015

Why Gender-Specific Medicine Matters in the Emergency Department – Emergency Physicians Monthly – 2015

Gender medicine: a task for the third millennium – Clinical Chemistry and Laboratory Medicine – 2013

Men and women get sick in different ways: Developing gender-specific medicine is a major challenge of the future – Science Daily – 2013

Incorporating and evaluating an integrated gender-specific medicine curriculum: a survey study in Dutch GP training – BMC Medical Education – 2009

 

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Big Pharma Q3 2015 Financial Results Wrap Up

WallStreet2

In the following table, the top pharma companies (ranked by 2014 annual sales) key stats for Q3 2015 are detailed in their reporting format and currency.

Currency  Q3 2015 sales (bn)  Growth yoy (CER)  Q3 2015 operating profit (bn)  Op Margin (%) Publication date
Novartis USD 12.30 6.0% 2.23 18.2% 27.10.2015
Pfizer USD 12.09 4.0% 3.28 27.1% 27.10.2015
Roche CHF 11.78 5.0%  Undisclosed 22.10.2015
Sanofi EUR 9.59 3.4% 2.78 29.0% 29.10.2015
Merck & Co. USD 10.07 2.0% 2.34 23.2% 27.10.2015
Johnson & Johnson USD 17.10 0.8% 4.80 28.1% 13.10.2015
GlaxoSmithKline GBP 6.13 9.0% 1.72 28.0% 28.10.2015
AstraZeneca GBP 18.31 0.0% 4.56 24.9% 05.11.2015
Gilead Sciences USD 8.30 Undisclosed 5.59 67.3% 27.10.2015
Takeda JPY 904.00 3.8% 110.40 12.2% 30.10.2015
AbbVie USD 5.94 26.2% 1.89 31.7% 30.10.2015
Amgen USD 5.72 16.0% 2.34 40.9% 28.10.2015
Teva USD 4.82 -7.3% 1.55 32.1% 29.10.2015
Lilly USD 4.96 10.0% 0.96 19.4% 22.10.2015
Bristol-Myers Squibb USD 4.07 11.0% 0.99 24.3% 27.10.2015
Bayer Healthcare EUR 5.65 10.9% 1.22 21.6% 29.10.2015
Novo Nordisk DKK 26.79 20.0% 11.98 44.7% 29.10.2015
Astellas JPY 687.50 15.7% 145.17 21.1% 30.10.2015
Allergan (former Actavis) USD 4.81 Undisclosed 1.94 40.4% 04.11.2015

Notes:

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Connecting Innovators in Life Sciences and Information Technologies – Lift Basel Conference 2015 – Day 2

LiftBadge

As promised, the summary of the 2nd day. I must admit, it is a bit long but all these topics were fascinating and the speakers really stood out from the “crowd” with excellent ideas. If you do not wish to read it all, just have a look at the headlines by scrolling down and skip to the topic that catches your eye.

Surgeons superpowers

Hans Florian Zeilhofer
Engineering the augmented surgeon

With the current trends in demographic development,more than 2 million people in Switzerland will be over 65 in 2050. What does it mean? More surgery as ageing is very often the synonym of diseases.

Surgery is more and more helped by technological tools, especially for complex cases like facial surgery where augmented reality could be really useful. But, technology has to be human centered and it is the moto of Mimedis, a fab lab for surgeons. Together with small interdisciplinary teams, the company focuses on design and manufacture (3D printing) of patient specific bone implants.

The speaker is not only the founder of Mimedis but also the initiator of MedTech Innovation Partners (MTIP), which helps finance innovative medical technologies. MTIP has a clear focus on innovations within health technologies. It offers business building support as well as continuity of funding and its network to accelerate growth.

More on augmented reality in surgery:

Augmented Reality for CMF-Surgery – Basel University

A Look into the Body – Augmented Reality in Computer Aided Surgery – Munich University

Philippe Cattin
Reinventing bone surgery

Nothing has changed fundamentally on how things are cut in surgery. But laser could be extremely helpful, leading to finer and more precise cuts. Plates will need to be smaller and even resorbable.

This technology also makes it be possible to perform functional cuts in order to avoid pain for the patient. It is a complete new thinking about how surgery is executed. No more straight cuts for an improved healing.

Together with enabling technologies, such as navigation and robots holding laser, surgery will be much more efficient with reduced doses of anesthesia and better recovery time.

The surgeon will not be replaced but empowered and the robot will be part of the surgery team.

AOT is dedicated to the development, manufacturing and sales of medical devices for osteotomy pursuing the vision of contact-free bone surgery using laser, robotics and navigation systems to re-invent bone surgery (osteotomy). 3 lasers are built into the system; one of them is a ruler and will measure across the cut. The main product, Carlo, is a robot, currently tested in animal experiments.

More on laser use in surgery:

Laser-cutting of bones replaces sawing – Nominated for the CTI Swiss Medtech Award 2015

Raimund Erdmann
Human-centered design

Innovation strategy coupled with human-centered design will deliver corporate value. Human-centered design is the primary goal of Erdmann Design.

HCD

For human-centered design to produce worthwile results, several and diverse stakeholders are requested to interact and think on how can you help with low tech simple solutions. Stand where problems occurred helps understand better the real context and will generate more relevant solutions.

More on human-centered design:

Usability results through human centered design and early test models – Medical Cluster Meet the Experts 2014

More on Swiss Med Tech Industry:

Swiss Medical Technology Industry 2014

Doctors and patients revisited

Haig A. Peter
Outcome-based healthcare

It is not big data anymore but it is a tsunami of data. Not only text data but pictures, videos, sensor data… and 90% of the data was created in the last 2 years.

How can we use it? What’s in there?

  • Clinical data only represents 10% of data
  • Genomics factors reprsent 30%
  • Exogenous factors represent 60%. What do we mean when we say exogenous factors? It’s the information about lifestyle (diet, sport, smoking,…), behaviors, drug adherence. It is immensely useful when combined with all the other types of information.

Machine vs. Humans?

Humans are the best machine ever because of feelings such as compassion, intuition, design, value, judgement and common sense. No robot or machine is ever capable of such skills. However, machines have huge learning capabilities, especially deep learning (+ machine learning), discovery, large-scale math and fact checking. The last competency is crucial because, as of today, we do not know exactly what’s true on the internet.

The key: Human + Machine – rethink whats possible, what would you do, how could we use it…

Examples:

Memorial Sloan Kettering teams are partnering with IBM to train Watson to interpret cancer patients’ clinical information and identify individualized, evidence-based treatment options that leverage doctors’experience and research. Big data could stimulate the building of knowledge for diseases without current treatment option – what can we do, other medications, which data do we consider,…

Watson will help reduce the time of drug discovery by identifying markers quicker and accelerate the time to market for drug projects.

Welcome to the cognitive era!

More about IBM Watson in healthcare applications:

IBM Watson Health

Watson in Healthcare

IBM pushes Watson into healthcare with new business unit – Barb Darrow – Fortune 2015

Cécile Monteil
The impact of technology on the patient-doctor relationship

Talking with patient was key before, science has now made huge progress. From “medicine is art” to “medicine is a science”. As a result, medicine today is taking the human touch away.

For a patient, talking and having explanations about the results of an exam is as important as undergoing an exam. Technology is here to increase the productivity of tasks but the relationship between the doctor and his patient has to stay and to be developed further. The human part of the process is already key in the healing process.

Technology can connect people. Today, technology allows patients to find information and to empower them. Participation in decision-making about treatment options and pathways is relevant for patients. Moreover, smartphone and connected objects can help track patient symptoms and treatment choices. It is used today for Type 1 Diabetes glucose monitoring.

With connected objects it is easier to monitor body parameters. Furthermore, doctors will be informed of those parameters and will be able to act upon.

The patient has to be at the center of care, beyond simply being part of the loop.

New types of expertise will show up, like medical data scientist, care coordinator, prevention doctor, education nurse,… and whole teams will collaborate in order to take care of the patient for better outcomes.

More about connected health:

Eppocrate

Santé connectée : quelle révolution pour la recherche médicale ? – TEDxUTCompiègne 2015

Patricia Sigam
Digital health – Time for new players
Integrated care – digitalMedLab

Yesterday, the patient-doctor relationship was compassionate, coordinated, comprehensive, continuous, accessible and family-centered. Today, the change is not only technological but also societal.

Patient-centered care is paradigm change, in which patients would like to be considered a they are and not as animals. A whole new ecosystem is emerging and developing itself.

Between a patient and his/her doctor, very often, there is a nurse. Thus, it is more a patient-nurse system or relationship.

But who is the expert?

It is crucial to visit the right expert that will be able to pose the right diagnostic. Provider empowerment (or nurse empowerment in this case) via technology will free time for the doctor while the nurse will do the consultation and collect the data to send them to the doctor. He will then be able to analyze them and act upon.

An interesting example comes from the dietitians of Canada, following obese patients and being their point of contact or new reference to talk to instead of the doctor.

Technology allows patients to stay connected with healthcare professionals following them. In addition, digital technology makes it possible for healthcare professional to be empowered.

Furthermore, caregivers and relatives can use digital technology as well. For example, Alertwatch is a tool giving relatives access to the localization of the loved one on a GPS map. Needless to say that caregivers will have more serenity, increased freedom themselves and improved information on the patient.

Remote support is complementary to human support without replacing it.

More on patient-centered care:

Patient-centered medicine and patient-oriented research: improving health outcomes for individual patients – José A Sacristán – BMC Medical Informatics and Decision Making 2013

Time for a Thorough Evaluation of Patient-Centered Care – Paul A. Heidenreich – Circulation: Cardiovascular Quality and Outcomes 2013

Patient expectations and the paradigm shift of care in emergency medicine – Fatimah Lateef – Journal of Emergencies Trauma and Shock 2011

Global ageing

Alexandra Stolzing
Solving ageing by reprogramming cells

The human metabolism will slowly start to malfunction when we age. This will lead to damage and initiate some age-related pathologies.

The speaker shows us how she works on reprogramming cells.

ReprogrammingCells

Reprogramming is not only reversing aging. It will reboot the cell and it will restart as a fresh cell.

Reversing Ageing

Reprogramming in vivo is the next step. For example in order to repair an infarcted heart.

More on reprogramming cells:

The aging signature: a hallmark of induced pluripotent stem cells? – L. Rohani & al. – Ageing Cell 2013

Aging and reprogramming: a two-way street – S. Mahmoudi – Current Opinion in Cell Biology 2012

Manouchehr Shamsrizi
Gamification for better living

The speaker is the CEO of RetroBrain R&D and trying new approaches promoting people to live healthier. As we all know, it is difficult to incentivize now for long term benefits. The key to have a switch into the behaviors, it to change the way it is percieved: you change your behavior because it is cool and not for long term benefits.

Gamification and videogaming are fundamentally different from the actions you could perform right know. You do not even realize you are changing your own behavior.

How to motivate people? The game is challenging you again and again and when people succeed, they have a dopamine surge. These games influence will stimulate the brain and could delay dementia because of movements, social dimension and brain activity. The game can be personalized with car shapes and music appreciated by the patient.

We should have fun when we are ageing. Interview in German and RetroBrain demo.

More on gamification in health:

Gamification in healthcare isn’t just about playing games – J. Kim – Tech Target Search Health IT 2014

From Fitbit to Fitocracy: The Rise of Health Care Gamification – Knowledge @Wharton 2013

Top Ten Gamified Healthcare Games that will extend your Life – Yu-Kai Chou

Exploring the Potential of Gamification Among Frail Elderly Persons – Gamification Research 2011

Scott Smith
New emerging business models connected to the ageing society

The speaker is the founder of Changeist. For him, it is fundamental to look at the macro picture when it comes to ageing.

He took the interesting example of Paro, a companion cuddle robot. It is a seal puppet therapeutic robot. It has been tested is geriatric facilities to help patients cope with multiple diseases such as dementia.

GreyingWorld

Source

The demographic time bomb challenge is fairly widespread.

Which solutions? Which possibilities?

  • Full automation, robots helping us, freeing time for more leisure
  • Designing our future
  • Human-machine combination – the pairing has to be culturally and socially acceptable
  • Senior Quantified-Self. These technologies will probably transform the way many families care for their loved ones. Estimated market size USD 14.6 bn in 2019.
  • California Life Company – Calico. It will help bring new technologies to the market and promote their adoption for a better management of ageing.

Intervention is easy to develop but the scale up is very difficult mainly for economic reasons.

More on ageing and new business models:

The New Booming Market? Aging Baby Boomers – C. Desmarais – INC 2014

The Economic Conundrum of an Aging Population – WorldWatch Institute 2004

Developing New Business Models in the eALT Sector – Coventry Consumer Models for Assisted Living

Strategic openness in life and data science

Bastian Greshake
Human genome: why sharing is crucial?

We are limited to reading the human genome and making sense of some of the parts today. Genetic testing goes mainstream.

Growth in DTC Genetic Testing

Source

Sequencing vs genotyping? (definitions from 23andMe)

Genotyping is the process of determining which genetic variants an individual possesses. Genotyping can be performed through a variety of different methods, depending on the variants of interest and resources available. For looking at many different variants at once, especially common variants, genotyping chips or arrays are an efficient and accurate option. These do, however, require prior knowledge of the variants you want to analyze.

Sequencing is a method used to determine the exact sequence of a certain length of DNA. You can sequence a short piece, the whole genome, or parts of the genome (such as the “exome,” which are the parts of the genome that contain genes). Depending on the location, a given stretch may include some DNA that varies between individuals, like SNPs, in addition to regions that are constant. Thus, sequencing can be used to genotype someone for known variants, as well as identify variants that may be unique to that person.

With genotyping, we look at SNP. We can then make some predictions with those data. For example: to see whether I will pass some of these genetic characteristics to my children. It is also widely used for ancestry analysis and microbiome exploration.

Why should this data be open?

Snpedia is sharing genomic data and helps determine whether you have higher risk. Connecting data to others can save lives. Big data is needed in this field.

Dna digest is promoting data sharing because of limited publicly available data despite huge sequenced DNA.

Examples for open data: personal genome project, opensnp, openhumans

More on the human genome:

Website: The Human Genome – Poems on the Book of Life

Tiny Genetic Differences between Humans and Other Primates Pervade the Genome – K. Wong – Scientific American 2014

Genomic data sharing for translational research and diagnostics – P. Robinson – Genome Medicine 2014

Marion Colombani & Paul Willis
Open science to advance drug discovery in neglected diseases

Malaria takes it toll on children as 86% of deaths are noted below age 5. Despite the 47% reduction in death since 2000 thank to an UN initiative focused on trying and improving public health in developing countries, the world still needs medicines to tackle the disease.

The traditional model of drug development in silos, obsessed by profitability and shareholders value is not working for developing countries. A reassessment on how we do drug discovery in this field is necessary.

A new model with a public health focus should be developed, like product development partnership. Interesting projcts are selected and funded. Advisors work in close collaboration with partners and open source science experienced.

OpenSourceScience

Open innovation is the standard model of MMV.

How do they fund their late stage development candidate? They try to find a willing pharma partner or secure sufficient public funding.

Open Access initiative: empowering research.

20’000 drug discovery starting points have been published, MMV selected 400. They are all commercially available.

Another initiative has been launched in order to enrich the drug discovery database: the Malaria Box. Launched in 2011, it has already been supplied to 30 countries for a total of 218 boxes.

A new project: the Pathogen Box, same initiative for neglected diseases to stimulate further research.

There is an ever increasing role of open source in new drug discovery models.

More on open source drug discovery:

Open Source Drug Discovery in Practice: A Case Study – C. Ardal – PLOS Neglected Tropical Diseases 2012

The Open Source Drug Discovery Project: Need for Global Collaboration – S. Brahmachari – 2015

Gernot Abel
Going open innovation and citizen science in biotech

The speaker sees brand new opportunities for collaborative innovation.

CollaborativeInnovation

How we manage, develop and initiate innovation will shift from traditional to open approaches.

FronTraditionalToOpenInnovation

When you create into a community you not only achieve, you exceed what you achieve.

Hackers want to change something and add a new innovation to existing products. The epicenter is both in US and Europe. Novozymes started recently to collaborate with hackers in an open mode. Biologigaragen is an open space for citizen science in biology. In addition, tools are getting cheaper, easier to use and more powerful.

Examples:

  • Open trons is a USD 3000 full lab available to everyone.
  • Transcriptic is a a fully automated cell and molecular biology laboratory in the cloud.
  • Arcturus BioCloud is a way of sharing biotech experiments.
  • SYNENERGENE is a four-years mobilization and mutual learning action plan (MMLAP) supported by the European Commission under the 7th Framework Programme.

NewHorizons

Joint value capture is fully present when engaging in open innovation.

For Novozyme, open innovation brings a lot:

  • Low cost analytical technologies
  • Evaluation on given technology and opportunities
  • Insight for business development projects
  • Spot the next big theme in biotech
  • Societal impact and mutual learning cycles

Last but not least – a fantastic lesson on how to engage in open innovation.

OpenInnovationTips

Connecting Innovators in Life Sciences and Information Technologies – Lift Basel Conference 2015 – Day 1

LiftBadge

I had the fantastic opportunity to attend the annual Lift Basel Conference at the end of October. The topics covered as well as the speakers were amazing.

I must admit, it is always refreshing to have access to all those passionate people with jaw-dropping experiences, new companies, innovative business models, renewed thinking (totally out of the box! even without the box!!)…

I really appreciated it and I’m delighted to share the main points with you, one talk at a time with added references on the discussed topic. I hope you’ll enjoy the first day! The second one is coming soon.

 

Synthetic biology today and tomorrow

Rob Carlson
Visions of the bioeconomy

Rob Carlson is interested in the future role of biology as a human technology. He has worked to develop new biological technologies in both academic and commercial environments, focusing on molecular measurement and microfluidic systems. He has also developed a number of new technical and economic metrics for measuring the progress of biological technologies.

Rob Carlson has been precisely predicting exponential drops in the costs of DNA sequencing and synthesis (reading and writing DNA), and resulting impacts on the global economy. The Economist magazine in 2006 identified this as the biotechnological equivalent of Moore’s Law, and named it the Carlson Curve after Rob.

Carlson_Price_Seq_Synth_Feb2014

Source

It was extremely interesting to see him explaining that, in biology, every piece has its purpose and, then, it can be repurposed. Needless to say, synthetic biology has evolved fantastically over time, from a single gene in a single cell to cell-grown organs as shown in the Nature chart below.

History_Synthetic_Biology

Source

Biotechnology will soon take over the other segments of the economy, like chemicals, energy generation,… Biochemicals are already competing today with oil chemicals. According to the last numbers recently published, biotechnology is the fastest growing field in the US economy. Economics are at the center as they are really driving the adoption of those technologies.

For more on Synthetic Biology, have a look at this article written by Tim Gardner: Synthetic Biology: from hype to impact (quote below).

“The promise of synthetic biology lies in its engineering roots. Engineers are trained to define, modularize, stan-dardize, characterize, specify, optimize, and control physi-cal systems in order to deliver reliable, repeatable outcomes. When such approaches are applied to biological experimentation, the results can be marvelous. When measurement systems and data are standardized and qualified, then biological knowledge can be stacked upon other knowledge in an information supply chain distributed across hundreds of thousands of people. If we standardize and improve the quality of biological characterization, then the tools for efficiently designing and building ever more complex systems will soon follow.”

 

Neil Goldsmith
New food ingredients into custom-built organism

Nature has treasures but sometimes we need huge amounts of raw materials to extract flavors or fragrances in tiny quantities. For example, vanilla is regularly made from petrochemicals and rarely extracted from vanilla seed pods as demand is far larger than supply.

Evolva developed a revolutionary technology to brew flavors from yeast.

For example, to manufacture Stevia, a natural sweetner, Evolva takes the genes the plant uses to make that molecule and put those genes into the yeast so it can make the molecule. They then ferment the yeast by brewing, just like with beer. The yeast takes up the sugar, turns it into Stevia and pumps it out; the yeast is filtered off and Stevia is in the «broth» which can be purified out.

Synthetic biology is an iterative process. It is not smooth, you need to go back and forth at each step. However, it has and will lead transformational changes on today’s science.

For more on Food Ingredients:

Synthetic-biology firms shift focus – Erika Check Hayden – Nature 2014

Synthetic biology is cheaper, faster and more sustainable – Elaine Watson – Food Navigator 2014

Widen everyone’s vision of what you can do with biology – Stephan Emmerth – i-net 2015

 

Xavier Duportet
Programmable biological agents

According to Xavier Duportet, editing DNA has become as simple as editing a newspaper. It is now possible to modify the DNA with a repair template.

That’s exactly what he’s doing: using CRISPR/Cas for the microbiome engineering. As we all know, antibiotics are not an adequate solution as they kill all the bugs… Bad and good ones. Eligo Bioscience, founded in May 2014 by Xavier Duportet as well as scientists and professors from the Rockefeller University and the Massachusetts Institute of Technology (MIT), found a fantastic way to tackle this issue: hijack the CRISPR/Cas system of the bacteria. Below a video (in French) explaining the technology.

Their “synthetic biology platform, which combines CRISPR/Cas system with engineered phage capsids, develops “eligobiotics”: a new generation of highly precise antimicrobials. They can program the eligobiotics to eliminate bacteria based on the genetic sequences they carry in their genome. As opposed to traditional antibiotics, their sequence-specific antimicrobials can therefore discriminate between close bacterial strains and selectively eradicate harmful bacteria from the microbiome while sparing the beneficial ones.”

Eligo Bioscience is also working on other diseases such as inflamatory bowel disease, acne. The company owns an exclusive license for the use of CRISP in the antibacterials field.

For more on CRISP/Cas:

Blog entry on CRISP/Cas

For more on Eligo Bioscience:

Xavier Duportet, le défricheur interactif – Laure Belot – Le Monde 2015

Xavier Duportet, « innovateur français de l’année » pour le MIT – Perrine Créquy – La Tribune 2015

Eligo Bioscience Raises €2M to Develop CRISPR Antimicrobials – Conor McClune – Synbiobeta 2015

 

The future of food and beverage

Reto Schnyder
Challenging the cash cows of Big Food

Reto Schnyder expects major disruption in food, especially in the field of business models.

We spend a lot of money on food. The consumer behavior is really changing. More and more online grocery shopping is used, as demonstrated by huge growth rates as well as booming household penetration rates.
Companies are trying hard to stimulate purchases and expand their reach. AmazonDash on AmazonFresh is a wonderful example of what can be done.


Amazon is definitely good at understanding big data and will not put somthing stupid in your basket, it will always suggest you new products to try.

Several other examples help us to understand the changes taking place in the food industry such as HelloFresh, June Intelligent Oven,…

Cooking good food is easier and easier. And this is just the beginning.

Before the food industry structure was: brands – shop – cook.
But now the ranking has changed: cook – shop – brands!

In the cosmetics and toiletries industry, the shaving blades domain has been completely shaken by outsiders, like Dollar Shave Club and Harry’s Blades. They put in place subscription services and Dollar Shave Club took over 10% market share in units in USA.

Lesson learned: easy to attack global power brands as they are not invincible.

Wisdom: how can we make our cash cow irrelevant? Disrupt the market before other companies do it.

More on disruption:

Break Through Ventures

10 Disruptive Business Models – Slideshare – Ouke Arts – 2013

 

Ralph Schmidthalter
Precision agriculture

How can drones can provide wings to farmers? The use of drones, coupled with analytical tools, could help farmers make better decisions.

Field analysis on foot is only giving a partial view of the crops. With a new software technology, Pix4D, it is possible to “automatically process terrestrial and aerial imagery acquired by light-weight drones or aircraft based purely on image content. This desktop software converts images into highly precise, timely and customizable results for a wide range of GIS and CAD applications.”

Experiments and tests are implemented in order to optimize yields. The systems are also helping to decide when and where to start the harvest.
Moreover, it is incredibly useful to detect diseases early by identifying spectral signatures. With the use big data and re-engineering, close monitoring is now feasible. Flight plan is defined in advance in order to optimize which data to record.
Sensefly is targeting multiple industries like agriculture, mining, humanitarian, environmental protection. Vitiscan is fully dedicated to vineyards.

Those technologies and their applications will lead to more transparency on which species to seed, which and how much fertilizers allowing for better quality and quantity of crops as well as improved variety.

More on precision agriculture with drones:

Why 2015 is the year agriculture drones take off – Clay Dillow – Fortune 2015

Drones and driverless tractors – is this the future of farming? – Peter Moore – The Guardian 2015

Bin Bin Pearce
Transdisciplinarity and design thinking

There are two broad schools of thinking: Design Thinking and Scientific Method.

Design thinking

DesignThinking

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“Design Thinking is a human-centred approach to innovation that draws from the designer’s toolkit to integrate the needs of people, the possibilities of technology, and the requirements for business success.”

Tim Brown, president and CEO, IDEO

There is no need to say more than the definition given by Tim Brown. It is really self-explanatory.

When it comes to scientific method, the approach is different.

steps-of-the-scientific-method

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In this way of thinking, you try to understand first, then hypothetize and start data collection, once it’s done you can analyze data and select some criteria. Ultimately, you can ask for peer review and then publish your work.

Neither of these methods serve as a path for the solution to more societal problems. It is then fundamental to combine both of them with system thinking and action. Transdisciplinarity is another crucial component toward solutions.

The main message of the talk was: “Whatever you produce and send to the society has an impact on the society itself. It is crucial to develop self-awareness and impact analysis of actions on society.

More on design thinking:

Design Thinking – Tim Brown – Harvard Business Review 2008

What is Design Thinking? – University of St-Gallen

Design Thinking… What is That? – Fast Company 2006

More on transdisciplinarity:

The Potential of Transdisciplinarity – Helga Nowotny

Foundations of transdisciplinarity – Manfred A. Max-Neef – Ecological Economics 2005

The future of medicine? Cells not pills

Siddhartha Mukherjee is a visionary cancer doctor and the writer of an awesome book about cancer published few years ago.

In the TED talk below, he takes us through a fantastic journey about the future of medicine and how it could change soon.

Medicine started with simple principles, such as have disease, take pill and kill something. It worked and is still functioning as of today for specific diseases. However, the future is elsewhere.

The natural world gives us some clues about how one might think about illness. In fact, the natural world is organized hierarchically upwards, not downwards. It begins with a cell that give rise to self-regulating, semi-autonomous units called organs, and these organs coalesce to form humans, and these organisms ultimately live in environments.

Siddhartha Mukherjee takes the example of cancer. To tackle this disease, we started to kill cells with chemotherapeutic agents and targeted therapies, then we realized that it would be a nice idea to harvest the immune system in the war against cancer. This gave birth to immuno-oncology drugs bringing extraordinary outcomes to patients. The next step is to change the environment but it is much more challenging…

Stem cells are also part of the solution according to Siddhartha Mukherjee. However, it raises tons of questions… as what’s at stake is not killing something, but growing something. This means that we need to think upside-down and shift our views as well as our traditional thinking.

  • Could your medicine be a cell and not a pill?
  • How would we grow these cells?
  • What we would we do to stop the malignant growth of these cells? Could we implant suicide genes into these cells to stop them from growing?
  • Could your medicine be an organ that’s created outside the body and then implanted into the body? Could that stop some of the degeneration? What if the organ needed to have memory?
  • Could your medicine be an environment? In every culture, shamans have been using environments as medicines. Could we imagine that for our future?

It is very often said that the reason we haven’t had the transformative impact on the treatment of illness is because we don’t have powerful-enough drugs, and that’s partly true. But perhaps the real reason is that we don’t have powerful-enough ways of thinking about medicines.