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

Source

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.

The Nobel Prize in Medicine 2015 is the recognition that nature plays a role in our pharmacopeia

Anopheles_stephensi

The Nobel Prize in Physiology or Medicine 2015 has been awarded for two major discoveries tackling severe illnesses. William C. Campbell and Satoshi Ōmura were rewarded for their discoveries concerning a novel therapy against infections caused by roundworm parasites and Youyou Tu for her discoveries concerning a novel therapy against Malaria.”

Collectively, the prize praises drug discoveries from nature that transformed the treatment of two of the world’s most devastating parasitic diseases.

327 scientists have been nominated for the 2015 Nobel Prize in Physiology or Medicine. Among them, 57 individuals were nominated for the first time.

All Nobel Laureates in Physiology or Medicine

 

Additional articles

Anti-parasite drugs sweep Nobel prize in medicine 2015 – Nature – October 2015

2015 Nobel Prize In Medicine Awarded For Discovery Of Malaria, River Blindness Drugs From Nature – Forbes – October 2015

Nobel Prize in Medicine Awarded to 3 Scientists for Parasite-Fighting Therapies – The New York Times – October 2015

Nobel prize in medicine goes to pioneers in parasitic diseases – as it happened – The Guardian – October 2015

The 2015 Nobel prizes: Physiology or medicine – The Economist – October 2015

Nobel Prize in Medicine honors treatments for malaria and parasitic diseases – The Verge – October 2015

 

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US drug pricing is on the verge of change

MoneyPills

Drug pricing is always a topic for discussion regardless of the country where you live.

The USA have long been considered as the most expensive country when it comes to drugs. Today, several initiatives are trying to contain their price and limit the explosion of healthcare expenditures. It is not easy and several political leaders failed in front of the powerful lobby supporting the pharmaceutical industry.

Maybe, instead of price cuts, we should think of more nuanced version of price control like value-based pricing or risk-sharing agreements.

An extremely interesting article explore the future opportunity of risk-sharing agreements in the USA. It is widely used in Europe as well as in other countries but shows a slow uptake in the USA. The conclusion of the article is positive as there is room for improvement. “Most manufacturers and payers expressed interest in RSAs and see potential value in their use. Due to numerous barriers associated with outcomes-based agreements, stakeholders were more optimistic about financial-based RSAs. In the US private sector, however, there remains considerable interest—improved data systems and shifting incentives (via health reform and accountable care organizations) may generate more action.”

However, despite hot debate launched by Hillary Clinton recently about drug pricing, the US Congress is still dominated by Republicans, who is completely supporting the pharmaceutical industry. Drug pricing and healthcare coverage will be one of the hottest debate question of the US Presidential Elections this fall.

Some articles are much less optimistic as they show that the bargaining power of private payers is far from sufficient to be able to negotiate discounts.

Drug pricing has to change in the USA because affordability and healthcare coverage will define the sales potential of the product. If the drug is so expensive that no one can afford it and no insurance will pay for it, it has no future sales opportunity. It is key to find a good balance between rewarding innovation and R&D efforts AND allowing patients to access the medicine and care they need.

 

Additional resources:

Private Sector Risk-Sharing Agreements in the United States: Trends, Barriers, and Prospects – American Journal of Managed Care – September 2015

It’s Time to Rein in Exorbitant Pharmaceutical Prices – HBR – September 2015

Why we can’t stop US drug companies from charging astronomical prices – Quartz – September 2015

Drug prices: Which companies may be the next targets? – CNBC – September 2015

Rational Drug Pricing – Huffpost Business – September 2015

Why Are Drug Costs So High in the United States? – Medscape – November 2014

High Cancer Drug Prices in the United States: Reasons and Proposed Solutions – ASCO – July 2014

Higher US Branded Drug Prices And Spending Compared To Other Countries May Stem Partly From Quick Uptake Of New Drugs – Health Affairs – April 2013

Pricing and Reimbursement in U.S. Pharmaceutical Markets – NBER – August 2010

 

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Alphabet (ex-Google) is the next big thing in Life sciences

A lot is currently written about the initiatives launched by Alphabet (Google) in the life sciences field.

I had the wonderful opportunity to have a look at the report written by the internet analyst, John Blackledge, from Cowen and I must say that he’s very smart at showing the huge potential of the life sciences at the core of Alphabet (Google).

This report is amazing as it allows you to have a better understanding of what’s happening now inside Alphabet (Google). I summarized the key points/quotes from the report below and I added other articles at the end of this blog post. Moreover, I will update it frequently as the news come in. This is a fascinating topic, I really hope Alphabet (Google) would be able to replicate the same success it has built with its search engine.

Key quotes & comments from the report:

  • Expansion into health care and related segments allows Google to leverage its core competencies in Internet communications technology, data structuring and analysis, and fundamental process reinvention.

 

  • Specific areas of focus in healthcare include:
    (1) the sequencing the human genome and the rise of precision medicine: despite the monumental significance of mapping the human genome and the implications for drug discovery, this was but one step in a long journey that continues to this day. Moreover, genes are but one factor in disease, and little is known about what role environment and lifestyle play.
    (2) the digitization of health data is exploding, with a virtually endless list of sources that can offer insight into clinical data, drug studies and more. As more data is digitized, there will be a profound impact on how patient care is administered, how therapies are researched, and how drugs are tested. EHRs (Electronic Health Records) are crucial but implementation is very challenging. Harmonization and data aggregation need to find their way. Wearables are another interesting topic in the digitization of health data. Social media and discussion boards as well as patients website are essential parts of the system that must be closely monitored as more and more patients use those communication channels in order to provide feedback and comments on treatments and daily struggles with healthcare providers.
    (3) the shift to value-based care, where payments are based on the value of care, is driving a change in how services are delivered and how much consumers engage in the process. From a provider perspective, doctors are incentivized to manage patients to the best possible health outcome at the lowest cost. From a patient perspective,
    consumers are being empowered to take a more active role in their own health care.
    These health care trends are being accommodated by technology advances in areas such as social, mobile, analytics and cloud computing, all areas of Google expertise.

 

  • Alphabet invests in health in five different ways:
    (1) Google Life Sciences originated in Google[x], a research lab within Google that was funded by the company’s board of directors in January 2010 to pursue “moonshots”—audacious new projects that have a low probability of succeeding, but could be truly revolutionary if they do. The company views moonshots as critical in driving the true innovation required to affect revolutionary change and avoid the “incrementalism” or evolutionary change that tends to lead to corporate irrelevance over time. The Life Sciences team is responsible for such innovations as glucose monitoring smart contact lenses. With an expanding list of intellectual property, Life Sciences has begun to accelerate its collaborative efforts with third parties. The company is aggressively partnering with leading players in the health care space on a growing number of programs.
    (2) Calico’s mission is to harness advanced technologies to increase understanding of the biology that controls lifespan. Calico was originally conceived by Google Ventures President and General Partner, Bill Maris, who observed that most companies seek to find treatments for disease and associated symptoms, but that none address the root cause of disease and death. He wondered if studying the impact of aging on genetic material could lead to the discovery of drugs that could address many age-related diseases and significantly extend the human life span.
    (3) Google Ventures has provided seed, venture and growth stage funding to a host of companies in diverse fields, but its stated focus is machine learning and life science investing.
    (4) Google Capital was formed to invest in later-stage technology companies with a focus on emerging technology leaders and potential disruptors. Unlike the earlier stage companies in Google’s other investment vehicles, the later stage companies in Google Capital tend to be fairly common household names. Although the stated focus of Google Capital is on technology companies, the collision of technology and health care is blurring the lines of what a traditional “technology” company looks like.
    (5) Google Core: Over time, Google has invested in numerous health-related initiatives within its main corporate division. These have tended to be very closely linked to the company’s core businesses, such as Search. Earlier this year, the company announced that it will add health information that has been fact-checked by physicians directly to search results. The company is also talking to the FDA about using search query data to identify adverse drug reactions.

 

  • Google’s Health-Related Focus Areas: regardless of where they are housed within Google’s corporate structure, most of Google’s health-related endeavors share common characteristics.
    (1) Longevity
    (2) Genetics and Chronic Care
    (3) Diagnostics
    (4) Diabetes/Digital Health
    (5) Medical Devices
    (6) Telehealth/Digital Health
    (7) Wearables/Fitness

 

  • Google’s health endeavors fit with the company’s goals of “making the world’s information useful” and helping millions of people. Indeed, Google believes that many of the same principles, techniques and problem solving capabilities employed by its software developers can be applied to the massive inefficiencies that exist in health care to create transformational solutions and medical breakthroughs that help people live longer, healthier lives. Health care ambitions can be summarized as:
    (1) Analyze: Analytics to inform decision-making and provide business insight
    (2) Attract: Attract health care constituents to platforms and solutions that drive engagement
    (3) Aggregate: Aggregate data from disparate sources onto the Internet or GCP

 

Additional resources:

Alphabet to help researchers predict disease – Financial Times – April 2017

Google Life Sciences Exodus – STAT – March 2016

Verily, Google’s Health Gambit, Is Stacked With Scientists. Now It Needs to Build a Business – ReCode – December 2015

Google hires mental health expert to lead new life sciences unit – Financial Times – September 2015 (Subscription required)

Head of Mental Health Institute Leaving for Google Life Sciences – The New York Times – September 2015

Google Bets on Insurance Startup Oscar Health – WSJ – September 2015

Is Health Care Google’s Next Big Business After Search? This Investment Bank Thinks So – Re/Code – September 2015

Why Google Is Going All In On Diabetes – NPR – September 2015

Google’s health startup, AbbVie team up on drug research – Chicago-Sun Times – September 2015

Google Life Sciences Company Has New Deal, Official Nemesis in Diabetes – Re/Code – August 2015

Alphabet Breathes New Life, Resources Into Google’s Health Care Projects – iHealthBeat – August 2015

Google Health – Easy as ABC. Alphabet, Calico and the Aging of Humanity – What on Earth are they doing? – Digital Intervention – August 2015

 

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Using “Tumour-Traps” to Monitor The Spread of Breast Cancer

Excellent & insightful article on how it is now possible to track cancer progression.

Snackable Science

Breast cancer is the most common form of cancer in the UK, with approximately 50,000 British women diagnosed with the disease every year. Despite this high occurrence, breast cancer patients have relatively good prospects and almost 80% of sufferers are still alive 10 years after their initial diagnosis. One factor that influences a patient’s chances of survival is the presence or absence of secondary tumours, which occur when cancer cells spread from the breast and establish themselves in other parts of the body.

In research published this month in the journal Nature Communications, a team of scientists led by the University of Michigan’s Dr Lonnie Shea describe an exciting new material, which can be implanted under the skin to capture invasive cancer cells as they move throughout the body. “Tumour traps” like this could be used in the future as part of an early warning system to alert doctors to the…

View original post 497 more words

A visual history of human knowledge – Manuel Lima – TED Talk

“When everything is connected to everything else, for better or for worse, everything matters.” Bruce Mau

From natural ranking order to network relationships, data visualization has always been present even in the early ages of humanity. However, that wish to classify and find an order is actually not relevant anymore in today’s world. Linear relationships cannot show what networks can communicate and promote: those notions of decentralization, interconnectedness and interdependence.

It is fascinating to see that this web architecture is widespread to several fields like knowledge, history, social ties between people, online social collaboration, terrorism, life sciences, species, ecosystems…

“This metaphor of the network, is really already adopting various shapes and forms, and it’s almost becoming a growing visual taxonomy. It’s almost becoming the syntax of a new language. And this is one aspect that truly fascinates me. And these are actually 15 different typologies I’ve been collecting over time, and it really shows the immense visual diversity of this new metaphor,” highlighted Manuel Lima.

Having an understanding of complex systems, with the support of IT technology, is crucial today as any decision could have unexpected effets.

How simulation could help us understand better elderly population’s needs and behavior – Scenario Magazine

Elderly

Simulation allows us to think about what the future might be. It also helps us to understand the current reality and day-to-day life of people, in this article, elderly ones.

Drafting global strategies for an improved care of that fragile population as one of the results of those simulations is crucial in today’s world. Actually, we need to plan for their evolution and needs as they will soon represent the majority of the society.

Read more

Additional resources:

A Silver Tsunami Invades The Health Of Nations – Forbes – 2015

Implications of long-term care capacity response policies for an aging population: A simulation analysis – Health Policy – 2014 (subscription required)

Ageing and the Macroeconomy – NAP – 2012 (free registration to access free PDF)

Video: MIT constructs old-age-simulator suit to make young people feel elderly – Popular Science – 2012

The silver tsunami – The Economist – 2010

 

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A Better Understanding of the US Drug Pricing Landscape and Financial Risks Associated – Health Affairs Blog

An excellent article posted on the Health Affairs blog takes a step back regarding US drug pricing and the financial risks associated with drug development well beyond the clinical trials stage.

Key quotes from the article:

  • It may be helpful for the policy discussion to think of a drug’s value as the clinical performance and patient outcomes, while the price reflects both the value and the growing uncertainty around in-market risks of market consolidation and restricted access, branded therapeutic competition, mandatory discounts, and restrictive coverage policy.
  • As competition heats up, each sector and each entity strives to reduce input costs and maintain or improve prices — and consolidation can be an important tool to accomplish these goals. Specific to biopharma, consolidation strengthens payers’ and providers’ ability to press for drug discounts that are contractual, proprietary, and confidential.
  • Net lifetime revenues of new biopharma therapies declined from profitability in the late 1990s to slightly negative profitability by the end of the first decade of 21st century.
  • In addition to cross-sector market competition through payer and provider consolidation, there is growing intra-sectorial competition among generics, biosimilars, and branded therapeutic alternatives.
  • We should not underestimate the potential effect of mandatory price discounts on drug launch prices.
  • In-market risks for biopharma are very significant today. Because of rapid changes in the market environment, revenue expectations established when the decision is made to proceed with product development can be very different than actual revenue several years later when a product is launched.

 

Additional Resources

When Is a Virtual Business Model Suitable for Biopharmaceutical Companies? – BioProcess International – 2015

Understanding the pharmaceutical value chain – IMS Institute for Healthcare Informatics – 2014

Innovative Business Models in the Pharmaceutical Industry: A Case on Exploiting Value Networks to Stay Competitive – International Journal of Engineering Business Management – 2014

The Real Cost of “High-Priced” Drugs – Harvard Business Review – 2014

Rapid growth in biopharma: Challenges and opportunities – McKinsey – 2014

 

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Google Willingness to Help Life Sciences – Wired

Google, or Alphabet, wants biomedical research and life sciences to be more than just side projects.

Several years ago, its efforts under way in that field were probably not considered seriously by the industrial stakeholders like Big Pharma and biotech companies.

Today it is different after several investments commited lately.

Discover more in the Wired article

 

Additional Resources

4 of the biggest healthcare challenges Google is tackling – HealthcareDIVE – August 2015

Here’s why Google Ventures invests so much money in life-science companies – Business Insider – May 2015

Andrew Conrad – Google Life Sciences – The 25 most influential people in biopharma in 2015 – FierceBiotech – May 2015

Google Continues To Build Upon Its Life Sciences Ecosystem – Forbes – September 2014

Meet the Google X Life Sciences Team – WSJ – July 2014

 

 

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The difficult implementation of value-based healthcare – The Commonwealth Fund

ValueBasedCare

“A new survey from The Commonwealth Fund and The Kaiser Family Foundation asked primary care providers—physicians, nurse practitioners, and physician assistants—about their experiences with and reactions to recent changes in health care delivery and payment.

Providers’ views are generally positive regarding the impact of health information technology on quality of care, but they are more divided on the increased use of medical homes and accountable care organizations.

Overall, providers are more negative about the increased reliance on quality metrics to assess their performance and about financial penalties. Many physicians expressed frustration with the speed and administrative burden of Medicaid and Medicare payments. An earlier brief focused on providers’ experiences under the ACA’s coverage expansions and their opinions about the law.”

Probably each start of a new system is painful and requires people to adapt to it. However, it will have to be carefully monitored as adoption by healthcare providers is crucial for the success of the new system. It will validate the concept of value-based healthcare.

Read more

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US healthcare coverage increased from 85 to 90% – TIME

In a little less than 4 years, US healthcare coverage increased from 85 to 90% according to a TIME article.

“Decreasing the number of uninsured is a key goal of the Affordable Care Act (ACA), which provides Medicaid coverage to many low-income individuals in states that expand and Marketplace subsidies for individuals below 400% of the poverty line.” as stated in an article of KFF.

However, it will be difficult to have a full coverage of the population as some individuals refuse to buy healthcare insurance as they do not see how they could take advantage of the money spent in it. Some of them could simply not afford to buy coverage despite the subsidies.

Moreover, some issues arise with the methodology used to count the number of insured/uninsured people (see the Health Affairs article at the end of the post for more details).

In conclusion and despite all the issues with people not willing to adhere or counting methodology, it is a real progress to expand coverage, especially because US were lagging behind some emerging countries (have a look at the OECD Publication “Health at a Glance 2013” on page 138-139).

And what’s really interesting is the impact of more coverage on global health as a blog post pointed out.

Additional information

Estimating the Affordable Care Act’s Impact on Health – The Commonwealth Fund – August 2015

Meet the Health-Law Holdouts: Americans Who Prefer to Go Uninsured – WSJ – June 2015

Survey: America’s Uninsured Rate Is Down To 10% – And Falling – Forbes – June 2015

Counting The Uninsured: Are We Getting It Right? – Health Affairs – May 2015

Key Facts about the Uninsured Population – Kaiser Family Foundation – October 2014

Is the Affordable Care Act Working? – The New York Times – October 2014

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MicroHealth Helps Patients Manage Chronic Illnesses

We know that chronic diseases account for the majority of health expenditures. Helping patients with digital tools improving the management of their condition is a great step forward!