5 hidden (but vital) sides of healthcare innovation
As with many aspects of modern life, the term 'innovation' can be overused in the healthcare sector. In my experience, it also tends to be associated with breakthrough medicines and treatments.
Yet while these are, of course, a vital and high-profile part of improving outcomes for patients, for me innovation should actually be viewed far more broadly. There are other aspects of healthcare innovation that shouldn't be overlooked.
Here are five hidden areas of healthcare innovation that I believe with the right focus and investment can truly transform the lives of patients and their loved ones all over the world.
As an industry, we need to re-shape the way we gather and evaluate data, especially for rare and ultra-rare diseases. If only a small number of people have a disease, it’s difficult to find efficacy data across a sufficient sample size to convince payers to invest in it. So, instead we must get smarter at using the data we do have to show how a new treatment or medicine could benefit a collective of patients over a wider geographical area or timespan.
Diversifying clinical trials to include participants from previously underrepresented or understudied groups is one way to do this. As is closer collaboration with medical and patient communities to expand the anonymised data pool. This is something Janssen is doing with increasing success in the area of pulmonary hypertension (PH), including through our PH Human App, available now in a number of EMEA countries, which is a self-education and symptom tracking app with the opt-in potential for the person with PH to share their disease journey with their healthcare team.
A rising challenge in the development of new medicines is the ongoing reliance on traditional endpoints. That's because as treatments become more innovative and effective, patient overall survival increases. While this is exactly what we want to see, the inability to gather overall survival data in a timely way can actually inhibit a medicine’s development and approval potential.
Encouragingly, regulatory agencies are starting to consider alternative endpoints, such as for promising cancer treatments, including prolongation of progression-free survival, disease-free survival or achieving minimal residual disease. However, there's still a preference for the use of overall survival rate data among national health technology assessment agencies.
Consequently, in Europe, the average time between regulatory authorisation and patient access to a new cancer treatment remains over 18 months. It's clear we can't rely on the same conventional endpoints for judging innovation if we’re to move quickly enough in getting innovative medicines to the patients who need them.
Across a variety of therapeutic areas, we must do more to embed diagnostics earlier in patient pathways to allow healthcare professionals to reach a diagnosis in a timely manner. This will also enable patients who receive a diagnosis to get referred to a treatment centre or consultant faster. Likewise, we must ensure prescribers and healthcare practitioners are familiar with new diagnostics by including them in treatment guidelines. After all, no matter how effective a novel diagnostic test, if no one's using it because it's not in the guidelines, progress won’t happen.
As my Janssen colleague, Lars Leppin, recently put it when talking about Pulmonary Arterial Hypertension (PAH), improving awareness of and access to diagnostic tools can help us "find the needle in the haystack quicker, enabling people to be diagnosed earlier and access life-changing treatment sooner."
4. Clinical relationships
Advancement in tackling unmet patient needs happens most successfully when the relationship between the pharmaceutical industry and clinicians is peer level. Now more than ever, we must see each other as fellows, working towards the same goal but providing different parts of the journey – from supporting studies and designing trials to sharing data and educating each other around new drugs and therapies.
As a responsible pharmaceutical company, we also need to be the experts of our own data. This will create a trusted partnership where clinicians feel confident that we understand the science, know what they want to achieve for their patients and can deliver the treatments they require.
Another overused word perhaps – but rightly so! As the global response to the COVID-19 pandemic proved, we undoubtedly achieve more as a healthcare community when we work together than we do by going it alone.
But how many organisations are genuinely reinventing the way they collaborate with each other to drive innovation? Answer: not enough. From individual innovators to industry peers, biotech companies to academic institutions, public-private partnerships to open-campus initiatives, we must keep looking in new places for inspiration, partnership and progress.
As someone who has been working in healthcare for many years, I know how motivating it is to work on cutting-edge treatments, like precision medicines and gene therapies. Indeed, for many of us, the idea of helping bring a genuinely life-changing drug or therapy to patients is what gets us out of bed and into work every morning.
Yet at the same time, we must never lose sight of the fact that innovation can come in various guises. There are many factors influencing our ability to deliver positive, lasting transformation in how diseases are tackled. The healthcare sector of the future requires progress in all of them.
 Lux, M.P et al. 2021. The impasse on overall survival in oncology reimbursement decision-making: How can we resolve this? Cancer Mang Res (13): 8457-8471
 EFPIA. 2021. Every day counts: Improving regulatory timelines to optimise patient access to innovative oncology therapies in Europe. Available at: https://www.efpia.eu/media/636486/improving-regulatory-timelines-to-optimise-patient-access-to-innovative-oncology-therapies-in-europe.pdf Last accessed: January 2023