Healthcare system reform

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Scenario wherein the healthcare system is more integrated, shorter lines between pharma, medicine, insurance companies

Developments in time

2010-2015

During first decade of new millennium, innovation in the healthcare system was primarily dominated by multinational companies. The most important factor contributing to this long term resilience of the drug-based innovation model, and its dominant role in the development of health care systems, was the regulatory system. The primary markets, Europe and USA, have very lengthy, expensive and complex set of regulations which impose significant constraints on the innovation system for drugs thus making product to market process a lengthy and costly process.

This was clear when comparing the lightly regulated information and communication technology (ICT) sector with the heavily regulated life sciences, the former sees a much greater degree and rapidity of change in products and capabilities arising from technological innovation and small start-up companies are able to build up rapidly to become major players on the basis of innovations that effectively challenge the status quo. At the beginning of 21st century, biotechnology was expected to have a similar impact on health care industries and, while it has indeed played an important role in their development, this has been mainly supportive of the prevailing model for drug discovery, rather than challenging it. Despite large scale public and private investment, the sector is still dominated by a similar set of companies (although their names may have changed) and the basic innovation model remains fundamentally unaltered. Regulation formed primary cause for this result by creating an insurmountable barrier to entry for any start-up company with an innovative idea that might challenge the status quo.

Around 2010 after the 2008 financial crisis, instead of seeing themselves as passive responders to events, regulators began to see their role in a much more proactive way. In line with “new governance” agendas and linked to globalization initiatives, discussions began to take place within regulatory bodies about their role in stimulating changes in the processes and outcomes of health care innovation.

Meanwhile next to the advancement in biotechnology, after dotcom buuble, IT world started to increase innovation. Especially with Apple Iphone and later Google's Android products turned mobile phones into handheld computers turned society to 7/24 online community and shifted the paradigm.

Thus fundamental, rather than incremental, change becomes increasingly inevitable, but also increasingly unimaginable. Some time in the future, the science and industry innovation system will experience a “Black Swan”.

2015-2020

Change of the regulatory system

Collaboration between a big pharma and a big IT (Apple or Google)

2020-2025

Reform established, result: a "Networked Healthcare System"

Shorter product lifecycle

No blockbusters but many lower margin products which target specific customers, overall better financial performance compared to old model multinational pharma's.