The plenary speakers tackled broad issues of personalized medicine, new funding models, and partnering with industry. The funding session was dedicated to the expanding role of philanthropic foundations in translational research.
Foundations are stepping up to fill the current funding gap and to provide translational education and guidance. Speakers provided a balanced perspective on funding strategies. Lesa Mitchell, Ph.D., vp, advancing innovation, at Kauffman, who provided vision and guidance for the forum, commented, “The critical role that scientists play in our economy is compromised because faculty and graduate students need a better understanding of commercialization to empower them to recognize and advance their own innovations.”
The keynote session, moderated by William Peck, Ph.D., director of the Center for the Study of Health Policy at WU, addressed how the modern health care economy will adapt to accelerating technological change. Dr. Peck presented the harsh reality of a complex U.S. health care system under siege. “Health care costs are high and rising, amounting to $2.2 trillion this year with an anticipated doubling by 2016 to $4.4 trillion,” he noted.
“The U.S. is spending more on health care than any other developed country in the world, but still there are 46 million uninsured and countless underinsured that do not have timely access to the best care possible.” He noted a crucial need to improve quality and challenged the panel to address how the health care system can improve itself and its economy.
Ralph Snyderman, M.D., James B. Duke professor of medicine and chancellor emeritus for Health Affairs of Duke University, looked to the consumer to play a bigger role and carry more of the financial burden. The greatest problem, he said, is that innovations are not translated into clinical practice and are used randomly and sporadically. His solution was to develop robust bioinformatic disease-delivery models that include personalization and prevention. He suggested that the Center for Medicare and Medicaid fund the development of several learning models for personalized prevention across the U.S.
Harlan Krumholz, M.D., Hines professor of medicine, director, Robert Wood Johnson (RWJ) clinical scholars program at Yale and director of the Yale-New Haven Hospital Center for Outcomes Research and Evaluation, suggested building health care reform on a foundation of new science, aiming to enroll large numbers of patients in trials. He also highlighted the importance of educating patients about discretionary care and the importance of shared decision-making.
“We should create a show-me culture that requires evidence of how best to practice,” Dr. Krumholz said. He envisioned collaboration between industry, academics, advocacy groups, and payers that would improve the way medicine is practiced. In later discussion, it was noted that involving more patients in trials would address the problem of force-fitting increasing amounts of foreign patient data to the U.S. population.
Peter Corr, Ph.D., an academic veteran and retired svp of science and technology at Pfizer (www.pfizer.com), thought that big companies should disaggregate to form smaller, more innovative groups. He pointed to the increasing number of precompetitive partnerships that bring worldwide data together and should make a huge impact on medical practice. “In the U.S., we do not have a health care system, we have a sick care system,” Dr. Corr remarked. “The biggest threat to innovation is the hype and regulation surrounding conflict-of-interest issues.”
Is the solution becoming a single-payer system like many other countries? Garry Neil, M.D., president of Johnson & Johnson (J&J) Pharmaceuticals Development (www.jnj.com), did not think so. Dr. Neil placed his bet on the laboratories of democracy in several states that are working on mandatory insurance schemes that would cover everyone. This solution would involve a combination of increased emphasis on health care and personal accountability, better end-of-life intervention systems, and utilization of information technology, more personalized medicine, and new disruptive therapies.