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Who Will Own The Future of Medicine?

Consider this article from 1991. Nature 1991 Paradigm Shift in Biology

Drugs are just information products Eisenberg article has written about the observations that drugs are information products whose only value is information about efficacy and safety in FDA clinical studies (so she extends that to say that this is the avenue for ensuring exclusivity).

Next-generation medical intervention will be information products in more ways, because they will be tied to personal genetic information.

I don't really care about treatment of acute conditions -- while there will be some personalization, things like treatment of infectious diseases will still likely be a mass approach, though there may be more refined diagnostic procedures, which are significant (who will control them? this can just be collected at the hospital level). Indeed, drug companies don't care about them. All the money is in chronic diseases, and/or making acute into chronic, or "preventive" treatment, which is basically just chronic but pre-symptomatic.

Importance of chronic disease globally

Prescription drug spending is a lot of money, but not all, and indeed what I'm talking about in terms of the future of medicine is a lot broader than drugs, because it also includes diagnostics and other kinds of physician "interventions" (and things like less ICU time) here is Kaiser's projected costs: Drug spending that is in 2009 approximately $250B more than doubling by 2020, driven by faster growth after a period of slower growth due to drugs coming off patents but with drugs having more exclusivity

Innovations happening now that are "open source" that I guess I have to talk about:

OpenNotebookScience, spearheaded by Jean-Claude Bradley at Drexel.

web-based platforms for collaborative drug discovery, like this product

the Open Source Drug Discovery project, which is working on TB (notably infectious disease)

drug costs have been estimated to be $802 million, though this is variable and is also subject to a lot of assumptions and it includes opportunity cost of capital, which is actually the majority of that figure ($574M). The people who came up with $802 came up with a similar $600-1B range for biotech products

What is a drug? Well, traditionally you go with the "Lipinski Rule of 5," based on certain physical properties, such as size and key chemical properties that make it compatible with metabolism. Of course, not every drug satisfies this rule (e.g. lithium carbonate)... also, it's sort of weird that biologics are treated differently than small molecule drugs when they are basically the same thing (though of course they are developed differently with different IP ramifications)

Also, biohacking and "garage biology" or DIY biology: OpenWetWare (closed access Nature article) or the Wired article I can also have a link to DIYBio, even New York City has Genspace

Also protein folding at home using passive grid computing. Aaron Chan's essay talks about some chintzy protein folding game stuff that isn't really all that interesting but has a "cool factor" that appeals to computer type people.

Community sourcing / social networking for patient experiences: PatientsLikeMe which has had some preliminary success in ALS being faster than traditional studies with similar results

Then we have something with genomics research by people sequencing their own genomes -- the most prominent effort in this regard is 23andWe, which has already published some results of genome-wide studies that appear to check out, including work on Parkinson's

-- BahradSokhansanj - 25 Oct 2011

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r5 - 28 Oct 2011 - 15:10:25 - BahradSokhansanj
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