In partnership with Healthcare: Pharmaceuticals, Biotechnology … · 2018. 6. 7. · Report of the 14th Foresight Seminar 11 December 2000 9 Slide 15 Biotechnology •tissue engineering

In partnership withScottish EnterpriseScottish Higher Education Funding Council

Healthcare: Pharmaceuticals, Biotechnology andMedical Devices

Report of the 14th Foresight Seminar11 December 2000

ABSTRACTS

Health Care 2020 - Some Outputs from the Healthcare Foresight PanelProfessor David T. Delpy, Department of Medical Physics & Bioengineering, University CollegeLondon.

The Healthcare Foresight panel has looked at some of the major trends likely to affect the future of healthcareover the next two decades, and made proposals for actions that it believes should be taken now. Although manyof the panel's recommendations are based upon future technological developments, their implementation willinvolve broader changes in both the structure and provision of healthcare. This talk will summarise some of thecommon points that emerged from the wide consultation exercise involved in the Foresight process, and will inparticular highlight some of the technical developments that are foreseen, discuss the changes that these maycause both in immediate patient treatment, the relationship between patients and healthcare professionals, theworking practices of the these staff and the involvement of the general public in making decisions abouthealthcare.

Healthcare in 2000A (personal) Scottish PerspectiveGraeme R. D. Catto

Scotland has a strong research base both in science and in medicine. With around 9.5% of the UK population,we employ around 12.5% of the academic community and continue to attract a disproportionate share of UKresearch funds – currently around 13.8% of MRC grants, for example. Spend in both higher education and inhealth is substantially higher than in England – around 20% and 15% respectively. Viewed in this way,Scotland has many advantages in these important areas.

If we look at the issues from a different perspective, however, potential problems become apparent. Firstly, ourindustrial base is weak. Interest in R&D from the commercial sector is limited; Scottish Enterprise is often notable to help identify business partners of any significant size in the growing areas of applied science andmedicine. The research push from universities is not yet matched by an equal pull from industry. Secondly,public sector funding is not fully co-ordinated. The substantial resources from the Scottish Higher EducationFunding Council (SHEFC) are distributed in ways that produce a relative disadvantage to biomedical research andthe dialogue with Departments within the Scottish Executive remains to be more fully developed. Following thelast Research Assessment Exercise, for example, SHEFC withdrew funding from areas of research promoted andresourced as priorities by Government departments.

The current expansion of medical education in England has placed Medical Schools at the heart of regionaldevelopment – largely because of the halo effect on SMEs. Current funding policies in Scotland, both fromSHEFC and the NHS have placed all the Medical Schools in deficit (despite the more generous funding of hostuniversities and the local NHS) making strategic developments more difficult to implement in this rapidlyexpanding area. These constraints apply to the three specific areas selected from this Foresight report.Although the pharmaceutical industry spends around 18-20 % of its available funding in Scotland and employsmore than 5000 people, most of the resources are devoted to clinical trial work and only a relatively smallproportion to basic science. Similar constraints apply to both medical devices and biotechnology. Althoughthere are pockets of innovation these are not well developed throughout the country. Paradoxically we performreasonably well in numbers of spin- out companies in international terms but it is entirely possible that we wouldmiss the opportunity for another MRI development if one were to be created now. I believe that there is a clearneed for a Science Strategy for Scotland bringing together the various currently disparate strands of ouractivities.




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PRESENTATIONSHEALTHCARE 2020 – SOME OUTPUTS FROM THE HEALTHCARE PANEL

Professor Dave Delpy FRS

Professor of Medical Photonics, Department of Medical Physics and Bio-engineering, University College London,and member of the Foresight Healthcare Panel

Slide 1

Health Care 2020

The Foresight Healthcare Panel Report

(“its Medicine Jim - but not as we know it”)

D.T. Delpy

Dept. of Medical Physics & Bioengineering

UCL

Slide 2

Summary of Key Recommendations:

Three General areas:

•Prevention

•Information

•Innovation

(www.foresight.gov.uk)




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Slide 3

Prevention•Preventing adult ill health through interventions in childhood

•Pursuing health objectives at global level

•Health through social change

•Preventing ill health caused by environmental degradation

•Prevention of ill health through education

•Preventing disease by changes in extrinsic factors to modulategenetic risk

•Prevention of acute exacerbation of chronic disease

Slide 4

Information•Intelligence about likely trends and likely future developments

•Oversight and development of informatics

•Use of the internet

•Information held by individuals

•Generating knowledge

•Uses of information

•Imparting information




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Slide 5

Innovation•A favourable milieu in government

•Inclusion of the lay voice in health matters

•Rethinking organisational structure, operation and functions

•Examining demand for healthcare

•Placing diagnosis on a rational basis

•Creating a coherent academic base

•Supporting research and platform technologies

•Translating research into development

Slide 6

The Redesigned NHS

•“rolled back” healthcare

•patient responsibility for health

•patient owned “health biography”

•new cadre of health advocate/mentor with IT skills

•genetic screening & support largely a primary care responsibility

•globalisation of healthcare

•loss of “gatekeeper” role

•more homecare supplied by voluntary sector, internet, technology

•“cyber physician”




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Slide 7

May 14-17, 2001 · The Venetian Hotel and Sands ExpoLas Vegas, Nevada

Join more than 8,500 decision makers from numerous industry sectors whocome together each year to find out the latest trends in smart cards, biometrics,identification, and security technologies

Slide 8

The Redesigned NHS

•“rolled back” healthcare

•patient responsibility for health

•patient owned “health biography”

•new cadre of health advocate/mentor with IT skills

•genetic screening & support largely a primary care responsibility

•globalisation of healthcare

•loss of “gatekeeper” role

•more homecare supplied by voluntary sector, internet, technology

•“cyber physician”




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Slide 9

Pharmaceuticals

•pharmacogenetics

•regulatory environment

•globalisation - world market via internet

•“kitemarking” information/advice on internet

•introduction & testing in “real world” primary care environment

•national strategy for clinical trials

•large scale epidemiology & data analysis

•testing “in silico” with large scale systems models

•longer term effects of “lifestyle” medicines & drugs

Slide 10

Most people have heard of molecules and atoms, but if one was to go even smaller (sub-atomic) one would find electrons, and even smaller than that photons and quarks. Imaginegoing even smaller (Super String Theory) and discovering a group of minute energies.They vibrate, or resonate, with each other (in sympathetic resonance). They are the mostelementary form of energy.

What some scientists and engineers believe is that when these energies are clarified, theycan be used more efficiently. When clarified through Sympathetic Resonance Technology(SRT™), then placed in the QLink, these refined energies will resonate with the body'sown energy. The stronger signals (the purest, most refined ones) will help re-shape andclarify the weaker ones. This is what happens when you wear the QLink Pendant.

The result is that people who wear the QLink will have more energy, be less prone tosuffer from headaches and sleep better. It is the modern day antidote to modern dayliving.

What is Qlink?

The QLink is at the absolute cutting edge of quantum physicstechnology.This statement in itself may need some explanation.




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Slide 11

What does the term 'QLink' mean?QLink is derived from 'Quantum Link' because the technology works at the deepestor quantum level

Whats inside it?

The QLink is worn around the neck and is powered by the wearer. It requires noother power source. It is engineered with three main components:

•The resonating cell has been programmed with SRT to resonatepermanently with the optimum life-giving frequencies for the humanenergy system•The tuning board protects the integrity of the resonating cell's 'note' fromoutside interference•The copper coil shapes the subtle energy field conducted by theresonating cell into a sphere surrounding the body. In effect, it creates afield that filters out unwanted energies

Slide 12

Pharmaceuticals

•pharmacogenetics












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Slide 13

Description of the Physiome Project

The PHYSIOME PROJECT is an integrated multi-centric program to design, develop,implement, test and document, archive and disseminate quantitative information andintegrative models of the functional behavior of organelles, cells, tissues, organs, andorganisms. The long-range goal is to understand and describe the human organism, itsphysiology and pathophysiology, and to use this understanding in improving humanhealth. but much or most of what must be learned will come from other species. Theproject aims toward providing models that summarize information on physiologicalsystems, integrating the observations from many laboratories into quantitative, self-consistent, comprehensive descriptions

The Physiome Project in understanding the heart: The CARDIOME (Denis Noble

Department of Physiology, University of Oxford)

(www.physiome.org)

Slide 14

Pharmaceuticals

•pharmacogenetics












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Slide 15

Biotechnology

•tissue engineering

•treatment of chronic degenerative diseases

•xenotransplantation problems

•stem cell research

•research into biomimetic materials

•longer scale growth of tissue constructs in vitro

•advanced bioreactor design and development

•NHS strengths, national blood & tissue banks etc

•entrepreneurial culture, access to early development funds

Slide 16

Biotechnology













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Slide 17

Spinal implants(stainless steel,titanium, carbon

reinforcedpolymer)

titaniumcranioplasty

rapid prototypermodels

Slide 18

Artificial hipcomponents

Artificial kneecomponents

Artificial fingerjoints




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Slide 19

Artificial bone (HAPEX)

Slide 20

micromachined stents

shape memory metals




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Slide 21

Artificial blood vessels

textile ptfe

Slide 22

Heart valvegrown invitro &chondrocytesin vitro

Collagenmatrices




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Slide 23

Biotechnology










Slide 24

Medical Devices•large scale genetic testing

•diagnosis, mega-analyte screening

•new sensors, in vitro & in vivo

•data analysis and interpretation

•very large scale whole systems models

•“cyber physician” expert support systems

•new functional imaging & monitoring at point of need

•assistive devices to restore/replace missing functions

•robotics, remote manipulation, telemedicine

•interdisciplinary groupings

•dynamic research/support groupings




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Slide 25

Dyes, arrays,

analysis software

Slide 26















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Slide 27

Non invasive Bilirubin measurement

Slide 28

Continuous non invasive glucose monitoring




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Slide 29

the “intelligentwearable

motherboard” -(Georgia Tech)

Intelligent clothing(Philips)

Slide 30















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Slide 31

“Never trust it until you can see it with your own eyes”

Slide 32

Arm Imaging Results (Absolute)

A

B

LongitudinalMRI

MRI µ′s µa

A

B




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Slide 33












Slide 34

Cardiacpacemaker

The cochlearimplant




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Slide 35

Successful Tricyclingwith an implanted

nerve root stimulator

Nerve root implant

Slide 36

Optic nerve stimulator




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Slide 37












Slide 38

Magnetic field catheter guidance




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Slide 39












Slide 40

Hopefully not!!




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HEALTHCARE IN 2000: A (PERSONAL) SCOTTISH PERSPECTIVE

Professor Graeme Catto FRSE

Vice-Principal of King’s College London, Dean of Guy’s, King’s and St Thomas School of Medicine and formerChief Scientist of the Scottish Executive Health Department

Slide 1

Foresight - Healthcare: a(personal) Scottish perspective

Graeme Catto

Royal Society of Edinburgh

11th December, 2000

Slide 2

Suggested Focus

• Pharmaceuticals

• Biotechnology

• Medical Devices




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Slide 3

Leap before you Look

• The sense of danger must not disappear.• The way is certainly short and steep,• However gradual it appears from here;• Look if you like, but you will have to leap

• WH Auden

Slide 4

Leaps

• Devolution• Business / SE• Academia / SHEFC• NHS / SEHD• Science Strategy for Scotland• Future?




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Slide 5

Figure 1 Total annual research expenditures by MRC, ABPI and AMRC, 1995 prices (3)

0500

10001500200025003000

1986 1988 1990 1992 1994 1996

Year

Res

earc

h Fu

ndin

g (£

M)

Research Funding (£M)

Slide 6

Figure 2 Sources of UK public domain biomedical resources for 1995 (3)

AMRC

NHS

Research Councils

Funding Councils

Govt Depts

APBI




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Slide 7

National/ InternationalStandards

• EU - Framework 5• MRC - £286M (£380M)• AMRC - Wellcome (£221M) & overheads• MAFF/ SOAEFD (£80M) - strategy• an’ thocht there was never a puddock like him• HEFCs SHEFC (£125M - £23M for Biomed Sci)• R&D £550M (CSO - £40M - 47%)

Slide 8

MRC & Wellcome Spend 96-7

• 9% population; 12.5% academics• MRC

– Scotland £39.5M (13.8%)– UK & Overseas £286M

• Wellcome– Scotland £20.7M (9.4%)– UK £221M




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Slide 9

So, all is well…...

• Scotland is different• public spending• HEI 50% uptake• treasury research spend disproportionate• high tech industry: computing ,

bio(medical) sciences• pharmaceutical industry - 18% spend

Slide 10

The Puddock

• A puddock sat by the lochan’s brim• A heron was hungary an’ needin tae sup• Sae he nabbit the puddock and gollipt him

up• Syne runkled his feathers, A peer thing quo’

he• But puddocks is nae fit they used to be




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Slide 11

Complacency

• England (in bed with an elephant)– medical schools focus for region– workforce confederations

• business base– SE– R&D pull

• public sector– NHS funding +– SHEFC funding +

Slide 12

Medical Schools

• definition?• focus for medical devices, pharma and

biotech• - 19% from SHEFC & NHS• (cf Univ & HB)




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Slide 13

R&D Funding Reviews

• DH - R&D for a 1st Class Service– NHS Support for Science– NHS Priorities & Needs R&D Funding

• SEHD– Support Fund– Grants Cmtees & Units

• NI - RRGs• Own account research at risk

Slide 14

SHEFC – Scottish Variations

• RAE– QR funding adjusted +/- mean for UoA– Depends on consistency across all UoAs– Problem funding moves against Parliament vote

• Medical Charities– Pay no “overheads” (UK issue)– Scottish recompense 3/5 England

• Teaching Resource– - 19% England

• ALL MEDICAL SCHOOLS IN DEFICIT• Transparency Review




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Slide 15

Commercialisation

• Disappointing– MRI

• Spin out companies• IPR

– Universities / NHS– Central guidance?– Cf USA - individual

Slide 16

Health Depts & HEFCs

• England– Strategic Alliance on R&D

• Scotland– Tripartite Group




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Slide 17

Coordination?

– Science Strategy Review Group

– Devices & Biotech?• University based• Often without influence• Expensive• T / R

– Pharmaceutical Industry• NICE/ Health Technology Board for Scotland• Basic science?

Slide 18

Future?

• Human genome project• Concentration on biosciences• Pharmacogenetics• Gene/ environment interactions• Move from population to person-based risk• Informatics• Clinical trials• Basic sciences




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Slide 19

Foresight

• What is the likely Scottish response?• SHEFC

– Not a planning body (?) and why not (?)– Who / what will fill the vacuum?– Acceptance (?implementation)

• Universities– Medical Schools constrained by deficit

• Who else cares?– SMEs?

• If these areas are important, how do they getgoing?

Slide 20

My view

• Funding is not the issue• Other Foresight reports• How is strategy determined?• How do we coordinate all the different bodies and

funding streams?• Even the Public Sector streams?

• NEEDS A CHAMPION

• This is opportunity - not threat

Documents

In partnership with Healthcare: Pharmaceuticals, Biotechnology … · 2018. 6. 7. · Report of the 14th Foresight Seminar 11 December 2000 9 Slide 15 Biotechnology •tissue engineering