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Defining features of sustainable healthcare innovators

In an era of growing demand and constrained budgets, pharmaceutical innovation is not enough
01 November 2021

    In the search to treat more people at lower costs and with better outcomes, making healthcare sustainable is about looking for true value, as well as efficacy from novel molecules. This means that pharma’s innovation efforts need to be holistic, focusing on wider benefits beyond how well the treatment works – to better outcomes for the system as a whole.

    From an investment perspective, this approach does not mean inexpensive, however. “Affordability is often equated with cheap, but that’s not necessarily true,” says Dr Nathalie Flury, co-head at the Global Equity Sustainable Healthcare Fund, which aims to achieve results by focusing broadly on true innovation that helps healthcare providers and payers do more for less.

    Roche’s haemophilia drug, Hemlibra, is a good example. “It costs $500,000, which is not cheap, but is significantly more affordable than the standard therapy scheme, which costs $1.3 million,” says Flury1. The established, more expensive therapy also requires other drugs to be taken to prevent complications, whereas the Roche drug reduces bleeds by 98 per cent on its own, says Flury’s colleague Dr Michael Schröter, and her co-head at the Global Equity Sustainable Healthcare Fund. “The patient is better off, and can lead a more or less normal life.”

    Prevention is better than cure

    Prevention and early treatment also hold great promise in cutting costs while improving outcomes for patients. New colon cancer screening techniques that allow for less invasive and more regular testing are another good example of healthcare innovation that has multiple payoffs for all parties, including earlier treatment.

    Liquid biopsies for cancer patients that can detect cancer earlier, as well as track cancer progression more closely, enabling clinicians to adapt treatment paradigms accordingly, is another example of exciting new investment horizons, says Flury. “Surgeons don’t like to take traditional biopsies serially and, sometimes, this is not even possible. Everyone knows that, if you can prevent a disease developing or intervene early for a patient, it will be better, with higher survival rates – and it will be less costly for the system. These are the solutions we are searching for.”

    Other emerging diagnostic investment themes include new testing possibilities enabled by the cutting-edge sequencing of genetic material at scale and at low cost. The combination of diagnostic tools with therapies to streamline and simplify condition management is another investment theme with promise. A good example is “closed loop” diabetes treatments comprised of insulin pumps paired with continuous glucose monitoring systems that, to a great extent, automate the management of diabetes.

    These systems, which can cut a patient’s use of insulin and reduce their risk of developing diabetic complications, as well as enabling them to monitor and manage their condition better and lead fuller lives – are one example of such solutions, which offer a wide array of health, lifestyle and economic benefits and, as such, offer great potential as sustainable investment propositions.

    The future is telehealth

    Pharmaceuticals and diagnostics are not the only way to improve outcomes for patients, providers and payers. Therapies that reduce hospital stays are attractive, and telehealth is increasingly proving its considerable potential to help here. The savings can be huge. Emergency room visits, for example, can cost $10,000 per day in the US. “If you average two or three days, that’s $20,000–$30,000 saved,” says Dr Schröter.

    An emerging generation of digital monitoring solutions that enable patients to leave hospital earlier, to be monitored by care teams while recovering at home, is another promising investment proposition that has been boosted during the pandemic. It is a long-term theme, Flury believes. “I am fully persuaded that this is not going to go away when the pandemic is over,” she says. “Quite a few telemedicine companies have realised that, now their patients can be online with their physician, they will continue to use it for many things post-pandemic, such as 10-minute update. For many people, especially in the rural parts of the US, it is a huge effort to go to a doctor. This system is easier for everyone.”

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