HL: Genomics, technology and the future of healthcare

How do you fly a plane whilst changing the wings? This was the question posed by Professor Sir Mark Walport (Chief Executive, UK Research and Innovation) towards the end of the Spectator Health Summit last month. In other words, how does the NHS integrate new technology, medicine and genomics while continuing to provide the day-to-day essentials?

Sir Mark was joined by Ben Osborn (UK Managing Director of Pfizer) and Professor Robert Plomin (behavioural geneticist, King’s College London) to discuss whether the UK can lead the way in medical innovation. In some fields, it already does. Much of Britain’s scientific infrastructure is on the cutting edge and it leads the world in genetics. Half a million people have their data on the UK Biobank and the Health Secretary Matt Hancock recently announced plans to have the whole genome of a million people sequenced.

For Plomin, in particular, this is a game-changer for prevention. ‘The ability to read our DNA blueprint can transform our healthcare,’ he said, ‘because DNA is the only early warning system where you can predict [health risks] at birth’. And if you can predict, you can help prevent not only physical ailments such as cardiovascular disease and breast cancer, but behavioural disorders such as depression, obesity and alcoholism. Moreover, Plomin argued that publicly funded systems such as the NHS have an advantage over insurance-based systems in this respect because while the NHS saves money from prevention, private systems make money from treating. He wonders whether the latter will even be able to survive ‘the DNA revolution’.

For Pfizer’s Ben Osborn, good health is also good business: ‘You can’t have patient health without business health and vice versa’. Whereas in the past, pharmaceutical companies have often been compensated for the volume of drugs sold, the market is now shifting ‘from volume to value’. Through a renewed partnership with scientists and government, drug companies should only expect to make money when a medicine brings clear benefits to patients. Repurposing drugs is not the answer to the chronic diseases of old age. The big challenges of modern medicine will only be dealt with by pharmaceutical companies working closely with universities, research institutes, charities and governments.

This kind of co-operation is already more common than the public realises. ‘The world has changed,’ said Sir Mark. ‘It used to be thought that the target for a drug was the intellectual property. It’s recognised now that that’s not really the case and so there’s been a tremendous amount of public-private partnership.’ Not only public-private partnership, but private-private partnership. Collaboration between pharmaceutical companies on research and development has become much more common as the diseases under the microscope have become more complicated.

The aim of companies like Pfizer is to bring drugs to market as quickly as possible. It takes, on average, ten years to get them through the rigorous tests required. The fundamentals in Britain are sound, said Osborn. Manufacturing infrastructure is in place, R&D is high quality, and there is now certainty about the NHS medicines budget going forward. For Pfizer, as for the NHS, the main benefit of new technology, including Artificial Intelligence, is that it ‘frees up time for us all to do more meaningful work’. All that is needed is the right policy.

Finding a shared vision should not be difficult given the huge opportunities that exist. The challenge is in translating Britain’s world leading scientific research into healthcare. In Sir Mark’s view, the UK makes an enormous contribution to innovation in health services, but it is less clear whether we are maximising the benefit to our citizens and the economy. Echoing a theme that ran through the summit, he said that the problem was not so much with the technology as with the people. The real challenge is to integrate the people with the technology.