Healthcare, medicine & pharmaceuticals

Patient made drugs

Trends like open source innovation and customer co-creation are all the rage in some new product development circles, but surely patients can't invent their own drugs? Wrong. Patient-facilitated drug discovery isn't new either. In the 1950s the National Foundation for Infantile Paralysis was responsible for the development of the polio vaccine (they paid for the research). More recently, organizations like the Myeloma Research Foundation (MRF), The Genetic Alliance (a network of 600 support groups relating to inherited illnesses) and the ALS Therapy Development Forum (ALSTDF) are bankrolling everything from individual scientists and clinical trials to research laboratories and bio banks. Some are also setting up information databases while others are funding their own biotech firms. Why is this happening? One reason is that big pharmaceutical companies aren't generally interested in so-called 'orphan diseases' - diseases that effect relatively small numbers of people. Other explanations include the influence of the Internet (which makes it easier for sufferers to connect) and the fact that while drug discovery is a slow business, many sufferers are no longer prepared to wait. The main reason though is the fact that for years patients have been encouraged to take responsibility for their own health - so they are. Add to this the growing number of private foundations and 'venture philanthropists' involved in healthcare and you have a powerful new player in the field of drug discovery that is much closer to patients and defines risk and reward in fundamentally different ways.

Pink and blue painkillers

There seems to be a growing volume of evidence to suggest that men and women feel pain differently. Part of this may be to do with genetics, but it's also likely that men and women are wired slightly differently, so male and female brains experience pain (and perhaps disease?) in different ways. If this is true, can we expect to see male and female versions of painkillers and other drugs in the future? A good example of this difference is provided by childbirth. Women giving birth tend to prefer nalbuphine to morphine, whereas with men in similar pain the preference is generally reversed. Moreover, it's not only how men and women feel pain that seems to differ, coping mechanisms also seem to vary by sex. From an evolutionary point of view this makes perfect sense. Historically, men and women were subjected to different types of pain so coping mechanisms may have developed accordingly. However, there's a problem. In tests men resist pain better than women. Anecdotally it's generally the other way around.

A doctor in every pocket

Despite developments in home-based monitoring, most healthcare is still procured inside hospitals, clinics and other medical premises. One way this may change in the future is the delivery of healthcare via mobile phones. As with most 'futurist' predictions, this one is happening in a small way already. LG sells a phone equipped with a blood-glucose meter to diabetics in its home market of South Korea, while in the US, My-Food-Phone helps patients with high cholesterol levels to monitor their diet. Patients simply take photographs of their week's meals with their phone (easier than writing it down in a food diary) and email the pictures to a nutritionist who sends a weekly critique of their food choices. Over in the UK there's a trial starting next year whereby patients will wear a small plaster on their arm to monitor vital signs such as their heartbeat. Data is sent to the user's mobile phone (via bluetooth), which is then sent to their doctor for analysis. Any irregularity can immediately trigger an alarm. There's even a system in South Africa (SIMpill) where patients (or their carer) are sent a text message if they fail to open a bottle of pills - because the cap of the bottle is connected to the phone which in turn is connected to the hospital's computer. The market for telemedicine is predicted to grow by an annual rate of 42% to 2011 according to a report by Frost & Sullivan. However, it's in places like central Africa that such 'telemedicine' could really deliver widespread benefits. In Africa and India more people have mobile phones than landline connections and the mobile will be the only computer most ordinary people will ever own.

People reading

Back in the 1940s a book called Forty-Four Juvenile Thieves: Their Characters and Home Life by John Bowby practically invented family therapy. This work is also partly the inspiration for some work being pioneered by Professor Dacher Keltner at the University of California at Berkeley. His idea is that you can 'read' people (and their future) by delving into their early childhood experiences. The area is notoriously unreliable because people can lie or forget about what really happened. So, instead of asking questions, Keltner simply asks to see early childhood photographs. The theory is that every face tells a thousand words, because we subconsciously reflect our feelings in our faces and other body language. This may sound unscientific, but there is a growing body of evidence that suggests it's true. If we are stressed or unhappy we tend not to mirror the body language of others. How people touch each other also gives away secrets about relationships. The face - from the eyes to muscle movements - is also a treasure trove of secrets. As a result it's possible to predict how people will get along in the future or tell how happy someone is in the present. If this is true it has all sorts of privacy implications ranging from who does what with your passport photo to putting images of your children online at flickr.com.

Body-scanning

Sales of body scan analysers are going through the roof in Japan, largely due to the low cost of technology and demand from dieters and people concerned about obesity. For example, sales the Karada-Scan (from Omron Corp) doubled from 400,000 in 2003 to 800,000 units last year. What's a body scanner? Basically it's weight scales with some added functionality such as the ability to scan the entire body and deduce body fat ratios. At the top end of the market, machines can measure skeletal muscle, download information onto the family computer and even link with exercise devices like pedometers.