Integrated Diagnostics and the Future of Health Care: Corporate Innovation as an Engine for Change by ProQuest


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									    Integrated Diagnostics and the Future of Health Care
                                Corporate Innovation as an Engine for Change
                                                              David Okrongly, PhD

I  n this discussion, I will be covering molecular diagnos-

     tics and how it fits into an integrated diagnostics com-
                                                                           vitro and in vivo diagnostics more strongly in our analysis
                                                                           of patients and in management of disease?
                                                                              To drive home a point I am going to turn to human
   Integrated diagnostics for Siemens Healthcare Diagnos-                  immunodeficiency virus, which is perhaps a strange topic
tics (Tarrytown, New York) was a dream 4 years ago, and                    for discussion at a pathology meeting, but it will serve to
in the last 18 months, it has become a reality. Siemens has                illustrate the role in vitro diagnostics can and will play in
brought together 3 leading diagnostics companies, Diag-                    the future management of disease, beyond how tests are
nostic Product Company, Bayer Diagnostics, and Dade                        typically being used today. Right now, in the world of
Behring, and created the largest in vitro diagnostics com-                 human immunodeficiency virus therapy, there are 3 clas-
pany in the world.                                                         ses of drugs used to manage the disease. These are highly
   I come from the molecular diagnostics group in the in                   targeted drugs going after a very limited number of tar-
vitro diagnostics part of the Siemens business. We are                     gets in the human immunodeficiency virus genome. Over
committed to drive, across all of our different platforms                  time, the way these drugs are used has advanced very
in both the in vivo and the in vitro side, a strong push in                rapidly to a world of personalized medicine, where ge-
innovation. The goal is to have a much more in-depth un-                   netic sequencing of the virus is used to determine drug
derstanding of disease by using techniques, such as higher                 resistance. From computer-based interpretation of those
resolution imaging technology and molecular tools, to                      genetic sequences, a laboratory report can now be gener-
gain a better understanding of disease. Then, we intend                    ated that is able to describe to the physician a resistance
to put that together with integrated medical data, and not                 pattern for a particular patient that allows the physician
just putting the report together, but using knowledge-                     to tailor the human immunodeficiency virus therapy spe-
driven information technology to provide better solutions                  cifically for that patient’s virus.
for diagnosis and work flow, which will improve the ef-                        Pharmaceutical companies are always looking to add
ficiency and lower the cost of health care.                                 new therapies, with the next classes being entry and in-
   Why do we need to lower costs? I think we have all                      tegrase inhibitors. More complexity means there is going
seen reports detailing what is happening with the cost of                  to be increasingly more complicated processes to decide
health care globally. In 2008, spending is well above $5                   on the right drug for a particular patient at any particular
                                                                           time. Fortunately, the solution is already in hand. It is a
trillion annually in global health care, and these runaway
                                                                           US Food and Drug Administration–approved process that
costs are starting to have an impact on what our expec-
                                                                           allows companies like Siemens to be able to provide a
tations for the future will be in both the Western countries
                                                                           resistance report on the medications that are available for
and in the developing world.
                                                                           a patient. This is personalized medicine being practiced
   What is interesting about this chart is that US spending
                                                                           in the world today. The question is: How do we now ex-
on in vitro diagnostics has been relatively flat over the
                                                                           trapolate that practice to more c
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