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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- pany. 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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