The Economist calls is “the trust machine” but can blockchain rejuvenate pharma’s savaged public image?
You have probably heard of blockchain – at least its better-known cousin Bitcoin. You might even have heard how this disruptive technology is transforming businesses across every sector, including pharma. But can ‘the trust machine’ help pharma to improve its public image – savaged by scandals, from pricing to corporate malpractice – at a time when its commercial future has never depended more on creating trusted customer relationships?
While the ‘cryptocurrency’ Bitcoin – a currency and payment system that works peer-to-peer without an intermediary – is the most famous example of the technology, we have only just started to explore the way blockchain can be used.
A general definition is “a decentralized, distributed database” – decentralized, because no single entity controls the network, and distributed, because every participant in the network has a full copy of the database. Cutting to the chase, blockchain makes it prohibitively expensive to alter or fake information, which allows people to directly trust each other without an intermediary.
Do you trust your broker?
When considering how many services rely on intermediaries to create trust, the transformative implications of blockchain become clear. There are obvious examples – where we pay intermediaries to transfer money, land deeds, company shares, etc. – but we also rely on intermediaries to guarantee less tangible but nonetheless important elements of our lives, such as the integrity of a supply chain, an election or, indeed, a patient’s medical history.
Bitcoin lets us trust another person to exchange money without the need for banks to guarantee that promises are binding. It’s effective at exchanging digital cash, but good for little else. However, a new wave of blockchain platforms are rapidly emerging that are designed to allow entrepreneurs to cheaply dream up digital services that spread the benefits of blockchain to new sectors, including pharma.
It’s growing fast, and we can more than imagine a future where payers can automate reimbursement in exchange for trusted real-world-evidence of product efficacy, while fairly incentivizing patients for sharing their data, all guaranteed by the blockchain.
Why should pharma care?
For thought leaders in blockchain, like Richie Etwaru, Chief Digital Officer at IQVIA (formerly QuintilesIMS) and Adjunct Professor at Syracuse University, healthcare needs to take blockchain seriously now or risk disruption.
The ecosystem that blockchain needs to mature is being rapidly built and pharma would be unwise to underestimate the pace of innovation.
“If we started from a blank slate and designed a drug company, we would not end up with the models we have in the industry today,” says Etwaru. “The car industry makes complex products, yet Mercedes can bring a new product to market within a couple of years and at a fractional cost of the time it takes pharma to innovate. It isn’t just apples and oranges; it doesn’t take so long to get the science right.”
In many cases, the extra time is due to a lack of patients in the trial process or the “ecosystem of participants” surrounding a trial, he says. “You have clinical research stakeholders that don’t integrate to share data, because, ultimately, most industries, including pharma, use platforms that aren’t always designed for truth.”
Blockchain is already on the pharma agenda, says Barry Springer, VP of Strategy, Innovation and Research at Janssen BioTherapeutics. “The potential [of blockchain] seems pretty intriguing. To have a distributed ledger with accurate real-time data that can be shared securely between providers, givers, patients, family members in a secure way, is extremely interesting.”
While pharma is intrigued, in the startup world the revolution is already well under way, says Darryl Glover, Chief Clinical Officer of healthcare blockchain company, iSolve. “Everyone we are speaking to has a blockchain group that is active within the company.”
His company applies its blockchain platform in two core areas – supply-chain and clinical trials. In the former, it cuts the time pharma has to wait to get inventory data from months to days, enabling companies to cut operating expenses by reducing the need to carry as much inventory and so growing towards just-in-time manufacturing.
In clinical research, blockchain can create and store unique identities for patients enrolled into a trial, preventing patients from enrolling in multiple trials at the same time.
In addition, by securely sharing data on the blockchain across trial sites, investigators can access the latest results and discover new ways to collaborate in real time. “The idea of groups working on the same problem, for example investigating a new target in relation to disease, is very powerful,” says Springer. “This collaborative effort that could make it go a lot faster.”
Plus, given recent incidents, such as the equifax hack, the importance of data security cannot be under-estimated.
There is a little doubt that we live in an exciting moment for blockchain, yet it is easy to get carried away by its transformative power. It took nearly 30 years for the internet to grow from the first email to a technology that has reshaped the modern economy.
As The Guardian points out, the active user base for blockchain technologies is much lower than that of the pre dot-com internet economy, despite significantly higher investment. Yet, Barry Springer is “cautiously optimistic” on the future impact of the technology on healthcare. “There is interest in blockchain technologies, but it isn’t quite water-cooler talk yet.”
Sometimes it takes hype and a bubble to drive us to build the infrastructure for true innovation. From the ruins of the dot-com collapse came the technology giants that define our world today, and it feels increasingly likely that we will see the same story with blockchain.
Momentum seems to grow with every day, and with announcements like Dubai’s intention to move all government services onto the blockchain by 2020, this version of the future is writing itself already. The real question is when it will happen, and it would be a real shame if pharma turned up late to the party or missed out altogether.
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