32-33 - Transformational change

The UK’s health sector has long been held up as a leader for innovation and research. That looks unlikely to change, but the next decade will pose challenges and myriad transformational changes on a scale not seen before in living memory. Dr Kath Mackay outlines three themes that will prove pivotal for the sector’s growth over the next decade.

When it comes to writing the history of the UK’s pharmaceutical industry in the 2010s, it will be a mixed bag of fortunes that’s presented. Significant drug advances that improved the lives of millions, technological developments that mean progress now moves faster than ever and the signing of the Life Sciences Sector Deals have led to more talent, investment and ever higher standards of research and development.

Yet the past decade also served up Brexit, which single-handedly poses the biggest test of mettle to ten years’ worth of progress. The potential of doors being shut to the finest talent, a decline in foreign direct investment and a deviation away from regulatory norms could spell trouble for UK pharma. But it’s not the only issue that will prove pivotal to the success, or otherwise, of the sector for the decade ahead. Looking beyond the here and now of leaving the European Union, three themes are likely to prove key to UK pharma’s growth and keep it the envy of the rest of the world.

The missing middle
The gap between small and big pharma has grown over the last ten years and it’s unlikely we’ll witness a reset, or even something resembling a realignment, in the next decade. But this brings opportunities. While big pharma plays an invaluable role within the sector – providing jobs, resources and the finance to fund innovation – it’s often smaller businesses that develop on the seeds of an idea that then go on to fundamentally change the industry. Both are vital, but what often happens when a small business makes the prerequisite progress and develops a USP is that it is usually acquired by a bigger player before it can reach the point of being medium-sized. A subsequent shift in management and business priorities incurs, and quite often what made a small company so exciting is lost. What’s actually needed is more support for small businesses to take the next step. Antimicrobial resistance research is a case in point. The issue poses a global challenge that needs tackling over the coming years, with those carrying resistant infections taking longer to treat, requiring more testing and needing more expensive methods of treatment. The latest data from the World Health Organisation states that 490,000 people developed multidrug-resistant TB globally in 2016 and that drug resistance is impacting the fight against HIV and malaria, too. In a world of seemingly endless headlines on NHS resources being stretched close to breaking point, additional stress provided by superbugs could prove mission critical for the sector. Yet outside of government-funded bodies and universities, there’s only a handful of businesses researching new antibiotics to tackle the issue, and these are made up of small teams of specialists with limited resources. Clearly the risk posed requires a more concerted effort to be defeated, and this will come about by bolstering and supporting these businesses. There are three ways to do this. First, more targeted government initiatives to develop research and innovation capabilities. Second, continued global collaboration to attract the finest talent from around the world to the UK. And third, an increase in the infrastructure investment needed to host world-leading laboratories and research centres for independent, small businesses to thrive in.

AI in motion
This leads onto one of the biggest all-encompassing themes expected to impact nearly every sector of the UK economy over the next ten years: artificial intelligence (AI). From financial services through to agriculture, business services and manufacturing, it would seem AI’s shadow looms large over the entire UK business landscape. Pharma would appear to be no different. The benefits of AI in the industry are anticipated to include improving drug discovery and synthesis, and automating pathology and radiology services. Should this potential come to full fruition over the next 10 years, it’s been said, the UK’s laboratories will be a robot-only landscape come 2030. That’s not going to be the case. While AI will play a massive role in the advance and development of life-changing drugs and treatments, the tools needed and technological steps required will take longer than ten years to be rolled out on a mass basis. This means that, similarly to the development of small pharma businesses, infrastructure will again be key. Its role will be twofold. On the one hand, the continued need for world-leading scientists means demand for high-quality laboratories and workshops will also remain high over the next ten years. Recent announcements, especially those pertaining to the establishment of the UK’s own version of the US’ Advanced Research Projects Agency, which will see funding for research and development doubled to £22 billion over the next five years, will be welcomed, especially given much of this money will be spent on laying the groundwork for scientists to thrive. The flipside of this is that despite the human resource going into research, scientists will still be focusing some of their efforts on implementing AI into laboratories to help assist in their day-to-day duties. While this will take time – much longer than a decade to witness wholesale changes – it nonetheless requires infrastructure built with the future in mind to carry out successfully.

The data dilemma
Where AI will be used more prolifically is as a solution to the third theme we will witness in 2020s pharma: data. The UK stands as a world leader for its use of healthcare data, thanks in no small part to the NHS and the government. On this front, it is used to inform and improve decision-making in patient care, bring together businesses, academia and the NHS to better understand data through the creation of Digital Innovation Hubs. But the private sector has a role to play too. Here this data is used by academics for research and by businesses tasked with developing life-saving drugs and treatments. But there are challenges too, not least in the technology used to share and use this information, but also in light of concern among significant proportions of the population about privacy and breaches of security. Advancements will be driven by both the private and public sectors, simultaneously independently of one another and collaboratively. For the NHS, using its vast reserves of data alongside existing AI technologies for analysis will help treat diseases, improve the quality of life of patients and develop medicines. Working with the private sector, where research is ongoing, to understand what this data means and how best to implement it is vital to achieving this. But independent firms also need to take their responsibility to patient confidentiality seriously, even if many are doing so already. The private sector must look to the example set by the NHS to achieve this. Progress is being made on both fronts, with the development of Citylabs 2.0, a joint venture consisting of public, private and government organisations coming together in Manchester a case in point. When completed in 2021, this will be home to global diagnostics company QIAGEN at the heart of a health innovation and precision medicine hub designed for the next decade and beyond.

A decade of change
The UK’s pharma sector faces a decade like no other in the 2020s. Brexit, and the potential impacts it will pass on through regulatory alignments, foreign direct investment and government spending, will have wide-reaching consequences for the sector and its science community. But opportunities to thrive exist for British pharmaceutical companies and SMEs after the UK has exited the EU. If the sector is committed to making a success of the post-Brexit landscape, investing in infrastructure, talent and technology will be vital.