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The Challenge of Changing Health

A new landscape fraught with obstacles, risks and opportunities

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The Challenge

There is perhaps no global enterprise changing as rapidly and as radically as human health. Shakespeare’s The Tempest offers an apt metaphor, in which the spirit Ariel sings of a “sea change”—a dramatic and profound transformation. This idiom—while often overused, much like its 20th-century successor, “paradigm shift”—succinctly describes the massive upheaval and ever-shifting landscape of patient needs and demographics, innovation processes and regulatory environments. While the biopharma and health industries must address an expanding population and explosions of new diseases, they must also work to fill the void left from the crumbling of the blockbuster-based business model, and make sense of the vast array of new scientific breakthroughs and technologies. As with any challenge of this scope, successful solutions will demand teamwork, and this teamwork will require balancing the interests among a diverse group of stakeholders: patients, physicians, payers, policymakers and biopharmaceutical companies. More difficult still, this balance must reach around the world, as the business and science of health is increasingly a global concern. For example, evolving infectious diseases can now move rapidly between countries, raising the threat of a pandemic.

For today’s health challenges and tomorrow’s solutions, numbers tell many of the stories. The foundation needed to support a strong healthcare system, for example, depends on how many people it must accommodate. And perhaps even more important, the needed health infrastructure must be designed to adapt to a growing number of consumers. According to the U.S. Census Bureau, the world population doubled from 1959 to 1999— increasing from 3 to 6 billion in just 40 years. Although the growth rate is expected to slow, the bureau estimates that the world population will hit 9 billion by 2045. Even now, the sheer size of the world’s population creates a formidable healthcare challenge. With today’s population still under 7 billion and health systems already stretched beyond capacity in many parts of the world, what changes must be made to accommodate a world that will include roughly 30 percent more people?

Beyond building healthcare systems that can treat more people, there must also be accommodations for the changing collection of people, which will include a growing percentage of senior citizens. The United Nations’ “World Population Aging 2009” points out that people over 60 years old made up just 8 percent of the world’s population in 1950, but that percentage grew to 11 percent in 2009, and it is expected to reach 22 percent in 2050. So, in a century, the percentage of senior citizens will nearly triple.

Indeed, aging will change the needs of tomorrow’s healthcare, but other challenges are also emerging. For example, “HealthCast: The Customization of Diagnosis, Care and Cure”—a 2010 report from PricewaterhouseCoopers (PwC)—notes: “While aging is often cited as a key driver of health spending, there is a growing concern that spending is increasingly spurred by generations of children facing costly chronic disease.” To build this report, experts at PwC surveyed 3,500 consumers and conducted interviews with academics, government officials, pharmaceutical executives and others in more than 25 countries—from Argentina and Brazil to the UK and U.S. A key finding revealed that “[b]oth young and old consumers are developing chronic diseases in record numbers, leading to explosive growth in the consumption of resources that is driving up spending and creating liabilities for future generations.” For instance, the report points out that more than one fifth of Australians under the age of 16 have been diagnosed with asthma. In addition, the report indicates that Alzheimer’s disease in Australia is expected to increase by 50 percent from 2003 to 2023.

Changing demographics of disease also exist in other countries. For example, India Today reported on April 12, 2010, that “heart ailments have replaced communicable diseases as the biggest killer in rural and urban India.” Such changes will surely continue in India and other countries, especially for chronic diseases.

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