The accelerating pace of biomedical advance

Bioscience has progressed exponentially, in scientific advances and enabling technology. From quicker and much cheaper gene sequencing to the emergence of data-mining tools, the last 20 years has been unprecedented in exploitable advances brought by research. We have the tools and insights to trace disease from underlying genetics and epigenetics, through proteins that represent intervention options, to ways to create molecules, diagnostics, and devices based on those insights. The life sciences enterprise, once largely confined to Europe, the USA, and Japan, is now seeing major investment from emerging economies. We should be poised to reap the benefits of this rising tide of research with lives transformed and health systems revolutionized. However, the two million biological science papers published annully results in about 14 000 patents, only 5000 drugs in the pipeline, and a mere 30 or so actual medicines. Translation of life sciences research into usable products is hugely inefficient.

The gaps in translating biomedical advance into patient benefit

There are no less than five major gaps in translation in the long journey from discovery to practical patient benefit. Insufficient understanding of disease mechanisms (T0), limited skills and motivation in turning lab discoveries into potential products (T1), huge wastage in bringing promising products to market (T2), disappointingly slow adoption by doctors and adherence by patients (T3), and failure to learn from past experience (T4): all cripple the productivity of life sciences. T2 is a particular challenge, especially in medicines, with a high attrition rate in costly clinical trials and increasing difficulties in persuading health technology assessment (HTA) agencies of the added-value of new technologies, combined with HTA differences across countries. Major cultural barriers between academia, practical medicine, and industry make matters worse, as mismatched incentives and mutual suspicion impede collaboration. The net result is poor yield at every stage in the innovation process and therefore very poor translation overall.