The way we assess value in medical technology is changing radically. In Bangalore, the mantra “made in India for India” echoes throughout GE Healthcare’s John F. Welch Technology Centre and Philips’ Innovation Campus. These research and development facilities have spawned such revolutionary devices as low-cost, lightweight, battery- powered electrocardiogram machines to serve remote, rural areas with little access to healthcare. In Europe, Merck Serono is revolutionizing the delivery of human growth hormone with diagnostic screening, counseling, and monitoring services tied to its easypodTM wireless injection device. The company focuses on the individual needs of patients, providing support that encourages adherence to prescribed treatment, improving their chances for better health.
These companies recognize that the old dynamic of the physician as arbiter of value is giving way to a new one: Government and private insurers and “self-pay” consumers increasingly determine what sells and at what price. They refuse to pay for incremental innovations that add bells and whistles but do not signifi- cantly improve health or reduce cost. The faster, better, smaller, cheaper advances so common in consumer electronics portend the future of medical technology.
In addition, providers are assuming more of the financial risk in healthcare
as payers increasingly base compensation on quality and results. If a new technology doesn’t help patients get better at the same or lower treatment cost, providers might not be motivated to use it.
Emerging-market countries such as China, India, and Brazil, despite comparatively weak healthcare system infrastructure, are quickly taking the lead in developing lean, frugal, and reverse innovation. This type of innovation simplifies devices and processes, retaining essential func- tions while applying newer technolo- gies that are more mobile, customized to consumers’ needs, and less costly. Such innovation will enable these nations to leapfrog developed coun- tries in innovative healthcare delivery.
The PwC Medical Technology Innovation Scorecard explores the changing nature of healthcare inno- vation. The results show that the innovation leaders of today will find their position slipping during the next decade. Three trends are evident:
• The innovation ecosystem for medical device technology, long centered in the United States, is moving offshore. Increasingly, medical technology innovators are going outside the United States to seek clinical data, new-product registration, and first revenue.
• US consumers are not always the first to benefit from advances in medical technology and could eventually be last in line. Innovators already are going first to market in Europe and, by 2020, likely will move into emerging countries next before entering the United States.
• The nature of innovation is changing as developing nations become the leading markets for smaller, faster, more affordable devices that enable delivery of care anywhere and help bend the healthcare cost curve downward. These countries are free of the handicap of an entrenched healthcare system infrastructure that seeks to maintain the status quo. However, the difficulty of doing business in emerging countries and poor intellectual property protection could make these markets less attractive to multinational companies, despite their size, and could hinder these nations’ innovation leadership.