The New Medical Frontier
Wednesday October 30, 2019
Understanding the Mechanism of Disease for Better Care
By Bert Liang, MD, Ph.D.
The high cost of health care is not a new discussion. Each day, we are inundated with heartbreaking stories of patients without access to essential therapies due to rising costs or the inability to pay momentous medical bills.
As a public, it is clear we recognize this challenge; however, despite years of discussion, we have not yet been able to create a workable solution that lowers the cost of care, increases access and ultimately gives patients better outcomes.
Perhaps part of the challenge is that we are seeking a silver bullet solution — a one-stop policy answer that will cost less, bring a better quality of life and fix an inherently broken system. To date, plans have focused on shifting cost structures or establishing better regulation, attempting quick, far-reaching solutions to a complex problem. This doesn’t work.
The challenge is that our system of health care is not situated for such easy solutions. The United States health care system is complicated with layers of regulation and a vast number of stakeholders, including providers of treatments, governmental overseers and those within the distribution channels.
Each of these stakeholders influence the ultimate consumer (or victim) of the chain: the patient. To be most effective, a solution must ensure that all stakeholders — payers, technology developers, regulators, doctors and patients — take some level of responsibility to address these challenges.
Viewing this through the lens of drug development provides an understanding of this challenge, showing where greater stakeholder involvement can lead to better access. Consider the context of moving products through research and development, especially within regulatory systems that are conveniently grouped into organ systems — e.g. cardiology, neurology, dermatology, rheumatology, etc.
Historically, the grouping system created a framework for easy categorical organization. It reduces products to the most simplistic nature to streamline the regulatory process.