Pharma’s Personalized Medicine Dilemma with Google et al and Treatment Guidelines

Maria Fe Paz
Patrick Considine

Maria Fe Paz and Patrick Considine of Diaceutics provide a further update on Google’s immersion into the health care realm and highlight an opportunity for pharma to collaborate.

We continue to follow Google’s inexorable march into health care and personalized medicine and have previously posted on this: Google’s Entry Shifts the PM Tipping Point to The Edge. Periodically, we like to assess the new entrant threat to pharma. The recent announcement (http://www.bbc.co.uk/news/technology-29802581) that Google is working on technology that combines disease-detecting nanoparticles, which would enter a patient’s bloodstream via a swallowed pill, with a wrist-worn sensor, seems on the surface to be relatively benign as a threat to pharma. The technology will potentially enable them to address a key unmet clinical goal in cardiovascular disease and cancer, namely early detection, and there is nothing inherently disruptive to pharma about early detection. In fact, it’s quite the opposite as many pharma companies, e.g., Roche, Novartis and Janssen, are making public their pursuit of diagnostic partnerships to identify disease earlier in the treatment pathway.

This further immersion into the health care realm comes just a few months after Google set out yet another challenging approach to improve the genetic and molecular knowledge of health, the Google Baseline study, as a way to detect diseases better and earlier. With Google’s proven capacity to manage and analyse huge amounts of data from healthy volunteers, the Baseline study will undoubtedly shed light into biomarkers, mutations and pathways related to the onset of diseases, and ultimately contribute to the personalization of therapies.

It is perhaps only when you stand back to look across the accumulating war chest of health care technologies and interventions in which Google is investing that the potential competitive rivalry of a powerful new health care entrant becomes more apparent.

A truly personalized medicine entrant would seek to move past the pill-centric business model of incumbents to reshape the traditional playground of the pharmaceutical industry, namely, guideline-driven treatment pathways. Thus, the vision and skill to introduce multiple integrating interventions, such as treatment, testing and education, alongside wearable monitors, to guide personal therapy decisions (versus rigid guideline adherence) is in fact the ‘disruption’ to a pharmaceutical industry which has too narrowly defined personalized medicine as a companion testing/targeted oncology paradigm and relies still (outside oncology) on its ability to shape therapy guidelines (versus treatment pathways).

Of course, Google protesteth that it is seeking to become a ‘pharmaceutical-style powerhouse’. Dr Conrad, inventor of this particular early detection system, is at pains to point out that, “We are the inventors of the technology but we have no intentions of commercialising it or monetising it in that way…We will license it out and the partners will take it forward to doctors and patients.” Recent partnerships, for example the glucose monitor contact lens with Novartis (http://www.novartis.com/newsroom/media-releases/en/2014/1824836.shtml), support this innovate, then partner, business model Google is promoting.

However, we note that industrial history is littered with such denials. Companies like Sony and Samsung have illustrated to us all that what starts as a business model to supply others with innovation is ultimately a Trojan horse business model to build scale, learn the rules and own key pieces of intellectual property and customer access.

And, of course, one cannot assess the threat from Google in the absence of the health care ambitions of the other consumer-facing powerhouses. Some game-changing initiatives are afoot there also, for example, Apple is partnering with major academic health care institutions including the Mayo Clinic, Mount Sinai, Johns Hopkins and the Cleveland Clinic. They have all partnered with the technology giant to develop health care apps for use with enterprise solutions on Apple’s Healthkit. Amazon recently hired the inventor of Google Glass, Dr Babak Parviz, in what can be interpreted as acknowledgement of health as the new consumer technology frontier.

Pharma should welcome collaborations with Google, Apple and other patient-facing organizations in the short term, but they need to beware the clinical bridgeheads they are surrendering to companies with deep, deep pockets, clearly expressed health care ambitions and the greatest direct patient access of any companies on the planet.


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