Trying to copy and follow others in a world of turbulence and massive uncertainty is a risky
business. Assuming that what worked last year will work in the future is also very risky. The
objective of this paper is to get people think beyond the here and now.
The future looks great providing:
- Honest about the challenges (the facts).
- Getting back to basics and break old, outdated habits.
- Helping each other and collaborate like never before.
- Medical decision making with artificial intelligence (AI)
- Digital health “around the pill”
- We have about 7.5 billion people in the world who needs hospital care. Sixty-five percent of
all health care are spending on developed nations and helping people whose age group is
- People above 60s will also be the most powerful political lobbyist in the world. They are
more likely to vote for politicians who promise to meet their healthcare needs.
- By 2025, 85 percent of the global population will be in emerging nations.
- Prevention will be preferred over treatment. Pricing and reimbursement schemes will
drastically change. Increasing levels of antibiotic resistance will render “routine” medicine
redundant. Governments will have to take a radically different approach to pricing and
reimbursement unless they want society to return to the pre-antibiotic era.
- Globalization, global warming, science and technology are all (for the first time in our
history) accelerating at the same time. Everyone will be impacted. Drug shortages will
continue, if not worsen, as supply chains are disrupted unless more is invested to improve
- Medical technology will change our lives – 3D imaging, ultra-resolution microscopy,
electronic patient records, computer aided diagnosis, low-cost gene readers and more.
Wearable devices will put patient’s health at center stage and in greater control of their own
- Short-termism will destroy corporations. Companies who run from one quarter-financial
report to the next, ignoring the future, will not survive.
- Pharmaceutical organization’s currently spends, on average, $1.3 billion on bringing a new
medicine to market with an attrition rate of 90 percent. Clinical trial failures over the last five
years have cost the industry $240 billion. This level of inefficiency is not sustainable
- Most of the current regulatory framework is no longer fit for purpose and is guilty of
stifling innovation when we need it most.
- Any job with any level of repetition (manual or cognitive) is at risk of being automated.
Except pharmacy, law and financial professions to look very different.
- Our world needs more economies of scale to achieve greater efficiencies. Expect to see more
mergers (consolidation) and also demergers as mistakes are made.
- In Europe and North America, companies often struggle to find the talent they need. This is
not the case elsewhere. More than 85 percent of the world’s graduates in science, technology,
engineering and math over the next two decades will be from Chinese and Indian
- Although the impact of artificial intelligence (AI) in pharma is open for debate, it will have
a profound impact on healthcare. Did you know that one in 10 medical diagnoses is wrong?
In some clinical areas AI can improve the efficiency. For example, AI is capable of
predicting (with 80 percent accuracy) which patients would die of pulmonary hypertension
within a year. Whereas medical personnel have only 20 percent accuracy. AI and wearable
devices helps to find the disease at the initial stage which can be cured with proper medical
How to Prosper in an Uncertain World
Excellence in any walk of life comes down to doing the basics to Ph.D. level. The companies
that will succeed in the future will, in my opinion, do the following exceptionally well.
Big Data, artificial intelligence (AI), robotics, and machine and deep learning all got a
mention. To be honest, a lot of what I had to say was educated guesswork on my part.
Whether what I predict happens or not remains to be seen.
Leadership: Dynamic, Risk - Smart and Future Oriented
There is a big difference between leadership and management. Leadership is about doing the right
thing. While management is doing things right. Pharma has relied too long on management. We
need to recruit and develop risk-smart leaders at every level and get them onto the shop floor.
Every leader needs to become a “futurist”, not only focused on the quarterly financials. The
benefits and risks of AI are not being correctly assessed by many senior leaders because many
know so little about developments in technology and science.
We Must Become Risk-Smart
Companies still talk about zero risk as if it’s real. It’s not. Zero risk is an illusion. In fact, risk
aversion is dangerous. It stifles innovation, increases complexity and (paradoxically) risk. We must
become risk-smart. We have to admit risks and manage them intelligently and quickly.
Simplification is Survival
Remember less is more. When we have simple systems, motivation improves, errors fall and
productivity increases. Simple systems also allow us to “fail fast”. In times of uncertainty we will
make lots of mistakes. These only become learning opportunities if we fail fast.
Stop Training and Start Educating
Most companies’ training programs just tick the compliance box and change little. Old
behaviors remain. If you understand 10/20/70 and NSF’s model for behavior change, B=M.A.t.H, your future looks bright. Your education programs must focus on providing the
skills that will matter most: emotional intelligence, risk-based decision making, critical thinking
and problem solving.
From CAPA to PACA
When problems and errors occur, so many companies focus on the immediate correction. The
“Band-Aid companies” who allow high levels of repeat errors and mistakes won’t be around for
much longer. The focus must be on prevention, not reaction, by designing out errors and mistakes
in the first place and by brutally simplifying everything.
Change Management: Fast and Effecient
Unless your change management system can review and approve changes in less than an hour, you
are going to be in trouble. In this turbulent world agility is key. Your change management system
must be quick (otherwise it won’t be used) and only approve changes that add value and reject the
rest (usually 80 percent!).
Collaborate Like Never Before
I leave the most important and hardest to last. We will not meet future healthcare needs unless we
all collaborate – regulators, industry, payers and patient groups. The latter have been ignored for
too long. Unless we collaborate, we won’t make it.
We still come across people and companies who are institutionally blind. They seem totally
unaware and ill prepared for what is coming. Is it arrogance or ignorance? Who knows? For me it
all boils down to simple economics.
If we as an industry fail to rise to the healthcare challenge, the results are likely to be soaring,
unsustainable and a burden on us all.