The national health-care debate is many things to many business interests. To the biotech industry, it seems to be a matter of life and death. Makers of biotech drugs, which are derived by manipulating genetic material in living organisms, insist that their products must be patent-protected from generic “biosimilars” for at least 12 years. That would ensure monopoly prices, which the industry says are required to earn back their big investments in research and development.
To reform the U.S. health-care system, the government shouldn’t be creating a road map to biosimilars, however long the trip. Instead, it should open the floodgate to “biodissimilars” and to the personalized medicine options they will enable.
Biotech is a great U.S. innovation success story with the potential to be the disruptive force that makes personalized medicine possible. Personalized medicine creates remedies designed for your specific genetic makeup or condition and offers a path toward better, longer lives, and lower health-care costs. Unfortunately, the biotech industry has moved away from its disruptive potential and morphed into Big Pharma, adopting the pharmaceutical industry’s unsustainable “blockbuster or bust” business model.
Blockbuster BustBiotech executives will claim that they are different from the pharmaceutical industry. Don’t believe it. Just check out the overlap of their participation in the Biotechnology Industry Organization (BIO) and PhRMA, the Pharmaceutical Research & Manufacturers Assn. The biotech and pharmaceutical industries have locked into identical business models, both dependent on producing a steady stream of blockbuster products, or drugs that generate at least $1 billion a year in revenue. Blockbuster drugs offer a one-size-fits-all therapeutic approach—think Lipitor or Advair—and the antithesis of personalized medicine.
Today both industries are valued on Wall Street solely by the net present value of their product portfolios and compounds under development. In addition, the few biotech companies with branded productsmarket them exactly as pharmaceutical companies do. It works both ways. Check out almost any pharmaceutical company and you will find that it has fully integrated biotech platforms into its R&D capabilities. You can’t tell the difference between these two industries.
Initially, all new technologies are deployed as a sustaining innovation. Biotechnology is no different. As predicted by Clay Christensen’s disruptive innovation theory, the pharmaceutical/biotech industry has deployed biotechnology tools and platforms in an effort to sustain its current blockbuster business model. Both pharmaceutical and biotech companies will fight to the death to wring out every possible blockbuster product from the current industry model. There is still money to be made—a lot of money, in fact—but the model is not sustainable.
Imagine needing to introduce three, four, or five products every single year each with more than $1 billion in market potential. That is the scale it takes to compete in the drug industry today. This daunting challenge will force another wave of consolidation as a few very large companies try to feed the voracious appetite of the blockbuster monster. Everyone else will be either a niche company or a development company feeding products to the few behemoths left standing.
Fail Faster!I don’t know how long it will take, but all of the disruptive innovation theory and supporting evidence predicts that the current industry model will fail. We need it to fail faster because the patient is waiting. Reform, as currently contemplated, is little improvement. Legislation under consideration today does nothing more than extend access and marginally increase the efficiency of our current system. Costs will continue to escalate out of control and outcomes will not improve.
Biotechnology has the potential to change the way we understand and treat disease. It has the disruptive potential to put the patient at the center of a new system with individualized diagnostic and treatment approaches. As such, it could deliver better care for less money.
To fix the U.S. health-care system, we need to design a system where incentives are realigned and the roles of the players—doctors, patients, insurers, hospitals, etc.—are reconfigured to create a “well-care” system that puts the patient in charge and at the center of the system. Biotechnology can help enable the transformation to personalized medicine, but not until we take better advantage of its disruptive potential.
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The frost has finally lifted here in New York City, and it is officially time to start thinking about Spring dates. Whether you’re strolling through a farmer’s market, going to your local botanical garden, or picnicking on a lawn, it’s key to dress appropriately. Below is a perfect outdoor Spring date outfit.
What’s your favorite thing to wear on an outdoor date? Life is busy. We live in a world that goes a hundred miles per hour, everyday. Eating healthy can sometimes get put to the back of the line. From day to day travel to business trips to flying on airplanes, learning the best ways to eat better when we are busy can be challenging, but they can be done. From the appendix of my book 12 Steps to Fitness Freedom here are 12 steps to eating on the go: Preparation
2. Knowing what restaurants are on the way on a three hour business trip that serve healthy options would allow you to stay within your healthy eating strategy and not go for convenience. If we prepare, we can succeed. Know Your Food
4. Use nutrition apps to look at menus and food items before sitting down for dinner. This will help you better understand the food quality. Bring Healthy Snacks
6. Know the ingredients and how to read the food label on the back to know what your are eating. Know How to Order Food
8. If it is chicken or beef I asked that it be prepared over an open fire and grilled. This cuts down on all the extra calories the cooking process can add. Drink Water
10. Keep big bottles of water on you at all times and refill as necessary. Say No to Fast Food
12. If you have to stop for something quick choose grilled chicken over beef and baked potato over French fries.
Music & science may seem to be strange bedfellows – the only songs I could think of were Thomas Dolby’s “She Blinded Me With Science” from the ’80s (and if you’re not old enough to remember that era and its fabulous goofy technopop, check out Devo while you’re at it), and “I Sing The Body Electric” from Fame (from the ’70s, which is making me feel really old . . . but I digress) Generally they would seem to be polar opposites – science is about concrete data and provable facts, where music is emotional and subjective. Sure, you can give a scientific description of sound waves, but that doesn’t explain why some pieces of music affect us so emotionally. (For example, I get goosebumps when I hear the french horn entrance toward the end of the 4th movement of Mendelssohn’s Scottish Symphony; I also start giggling every time I hear the intro to Spike Jones’ version of Hawaiian War Chant . . . ) Besides, trying to analyze the beauty of music reminds me of E. B. White’s comment about why analyzing humor was like dissecting a frog – “Few people are interested and the frog dies of it.” However, there is concrete scientific data on music’s value in aiding retention of information – it connects with the brain on multiple levels, which is why we teach kids the ABC song, or why anyone who ever learned the “50 Nifty” tune has no trouble remembering all 50 states in alphabetical order. (This multi-layer connection also explains “ear worms,” which is a disgustingly appropriate term for a tune that you can’t get out of your head. Often a TV theme or a commercial jingle . . . anyone old enough to remember “Plop, plop, fizz, fizz, oh what a relief it is?”) Science is getting a bad rap these days from people who deny climate change – an affliction common among right wing politicians and media pundits. Cosmos host Neil DeGrasse Tyson is doing his best to combat this willful ignorance, including his wonderful quote, “The good thing about science is that it’s true, whether or not you believe in it.” I don’t have Tyson’s scientific expertise (or a TV show), but I can do my part by using music to help make the same point. (And to tie this all together, I’ve borrowed an ear-worm-ish ’80s TV theme . . . ) We have all made the argument before in our lives, pleading “I promise I’ll take care of it, I’ll feed it and walk it and bathe it everyday…it can even sleep with me.” This time the argument didn’t even need to be made, thinkCHUA wanted to take home a tiger too, only they weren’t for sale. On our visit to the Tiger Temple in Kanchanaburi, Thailand we were able to pet the tigers, play with the cubs and take the tigers on a walk under the watchful eyes of the monks, but we couldn’t take them home. We were only able to take pictures and memories with us, even though the temptation was great to sneak a cub into our bags and back to our hostel.
thinkCHUA with tiger cubs at the Tiger Temple The Tiger Temple or Wat Pha Luang Ta Bua is located in western Thailand, an easy day trip from Bangkok. This temple is a sanctuary not only for Buddhist monks but tigers and other wild animals. The temple was founded in 1994 and received their first tiger cub in 1999. Villagers brought tigers to the monks at Tiger Temple in cases where their mothers had been killed by poachers or the tigers were injured therefore unable to survive in the wild. Slowly their tiger population grew until they turned the operation into a conservation project and started breeding tigers. Tigers are expensive “pets,” which is where tourists come in.
One of the many devoted monks that care for the tigers at the temple. It costs roughly 100 USD a day to care for a tiger and being that monks don’t earn any money to cover these costs, tourists can visit the temple for 600 baht per person (roughly $20 at 30 baht to the dollar). This is substantially higher than visiting any other temple but gives you the opportunity, as I mentioned above, to touch fully-grown tigers and to play with cubs. The money brought in by entrance fees covers the costs of feeding and caring for the tigers. The temple is also reforesting a large amount of land nearby (‘Buddhist Park’) in order to give tigers a chance to be released into the wild in the future. Read the rest of…
I have known many people who sacrificed learning curves for money and other extrinsic rewards and in the long run most ended up unhappy. In my experience innovators who follow their passions and are in it for the learning always end up happier and making more money anyway. The tricky part for innovators is to know when to leap from one learning curve to the next the way Tarzan traversed vines to move through the jungle. Innovators get restless when any curve starts to flatten out. Instead of enjoying the flat part of the curve where it takes less effort to produce more output, innovators get bored and want to find new learning curves where they can benefit from a rapidly changing rate of learning. If the goal for innovators is to get better faster the only way to accomplish it is to live on the edge where the knowledge flows are the richest. It isn’t the most comfortable place to be. It’s understandable most suffer the pain of the steep part of the learning curve, not for the kick of learning, but to finally reach the flat part of the curve. No urgency to move to another curve once the plateau is reached. It is comfortable on the flat part of the curve where the workload lessens and rewards are only available to those that have paid their dues and put in the time to climb up the curve. Yet innovators seem to extract what they need from the steep part of the curve and leap off to do it again moving on to the steep part of the next curve just when the effort required to further climb the current curve gets easier. Read the rest of…
To paraphrase from the video above, “greatness is not one big thing, it is lots of little things.” That is astoundingly true. It is the little things that add up to make the big things. Our greatness in life is not one thing we have done, it is a collection of small things amplified together to create who we are. I challenge everyone, including myself, to watch the video above and apply the message to everyday. The narrator states there are 84,000 seconds in day and we all decide how we will spend each one of those. My mission for this week is to make a hit list of things that must be worked on or accomplished by weeks end and to rid myself of the mental clutter that clogs my brain from time to time. I want to be phenomenal and as it says in the video, “no one cares what you did last year, it is what are doing now that matters.” Move towards greatness. Enjoy the video. I’m probably dating myself by referencing that antique, fairly offensive Virginia Slims tagline, encouraging women to embrace feminist progress by flaunting their own florally decorated brand of cigarettes. Now it comes across as hideously dated, but in the 1960s, the idea that women could do anything that men could – including poisoning themselves with nicotine – was both novel and incredibly exciting. When I was around eight years old, I remember struggling with whether I would prefer to be a world famous concert pianist or the first female president. (Yeah, I was thinking small . . . . ) I got a taste of politics as a college intern in Washington (although no one made a pass at me except for a bartender with bad breath. . . but I digress), and learned fairly quickly that I didn’t have a thick enough skin to survive in that arena. But I always wondered whether I’d get to see someone else achieve that ‘first female president’ goal. Like all good starving artists, I was working as a waitress in New York when Mondale selected Geraldine Ferraro as the first female member of a major party presidential ticket, and all of us called our mothers in a collective burst of feminist solidarity. So by 2008, I was ready for some more groundbreaking – excited for Hillary Clinton to be even a viable candidate, and thrilled that I resembled Sarah Palin enough to come in 2nd in a lookalike contest. But now it’s looking like Mrs. Clinton isn’t just a possibility, she’s already assumed to be the de facto nominee for 2016 (if she chooses to run; the suspense over that choice has been as gripping as any of the soap operas that have gone off the air). It’s fascinating to see how people react. If nothing else, she has proven that she definitely has the resilience, thick skin, and quick reflexes to rebound from whatever gets thrown at her, from insults to conspiracy theories to random shoes (to insulting conspiracy theories about how she was somehow behind that shoe throwing . . . ) Let’s be honest, sometimes you just do what’s easiest. Even on a quest to do everything, on-the-fly adjustments are based on convenience. For example, we took a night bus from Vientiane to Pakse to visit Vat Phou, pre-Angkor ruins. Coming off a 12-hour bus ride we realized that our enthusiasm would fade quickly, as it would take five hours of additional travel to Vat Phou, then a 3 hour bus ride to 4000 Islands; traveling with all our bags. As we considered our next move, a bus to 4000 Islands pulled up; hitting the easy button, we boarded.
The entry point to Don Dhet, the beach. With plans as fluid as the Mekong which we stood on the banks of, we waited for additional travelers to share a boat to the islands. Though we intended to stay on Don Khone, the next travelers to arrive were going to Don Det. For the second time in one morning, our “plans” were pushed aside by the realities on the ground. We joined them on the boat to Don Det, knowing little about where we were headed. Read the rest of…
I haven’t been able to get a picture of a lightly toasted Thomas’ English muffin with butter and strawberry preserves oozing into those marvelous nooks and crannies out of my head. Maybe it’s because I’m resisting the temptation while on one of my frequent short-lived diet and exercise delusions. More likely it’s because of a story that caught my eye last week about an executive who left the company (Bimbo Bakeries, I’m not kidding) that makes Thomas’ English Muffins to join the arch enemy, Hostess Brands. It seems that Bimbo is suing to prevent the executive from joining Hostess because they suspect he has absconded with and will divulge the secret of how to make English muffins with perfect nooks and crannies. You heard right. The row is about protecting the trade secret for creating nooks and crannies in an English muffin. Bimbo claims there are only seven people who possess the trade secret and of course the executive leaving to make Twinkies is one of them. I find it hard to believe that only seven people have the know-how necessary to create great nooks and crannies. It sounds more like a marketing ploy. But what do I know. I thought it was just using a fork to split the muffin! Think about it. Samuel Bath Thomas left England headed for America in 1874 with a recipe for his muffin baked on hot griddles. Surely in over 135 years more than seven people have accumulated the know-how for nooks and crannies. And how are we to know if Samuel Thomas didn’t borrow the formula before heading for fame and fortune in America. Not to accuse Samuel Thomas of pilfering the recipe and starting an English muffin revolution but it does sound eerily similar to Samuel Slater escaping England with the trade secrets for the textile mill, which of course started the U.S. Industrial Revolution! No surprise that nooks and crannies are the secret to a great English muffin. Those air pockets allow for both perfect toasting and a natural repository for the aforementioned butter and jam. So Bimbo Bakery goes to incredible lengths to protect its know-how. Instead of recipes they use codebooks. Employees are on a need to know basis and only have access to the pages of the codebook necessary to complete their specific task. They are shielded from the information and people in departments working on other tasks. It doesn’t sound like a formula for innovation but then maybe Bimbo isn’t interested in innovation. Perhaps they are just obsessed with protecting the status quo for the nooks and crannies of English muffin making. Nooks and crannies are also the secret to great innovation. Innovators thrive in nooks and crannies and refuse to stay in any silo barred from communicating across them. They know freely exploring nooks and crannies is the only way to get better faster. Nooks and crannies increase the surface area an innovator can expose to the best knowledge flows and new ideas. With more surface area comes greater exposure to and absorption of a broader range of ideas, experiences, and capabilities. A thoughtfully comprised network of unusual suspects increases an innovator’s surface area. Social media platforms are just nooks and crannies on steroids to an innovator. Innovators also know that most important innovations emerge from the nooks and crannies between silos, disciplines, and industry sectors. It is by combining and recombining ideas and capabilities from across silos that innovators create new ways to deliver value. System solutions for the big social challenges of our time including education, health care, and energy, will only be found if we get more comfortable in the nooks and crannies between us. Pass the strawberry preserves. |
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