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The curious case of Brian Mahony
Brian’s phone quickly blinked. A message from the heart. Literally, from your heart, the beginning of the short text read. The nano-swimmer sensor circulating in his blood vessels encountered something strange which might need to be examined, so it sent a notification to his smart devices. One of them already decided to schedule a visit with his GP.
It was a frosty January afternoon in 2035, the sun gleamed on the icy blocks in Vancouver’s Stanley Park. Brian was nervous about the visit and tried to divert his attention by walking around under the pines in the freezing cold. He suspected that his old condition is back, and he didn’t want to have that torture called therapy again. Yet, his phone reminded him constantly and rigorously, he’s got an appointment to attend to. When he entered the GP’s office, there was no line, he did not have to wait a minute and the assistant smiled at him nicely.
But when Brian looked at his doctor, he knew there is no good news here. He was right: his endocarditis came back. To confirm the diagnosis, the GP looked at Brian’s chest patch that recorded ECG data, punctured his finger to get a one-drop blood test and did a quick chest X-ray. Unfortunately, the results showed endocarditis and the disease agent was some particularly aggressive and rare bacteria.
Personalized drug design instead of one-fits-for-all solution
Brian’s GP couldn’t prescribe the appropriate antibiotics at once. At first, he diligently studied the patient’s genetic background; how his body metabolizes certain drugs and whether there is a risk of any possible allergic reaction. Back in the 2010s, this practice was named pharmacogenomics. As a consequence, physicians could improve health outcomes, reduce the risk of side effects and patients could also save a significant amount of money by avoiding ineffective medications. So, it turned out that Brian’s bacteria had resistance to certain types of antibiotics which would have been efficient in his treatment. Those had to be excluded.
Now, his doctor turned to artificial intelligence for some more help. A smart algorithm that would root out a specialized therapy for Brian based on his antibiotic resistance and the rare bacteria. They only had to wait a couple of hours for the results. Unlike back in the 2010s, when the design of a new drug could typically take months or years, not to speak about the clinical trials!
Organs-on-chips instead of large-scale clinical trials
When the smart algorithm on a supercomputer found a potential molecule combination to help cure Brian’s disease, it turned out the drug solution was a redesign of existing drugs, and there was no need for further tests similar to a clinical trial before printing out the medication.
Traditional clinical trials were anyway replaced in the 2020s by a technology called organs-on-chips, in silico trials and bioprinting. Neither animals nor humans were tested anymore on experimental drugs, the costs have fallen, and the time significantly shortened for the development of new drugs. Many experts already believed in the 2010s that these technologies, including organs-on-chips, could revolutionize clinical trials and replace animal testing completely. These tiny “chip-like” devices are engineered to mimic how the lung or the heart works at the cellular level. They are translucent, and so can provide a window into the inner workings of an organ. They mimic whole–body physiology better, and thus better assess responses to new drug candidates.
3D printing drugs in the pharmacy
In Brian’s case, when the A.I. algorithm finally designed the appropriate medication and his doctors agreed on the right dosage, he could go to the hospital pharmacy to let the pharmacist print out his personalized pills. It was a common practice, but it took many years to get people used to it.
3D printing was applied in healthcare first in the 2010s. The technology was revolutionary back then. Today, it’s common practice. The machine prints out the powdered drug layer by layer to make it dissolve faster than average pills. Moreover, you can ask your pharmacist to 3D print drugs in odd shapes; such as dinosaurs or octopuses in order to make it easier for kids to take pills. Now, Brian could have also asked the pharmacist to print out Batman or a small Porsche, but the doctors agreed that the tiny pyramid shape delivers drugs more expediently, so he should swallow his medication in the form of small, Egyptian pyramids.
Health counseling meeting points instead of traditional pharmacies
When Brian went to the hospital pharmacy for the drugs, he directly felt the benefits of automation. While the drug dispenser robot quietly murmured in the background and monotonously selected the medication on demand, he could have a chat with the pharmacist about his illness. She was very kind and gave him invaluable tips how to feel better.
Postmodern pharmacies do not solely act as institutions for drug distribution, as with the help of technology they have more time, they gain more importance in filtering patients. They act as health managers helping healthy patients, as well as patients with medical conditions, manage their treatment, they manage medicines for people taking multiple drugs, they provide advice for minor ailments and deliver public health services.
Brian was content with how fast he received the appropriate medication, and how well his doctors could coordinate his needs with the pharmacy and drug producing companies. He called to mind his experiences when he was first diagnosed with endocarditis, exactly 20 years ago. Back then, in the 2010s, the system was completely different. He had a long treatment period, had to wait too much for his medication, his doctors couldn’t find the right drugs for him and he got allergic a lot of times. These made his illness almost unbearable.
Now, pharmacogenomics, 3D printing, robotics or artificial intelligence all turned healthcare and pharma into systems truly designed for his needs. And he assumed, for the needs of all other patients, too.
It is up to us; what kind of future we create from the means available to us. Trends and technologies show that drug design, manufacturing, and distribution, the role and place of pharmacies or insurance companies will be completely different than today.
In order to figure out how to arrive at a positive future, The Medical Futurist’s latest e-book about Technologies Shaping the Future of Pharma could offer some guidance and a clear picture where we are heading. Read on!