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MedTech industry – Crystal gazing

It is aphoristically said, “All the forces in the world are not as powerful as an idea whose time has come,” and this is nowhere better exemplified than by the medical technology (MedTech) industry. Now is the time for MedTech industry, and its subsidiary in-vitro diagnostics (IVD), to blossom; now because of the heft and the pelf of artificial intelligence (AI), machine learning (ML), big data analytics, quantum computing, natural language processing; and now because it is the felt need of all the stakeholders – consumers, providers, regulators, and the industry itself. And this now shall inexorably march well into, not only near foreseeable, but even distant, future. Ultimately, it would be the dynamic play of innovations, economics, market forces, regulatory and governmental policies, and the acceptance of technology by the patients and the medical professionals alike, which will decide the shape MedTech sector will take …indeed exciting times ahead.

Till now, a lot of innovations in technology sector were in vertical silos, with concerns related to security, confidentiality, and privacy leading to a reluctant acceptance by the end-users. I foresee an attitudinal shift of mind-sets consequent to seamless lateral integration of technology-driven medical care, which would include AI- and ML-based diagnostic and therapeutic algorithmic paradigms, with classical care-based healthcare. It is this modern synthesis of the apparently disparate and squabbling twains into an all-encompassing organic health ecosystem, such that deficiencies of one are covered by the other and their pluses added, not mathematically, but geometrically, which is going to define the medical care of the future. Certainly, the empathy, sympathy, and the touch-based medical care, would not, and should not, lose its salience. In fact, later, once complemented with low-hanging fruits from core research in other fields of science, through translational research, it shall create a very potent system of medicine, which will ensure not only better outcomes, but also better compliance, continuity of care and, cost effectiveness. Improving healthcare delivery and financing and ever so rapidly evolving MedTech landscape in new age sector of proteomics, metabolomics, and genomics, suitably backed by hybrid imaging technologies, shall be the drivers of future growth. Developments in molecular cytogenetic techniques like 16S RNA polymerase chain reaction (PCR), metagenomic next-generation sequencing, fluorescence in-situ hybridization (FISH), etc., shall be revolutionary for in-vitro and point-of-care (POC) diagnostics.

Health education of the laity, with a view to sensitizing them to the need of taking health in their own hands by using wearable devices, remote sensing and telemedicine, has already led to a sustained growth of these technologies. Complementary to this behavioral change in the public, there has lately been increased governmental spends on control of lifestyle disorders, need-based personalized care, universal insurance, and better standards for quality control and regulation of data. The new Medical Devices Policy 2023, with its stress on export rather than import, and the creation of an Export Promotion Council for medical devices has the potential to catapult India on to the forefront of MedTech industry, a position in which it is placed fourth in the Asia-Pacific region at present. Initiatives like Promotion of Research and Innovation in Pharma MedTech sector (PRIP), Assistance for Medical Devices Clusters for Common Facilities (AMD-CF), and multiple production-linked incentive (PLI) schemes are initiatives certainly in the right direction. Even the Genomic India Project of the Council for Scientific and Industrial Research (CSIR), jointly with the department of Biotechnology of Government of India, is an important step toward personalized medicine. This is especially relevant in India because of extreme diversity of its population, not only socio-economically and culturally, but even ethnically and genetically. India with its demographic dividend, sizeable English speaking population, as well as a large force of technologically enabled and skilled youngsters, is poised for leading the world in this field in the next decade. We shall be in a position to not only meet the enormous demands of our own population, but also be the feeder for global consumption.

Needless to say, and a no-brainer – socio-political imperatives, economics, and social determinants of health will dictate the trajectory of the MedTech industry. All this, rosy a picture, can derail, if the recent trend of our political masters of dithering on their responsibility and mandate to deliver quality, affordable, and accessible healthcare to the masses is sustained in the future too. Brazenly, and unabashedly, they pass on their moral and statutory responsibility of delivering quality healthcare to the suffering humanity on to the shoulders of private sector. They cover their misdeeds of governance using euphemistic jargons like affirmative action, to cap prices of devices, drugs, and overall healthcare. This will not only be a deterrence to innovations, but shall also lead to surreptitious delay and denial of treatment to the hapless patients…the very raison d’etre of the entire industry. Pavan Choudhary, an intelligentsia, sums it up all so very succinctly, “Price controls led to distortions in the market, inefficiencies, and reduced investment in production,” citing the Venezuelan and USSR breakdown experiences and foresees such measures as “a body blow which will put the private hospitals in ICU,” and as a corollary thereof, the entire MedTech and IVD industry too….God save the king!

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