21VOL 28, NO.1 - JUNE 2012

In this cont e x t , the role s of he a lt h profe s si o n a ls a re cle a r l y de s t in e d to e vo l v e . In p a r a ll e l , p at i e nt s a re incr e a singl y int e r c o nn e c t e d a n d wa nt to hav e a voice . T he fut ur e se e m s to b e in the regio n a l , nat io n a l a nd int e r n at i o n a l net wo r k s a nd e x p e c t at i o n s a re high towa r ds comp ut e r to o ls to imp r o v e me dic in e in the 2 1 s t cent ur y. T he s e to o ls ten d thus to b e co m e the ner v o us s y s t e m of pub li c he a lt h . We mus t b e able to com - muni c at e , und e r s t a n d , de ci d e , ma na ge a nd de v e l o p our he a lt h s y s t e m s in a wor l d whe r e info r m at i o n is b e co ming a re a l st r at e gi c is su e , mor e and mor e e ve r y day.

In ho sp it a ls , for ins t a n c e , comp ut e r i z at i o n c a n re du ce comp li c at i o n s , m o r t a lit y r at e s a nd co s t s . Howe v e r, p o o r ado p - t i o n or us e of comp ut e r to o ls c a n b e dr a m at i c (e - iat r o ge ny ) . A prer e quisit e for opt im a l b en efit is the de sign of progr a m s that are simp l e a nd er go n o mi c , conn e c t e d a nd mobil e , cont e x t - aw a r e (lo c a li z at i o n , ac t i v it y, vit a l signs , emot i o n a l st at us) a nd rel y ing on a rob us t inf r a s t r u c t ur e (s e cur it y, et c .) . For out p at i e nt s , int e gr at e d , p er s o n a li ze d a nd lo c a l I T ser v i ce s coul d a ls o allow a bet t e r c a r e of p at i e nt s at hom e (e . g . A mbi e nt A s sis t e d L i v ing progr a m; A A L ) , gi v e n the a ging p op ulat i o n a nd grow ing inci d e n c e of chro ni c dis e a s e s . Tele m e di c in e is a ls o ga ining imp o r t a n c e a nd se e m s to imp r o v e p at i e nt comfo r t a nd c a r e wit hin regio n s wit h fe w he a lt h c a r e pro v i d e r s . Fina ll y, he a lt h info r m at i o n net wo r k s proj e c t s (e . g . e - t oil e in Gen e v a ) coul d imp r o v e the qua lit y a nd ef fic i e n c y of c a r e by ef fic i e nt l y sha r ing info r m at i o n a mo ng a ll he a lt h c a r e pro v i d e r s whil e ac t ua ll y put t ing the p at i e nt at the cent e r of the pro ce s s .

T hus , like their me dic in e a nd nur sing conf r e r e s , communit y pha r m a c is t s (in c lu ding tho s e invo l v e d in hom e c a r e) , a s well a s ho sp it a l or indus t r y pha r m a c is t s , a re e x p e c t e d to int e gr at e the s e ne w p a r a digm s a nd to o ls in their pr a c t i c e , whil e rem a in - ing a ble to judge their ac t ua l us ef uln e s s for opt im a l ma na ge - m e nt of the p at i e nt .

Pharmaceutical industry ’s development strategies 6 , 7 Fo r c e d by the high at t r it i o n r at e of lat e st a ge me dic in e c a n di d at e s , a nd incr e a singl y empt y pip e lin e s , se v e r a l st r at e gi e s a re b eing foll o w e d by pha r m a c e ut i c a l indus t r i e s to incr e a s e the numb e r of c a n di d at e s . A mo ng the m is the es t a b lishm e nt of high thro ughp ut scr e e ning met h o ds to se a r c h la r ge lib r a r i e s of che mi c a l st r u c t ur e s a nd to ide nt if y p ot e nt i a l me dic in a l c a n di d at e s . Howe v e r, high e x p e c t at i o n s

of this app r o a c h hav e not ent ir e l y b e e n met and the huma n e x p e r i e n c e may pro v e to b e a s ef fic i e nt (e . g . tha nk s to the Lipin sk i « Rul e s of 5 » to e v a lu at e dr ug like n e s s) . A not h e r a pp r o a c h is the de v e l o p m e nt of bio l o gi c a ls (prot e in s a nd ant ib o di e s) . T h e y hav e b e e n the dr i v e r of inn o v at i o n for the la s t fe w ye a r s , ma d e po s sib l e by the ad v a n ce m e nt of stu d - i e s on their b a sis of ac t io n , st e mming fro m prot e o mi c s a nd gen o mi c s . A not h e r bu z z - w o r d in cur r e nt me dic in e s de v e l o p - m e nt is “In di v i du a li ze d Me dic in e ”, whic h t a ke s int o acco unt the imp a c t of dif fe r e n c e s b et w e e n p at i e nt s on dr ug s ’ ef fic a c y (t a r ge t e x p r e s si o n , pha r m a co k in e t i c s , pha r m a co ge n e t i c s , et c .) . Tr a s t u z um a b is an e x a mp l e . Mor e and mor e , the r a p e ut i c s will b e acco mp a ni e d by so - c a ll e d “co mp a ni o n dia gn o s t i c s ”. L a s t but not le a s t , p or t fo li o ma na ge m e nt , i.e . the se a r c h for addit i o n a l indic at i o n s for the s a m e me dic in e (by va r io us app r o a c h e s su c h a s re v e r s e gen et i c s) or acquisit i o n of biot e c h comp a ni e s to obt a in acce s s to ne w me dic in e s c a n di d at e s a re ot h e r opp o r t unit i e s for “B ig Pha r m a ”.

H o w e v e r, such nov e lt i e s mus t b e know l e dge - b a s e d , whic h dema n ds a clo s e int e r a c t i o n b et w e e n ac a d e mi a a nd indus t r y. T his co o p e r at i o n is yet not ea s y to ma na ge (dif fe r e nt a s sump - t i o n s , confli c t of int e r e s t s , et c .) . A c a d e mi a is int e r e s t e d in cre at ing a nd dif f using know l e dge , a lt h o ugh it is als o slow l y mov ing to ma r ke t ac t i v it i e s (p a p e r s pub li c at i o n to acquir e fun ding , p at e nt ing , et c .) . A c a d e mi c scie nt is t s a re yet of t e n b eing fo cus e d to o much on the fun da m e nt a l sid e of dr ug dis co v e r y a nd de v e l o p m e nt , negl e c t ing the tr a nslat i o n a l a pp r o a c h in whic h their finding s sho ul d b e tr a nslat e d int o a re a l - w o r l d pro du c t . To the cont r a r y, dr ug de v e l o p m e nt in the cor p o r at e wor l d is de sign e d to cre at e re v e nu e for the com - p a ny. In an indus t r i a l env ir o nm e nt , scie nt ifi c cre at i v it y is of t e n sup p r e s s e d . Indus t r i a l or g a ni z at i o n s a re awa r e of the s e limit a - t i o n s a nd st r i v e to eit h e r imp l e m e nt “biot e c h - like ” st r u c t ur e s in dr ug dis co v e r y a nd ea r l y de v e l o p m e nt , or se e k int e r a c t i o n wit h ac a d e mi c ins t it ut i o n s (c a ll e d a “co lla b o r at i o n bub b l e ” ) . In addit i o n , mult ilat e r a l “op e n inn o v at i o n ” mo d e ls do e x is t , in whic h know l e dge is sha r e d b et w e e n se v e r a l p a r t n e r s fro m ac a d e mi a a nd indus t r y, of t e n using “ We b 2 . 0 ” to o ls (e . g . “O p e n S our c e Dr ug Dis co v e r y ” net wo r k , for nov e l a nt i - t ub e r cul o sis dr ug s) . Fo r co m m u n i t y a n d cli n i c a l p h a r m a c y, su c h n e w d e - v e l o p m e nt s sh o u l d h a v e a sig n i fi c a nt im p a c t (e . g . di a g n o s t i c / m o n i t o r i n g k it s , et c . ) .

Fig. 1. Round table

THE FUTURE O F PH A R M A C Y