The Smithsonian published this month a fascinating article about the future of implants. It’s a must read for anyone interested in how organs and limbs are being manufactured and how we are moving quite quickly toward replacing a large percentage of the human body with devices, which will be connected to the brain. It’s astounding. Here are just some of the excerpts that caught my attention:
“The past five years, in particular, have seen an explosion of innovation.”
“…the robot vividly showcases how much of our bodies can be replaced by circuits, plastic and metal … his team was able to rebuild more than 50 percent of the human body … bioethicists, theologians and others are contending with the question, How much of a human being can be replaced and still be considered human?”
“Improved software, longer-lasting batteries and smaller, more power-efficient microprocessors — the technologies driving the revolution in personal electronics — have ushered in a new era in bionics. In addition to prosthetic limbs, which are more versatile and user-friendly than ever before, researchers have developed functioning prototypes of artificial organs that can take the place of one’s spleen, pancreas or lungs. And an experimental implant that wires the brain to a computer holds the promise of giving quadriplegics control over artificial limbs. Such bionic marvels will increasingly find their way into our lives and our bodies. We have never been so replaceable.”
“Herr believes that insurance providers need to radically rethink their cost-benefit analyses. Although the latest bionic prosthetics are more expensive per unit than less-complex devices, he argues, they reduce health care payouts across the lifetime of the patient. ‘When leg amputees use low-tech prostheses, they develop joint conditions, knee arthritis, hip arthritis, and they’re on continual pain medication,’ says Herr. ‘They don’t walk that much because walking is difficult, and that drives cardiovascular disease and obesity.’”
Here’s how it boils down for me. For those needing replacement limbs and organs, these are unbelievably exciting developments, and the pace of innovation and change is remarkable. We should all welcome, embrace and encourage it. In addition to sparking imagination and inspiring hope, these breakthroughs also need to spark a dialogue about the best way to ensure that we can afford to deliver these medical miracles in a cost-effective, quality-conscious manner. It starts with paying more for truly innovative products that can demonstrate medical and clinical ROI, not just with the surgery but the continuum of care and patient needs including reducing adverse effects longer term. Too often we have seen in the implant space “me too” products introduced with tweaks here and there and marketed as “next generation.” Instead these products are not reflective of truly meaningful and measurable innovation and in many cases these are not forward steps but rather disastrous backward ones. (See the incredible number of recalls occurring with implants.)
Every health plan out there, or an employer offering health care, or governments covering large populations, have to be reading between the lines of this article and asking honest questions about how those who are so deserving of these devices are going to get them clinically and financially. It’s a simple one-word answer to a complex question: management. Even today’s implantable medical device sector is largely unmanaged, with compromised quality in some cases, high and escalating costs, a lack of data and visibility, poor communication and nearly none of the market-driven advantages to which the American consumers are accustomed.
We have to address today’s issues today, and that will prepare us for the fantastic challenges of the near future, as the Smithsonian highlighted. Let’s start by “managing,” but managing in a good way, so that patients, surgeons, surgical facilities and device manufacturers all win. I know it can be done because I’m doing it every day with my colleagues for some of this nation’s largest insurers. We’ve got problems to address today on this front that will only grow exponentially greater as we are able to alleviate the pain and suffering of our fellow human beings. Let’s take the blinders off and tackle this problem, together!