Simplifying Diagnostics to Create More SolutionsWed, 09/07/2016 - 15:15
Q: How are economic fluctuations affecting the diagnostics segment?
A: Mexico’s potential financial growth is surpassed by possibilities in healthcare. We aim to create win-win situations alongside hospitals to expand our business, and help them to provide better services. Unfortunately, the current budget pressure and the weakened peso has led public institutions to continuously push for lower costs. Public institutions are constantly pushing for 10 to 30-percent cost cuts, and that is not easy with the current exchange rate.
Economic turmoil also affects ongoing projects such as the microbial resistance program. This initiative collects data about microbial sensitivity to antibiotics and the doses in which these drugs are effective. There is room to introduce new platforms in public institutions to support the identification of pathogens quicker. This will result in better health outcomes for patients, and represents an important measure in stopping the spread of superbug microbes that are highly resistant to most if not all antibiotics. Budget constraints and high exchange rates are causing ROIs on these kinds of projects to take five years, conflicting with public tenders that last three years. Therefore, we focus on generating sustainable growth and increasing effectiveness within the organization to do more with fewer resources.
Players in the healthcare sector should increase their focus on pharmacoeconomics. Public institutions must realize that incorporating innovations can save money by reducing the patient hospitalization times. Thus, hospitals could provide medical services to more patients with the same infrastructure. The new director of IMSS, Mikel Arriola, recently announced plans to build 40 new clinics but we believe they should focus on improving diagnostics inside existing hospitals. Investing 30 percent more in diagnostics could generate significant savings in areas such as treatment and hospitalization. The system needs more people with a holistic view, making decisions to serve the bigger purpose, which is having a healthy population.
Q: According to clinics operating your equipment, should the healthcare system prioritize hiring specialized technicians or increasing infrastructure?
A: Staff members generally leave within their first six months significantly increasing job rotation. Considering technicians’ learning curve of four to five months we have to provide training twice a year. Moreover, hospitals and clinics lose their expertise as high-technology diagnostic equipment requires fully trained personnel.
We have created user-friendly molecular biology applications that do not require highly specialized operators. We aim to simplify diagnostics to bring more solutions to areas lacking specialized personnel. Molecular biology applications are already employed in private and public markets and shorten diagnostic times while improving pathogen detection accuracy. Many key decision makers in the public sector are interested in new technology but struggle against budget constraints, and depend on discounts.
Our company wants BioMérieux’s platforms to be included in the basic formulary. However, this is a sophisticated process and we are conducting pharmacoeconomic studies to collect enough evidence of the impact and value they can generate for institutions. However, little information on mortality, septicemia cases, or nosocomial diseases is available, and we cannot fix a problem that cannot be measured. This is a huge gap in Mexico and we cannot fix a problem that is not measured. In Europe and the US all these cases are reported and recorded, so there is plenty of data available for healthcare providers and patients. In the US there have been trials that resulted from ineffective detection of septicemia, whereas in Mexico septicemia cases are not properly reported and are excused as mere complications. The first step to finding a solution is recognizing the problem.
Q: What is unique about your molecular biology platform for pathogen detection?
A: A clinician can identify up to 20 pathogens with this test. We are commercializing panels for infections of the digestive and respiratory tracts, and for sepsis. The respiratory panel includes influenza and detection of other viruses, parasites, fungi and bacteria, while the gastrointestinal panel mostly detects parasites.
This panel is helpful to avoid misuse of antibiotics, for instance during viral infections, and detects the drugs to which these pathogens are sensitive. It is perfect to diagnose infectious diseases and design the best treatment.
When physicians receive cases of acute and severe infections, they can use the panel to detect the reason behind the symptoms within an hour. This is relevant in the detection and treatment of septicemia, which becomes more deadly every hour the patient remains without treatment. The mortality rate of septicemia is 98 percent after 36 hours.
Q: Influenza is considered an important driver in your annual financial report. What applications do you have for this disease?
A: The flu pandemic is certainly driving this business division. Physicians frequently use a low cost, rapid test to detect influenza. But this is a test for an individual virus, so every day they do several tests to identify what virus or pathogens patients have.
We have a very affordable solution for that and also a molecular biology platform, which costs 15 times more than the rapid test but it’s better to use from the beginning and provides results within an hour. This is a multiplex PCR technology called FilmArray that was commercialized by BioFire, a company acquired by BioMérieux in 2015.
The healthcare system needs people with a wider view, who can push for the implementation of these solutions. The latter are quite important in the treatment of immunosuppressed patients or those with complex diseases such as diabetes and cancer. Our test is now available in private hospitals and not in public institutions, yet physicians in public hospitals are aware that this application exists and are interested in acquiring it. Insurance companies can benefit greatly from this test to avoid unnecessary expenses.
Q: What role should new molecular biology applications play in improving patients’ access to diagnostic tests?
A: Mexico has many challenges to deliver healthcare services to rural and remote areas. Sometimes patients have to travel 50 km to visit the nearest clinic, which increases expenditures. Our FilmArray is portable enough to be taken to remote communities, so this changes the whole paradigm of medical care. Instead of expecting patients to travel long distances, we take the equipment with us and improve access to cutting-edge diagnostic tools. Mexico is not the only country with this problem, this happens in all Latin America, including Brazil and Argentina.
Our platform is the simplest to use with a broad coverage of more than 200 pathogens of infectious diseases that have a high impact on public health. These include sepsis, respiratory meningitis and gastrointestinal infections. Symptoms of all of these pathologies overlap representing a diagnostic challenge. Many of these illnesses are timesensitive, and FilmArray provides rapid information to improve medical decisions and patient recovery. We believe that molecular testing will become routine.
This molecular biology platform for pathogen detection is our priority. We are also tapping into implementing process automatization solutions in laboratories. These require significant investments and changes to how processes are managed inside institutions and hospitals.