How Far Will the Biosciences Take Us?
"A stimulating and exciting look at how we got to the present state of health care and where we can potentially go. A unique perspective and a great read." David Lester, Ph.D., President, ITHW Inc.; formerly Director, Human Health Technologies, Pfizer Inc. "The explosion of new knowledge in the biosciences will raise important challenges for our social, ethical, and economic thinking. The Schoemakers have given us an incredibly useful book to stimulate that thinking. One could not ask for a better guidebook to an exciting if challenging future." Professor Arthur L. Caplan, Director of the Center for Bioethics and Hart Professor, University of Pennsylvania "What a fascinating book! The authors have really mastered all the aspects (social, human, scientific, and business) of the biomedical revolution that is taking place this century. Awesome." Giancarlo Barolat,M.D., Director, Barolat Neuroscience, Presbyterian St. Luke Medical Center, Denver; formerly Professor of Neurosurgery at Thomas Jefferson University, Philadelphia "Wonderfully comprehensive, yet still digestible for non-scientists.; Wish I had this book when we examined some health care innovation opportunities at GE; it would have provided a great foundation for the team." Patia McGrath, Global Director - Innovation and Strategic Connections, Corporate Marketing, General Electric The key scientific discoveries of the 21st century are coming from the biosciences. These discoveries will impact our lives in ways we can only begin to imagine. Now, two leading experts will help you imagine those impacts--and prepare for them. Paul and Joyce Schoemaker preview the research innovations most likely to emerge in the coming years and reveal what they're likely to mean for everything from human longevity to the health of society, from bioterrorism to personalized medicine. Writing for every interested citizen and consumer, the Schoemakers illuminate the hottest technologies and most controversial issues associated with contemporary biotechnology--including stem cells, cloning, pharmacogenetics, DNA chips, proteomics, gene therapy, and much more.; Then, drawing on Paul Schoemaker's unsurpassed experience helping global organizations prepare for the future, the authors sketch multiple long-term scenarios for the biosciences!and reveal how they will impact your health, family, career, and the society you live in. / How long will you live? How long can you live? Beyond 100: breakthroughs made, breakthroughs yet to come / New business opportunities for the age of biosciences The future of pharmaceuticals, medical devices, diagnostics, disease management, and prevention / The economics, politics, and technology of the bioscience revolution What's driving the biosciences--and what could halt them dead in their tracks / To 2025 and beyond: powerful scenarios and what they mean Making sense of the age of biosciences--so you can make better decisions for you and your family
Foreword xii Preface xiv Chapter 1 Living well beyond 100 1 Great progress made, much more to come 1 Medical challenges and promises 4 Living well versus living longer 7 Social challenges and promises 10 Can we afford old age? 11 Government and business 13 The journey ahead 17 Chapter 2 A short history of biomedicine 21 Improving hygiene 21 The power of immunology 23 Monoclonal antibodies 24 The discovery of antibiotics 25 The DNA revolution 26 Recombinant DNA and cloning 27 Biotechnology 29 Unraveling the code 31 Conclusion 33 Chapter 3 Snapshot of the biosciences 35 DNA-based technologies 35 Genomics 37 Genetic testing 37 DNA chips 39 Pharmacogenetics 40 Cloning 41 Gene therapy 43 RNA-based technologies 45 Antisense technology 45 RNA interference (RNAi) 46 Protein-based technologies 46 Vaccines 47 Monoclonal Antibodies 48 Proteomics 49 Cell-based and other technologies 50 Stem cells 50 Antimicrobials 51 Conclusion 52 Chapter 4 Bio-driven convergence 57 Converging technologies 58 Telemedicine 58 Remote diagnostics 59 Biological drug factories 59 Biochips 59 Tissue engineering 60 Imaging 61 Multidirectional synergies 62 Shifting industry boundaries 64 Healthcare and IT 65 Medical information handling 65 Medical data storage 66 Computers and drug discovery 66 Remote monitoring and the wired home 67 Reshaping bioinformatics 67 Bioinformatics and gene banks 69 Personalized medicine 70 Systems biology and holistic medicine 70 Biosensors 72 Nano devices 72 Commercialization challenges 73 Technological challenges: biocompatibility 74 Regulatory challenges: clinical safety and efficacy 74 Political challenges: privacy and ownership 74 Social challenges: consumer advocacy 75 The road ahead 76 Chapter 5 The business of biomedicine 79 The pharmaceutical industry 79 Diminishing drug pipelines 82 The biotechnology sector 85 Medical device industry 89 Cardiovascular device segment 89 Orthopedic device segment 91 Neurological device segment 91 Medical diagnostics industry 92 Laboratory testing 93 Point-of-care (POC) patient monitoring and diagnosis 94 Prevention and disease management 95 Conclusions 97 Chapter 6 Healthcare under stress 101 Stress in developed nations 103 Healthcare funding 104 Major diseases of the developed world 105 Cardiovascular diseases 106 Cancer 106 Stress in developing nations 107 Acquired Immune Deficiency Syndrome (AIDS) 109 Malaria 111 Which technologies will succeed? 113 Illustrative cases 114 AIDS and malaria 115 Cardiovascular diseases 115 Cancer 116 Chapter 7 Wildcards for the future 125 Trends versus uncertainties 125 Wildcards 127 Society and politics 127 Public support of the biosciences? 127 A major pandemic? 129 Biotech rogue states? 130 Science and technology 131 Raging success or major meltdown? 131 Role of complementary industries? 132 Intellectual property regimes? 133 Qualified staff for healthcare and research? 133 Business and economics 134 Economic growth and global power shifts? 134 Venture capital and other funding sources? 135 Climate change and resource scarcity? 135 A scenario framework 136 The first overarching uncertainty: technological success 137 The second overarching uncertainty: societal acceptance 137 Multiple scenarios are possible 138 The role of stakeholders 141 Chapter 8 Scenarios up to 2025 143 Bio gridlock scenario 143 The view from 2025 143 How we got here 145 The world we live in 150 Analogous cases 151 Golden age scenario 153 The view from 2025 154 How we got here 154 The world we live in 158 Analogous case: information technology 160 Chapter 9 What it all means 163 You and your family 163 At work 168 Business and commerce 170 Society at large 172 Appendix A DNA, RNA, and protein 177 Molecules of inheritance 177 The structure of DNA 178 Cracking the code 179 Making proteins 180 Regulating gene expression 181 Appendix B Cloning genes 183 Restriction enzymes 183 Cloning procedure 184 Appendix C Complexity of the genome 187 Non-Coding RNAs 187 SNP variations 188 Glossary of Biomedical Terms 191 Acknowledgments 199 About the Authors 201 Index 203