In a prior post, I sought to explore the shifting nature of the medical industry, from clearly defined categories of devices, drugs and diagnostics to a spectrum of products that defy categorization into any one category and instead frequently qualify as multiple.
…Competition in the medical product industry has long since changed from being defined as those products performing a similar, albeit narrowly-defined function, like when the angioplasty manufacturer could reasonably consider his/her competitors to be all other manufacturers of devices that produce catheter-based recanalization of the atherosclerotic lumen. It is a myopic angioplasty manufacturer who does not now also consider atherectomy, transmyocardial laser revascularization, bare metal stents, drug-eluting stents, and traditional/open, MIDCAB (and similar) or even percutaneous coronary artery bypass graft, as well as the classes of drugs and other non-device approaches to produce non-surgical reversal of atherosclerosis….
Gauging the state of technology development in the recent past and the present, the trend toward less demarcation between medical product categories continues unabated, not just for treatment of ischemic heart disease, but for other diseases and disorders. Advances in technology enable this, while the customer — healthcare systems, third party payers and, increasingly, patients — are demanding this.
There nonetheless remain certain aspects of select diseases and disorders that sustain preference if not dominance by one class of medical products. The spine, playing as it does such a physical, structural, functional role, demands solutions that are device-intensive (e.g., discs, cages), however much bone growth factors, bone graft substitutes and other non-device products are moving in. Cancer treatment, aside from surgical intervention, remains largely a drug-intensive effort, although "drug" continues to be redefined to include moieties that are clearly biotech in nature.
I continue to think about ischemic disease in particular because it represents a sort of microcosm of medtech development. Physicians like to view treatment in terms of "gold standards" or the current state of the art, but as ischemic heart disease (and many other diseases) have shown, the goal line keeps changing as new technologies advance the quality of life, clinical outcome, cost of care and other criteria that determine value of innovations in the market. Ischemia can be addressed from so many different perspectives that it has become a lightening rod for development efforts.
Ultimately, I am thrilled at bearing witness to the evolution of technology development. At the same time, however, I must empathize with. and work hard to come to the aid of, my medtech clients who must continually look to the bigger picture to ensure that their products and technologies remain relevant, lest the trend suddenly make them obsolete.