Guest Column | March 30, 2018

15 Bold Predictions About Healthcare's Future — And What Bio/Pharma Must Do To Prosper In It

By Martin Lush, VP of Health Sciences, NSF International

Ever participated on one of those benchmarking exercises? You know what I mean: a (usually) fresh-faced consultant asks lots of questions and fills in a spreadsheet comparing what you do with your competitors. Well, beware.

Benchmarking Can Be Dangerous

Trying to copy and follow others in a world of turbulence and massive uncertainty is a risky business. Assuming that what worked last year will work in the future is very risky.

I recently presented a webinar on The Political Landscape and the Future of the Pharma Industry. I talked about lots of things, including the impact of Google, Amazon, and others on the pharma industry. Big Data, artificial intelligence (AI), robotics, and machine and deep learning all got a mention. To be honest, a lot of what I had to say was educated guesswork on my part.  Whether what I predict happens or not remains to be seen.  After all, 20 years ago we were told to expect a paperless society, flying cars, and more leisure time by now!  The whole objective was just to get people thinking beyond the here and now.

If you’re interested in your future read on. If you’re not, read on for the sake of your children.

15 Predictions About The Future Of Healthcare

  1. We have 7.5 billion people in the world who need looking after. Sixty-five percent of all health spending in developed nations will be on those age 65 and older. People over 60 could  also be the most powerful political lobbying group in the world if they so choose. They are more likely to vote for politicians who promise to meet their healthcare needs. Oh, and by the way, half of our population will be obese by 2030.
  2. By 2025, 85 percent of the global population will be in emerging nations.
  3. Governments simply can’t afford to treat the sick any longer.  Prevention will be preferred over treatment.  Pricing and reimbursement schemes will drastically change. Increasing levels of antibiotic resistance will render “routine” medicine redundant. Governments will have to take a radically different approach to pricing and reimbursement unless they want society to return to the pre- antibiotic era.
  4. Globalization, global warming, science, and technology are all (for the first time in our history) accelerating at the same time. Everyone will be impacted. Drug shortages will continue if not worsen, as supply chains are disrupted unless more is invested to improve their resiliency.
  5. Medical technology, including 3D imaging, ultra-resolution microscopy, electronic patient records, computer-aided diagnosis, low-cost gene readers, and more, will change our lives. Wearable devices will put patients center stage and in greater control of their own healthcare.
  6. Short-termism will destroy corporations. Companies that run from one quarterly financial report to the next, ignoring the future, will not survive.
  7. Pharma currently spends, on average, $1.3 billion bringing a new medicine to market, with an attrition rate of 90 percent. Clinical trial failures over the last five years cost the industry $240 billion. This level of inefficiency is not sustainable.
  8. Taking 15 to 20 years “from bench to bed” will not meet future healthcare needs.
  9. Much of the current regulatory framework is no longer fit for purpose and is guilty of stifling innovation when we need it most.
  10. Eighty percent of university students are earning degrees for jobs that will no longer exist. Any job with any level of repetition (manual or cognitive) is at risk of being automated. Tell your kids now! Expect the pharmacy, law, and financial professions to look very different.
  11. Survival will require simplification. Unless pharma breaks down silos and reduces bureaucracy, it will not balance the books. Simplification is survival.
  12. Only risk-smart companies will survive. Those that remain risk averse will not last long.
  13. Our world needs more economies of scale to achieve greater efficiencies. Expect to see more mergers (consolidation) and also demergers as mistakes are made.
  14. In Europe and North America, companies often struggle to find the talent they need. This is not the case elsewhere. More than 85 percent of all the world’s graduates in science, technology, engineering, and math (STEM) over the next two decades will be from Chinese and Indian universities, not from North America or the EU.
  15. Although the impact of AI in pharma is open for debate, it will have a profound impact in healthcare. Did you know that one in 10 medical diagnoses are wrong? In some clinics, AI can do a lot better. For example, AI is capable of predicting (with 80 percent accuracy) which patients will die of pulmonary hypertension within a year. Medics have only 20 percent accuracy. The point is AI and wearable devices will allow medical interventions to be made earlier to cut back on treatment and hospital costs. Prevention is the name of the game, not treatment. The pharma business model is completely different …things will have to change.

Back to Basics: How To Prosper In An Uncertain World

Excellence in any walk of life comes down to doing the basics at the Ph.D. level. Remember: Extraordinary companies don’t do extraordinary things; they just do ordinary things to an extraordinary level. The companies that will succeed in the future will, in my opinion, do the following exceptionally well.

Leadership: Dynamic, Risk Smart, And Future Oriented

There is a big difference between leadership and management. Leadership is about doing the right thing. Management is doing things right. Pharma has relied too long on management. We need to recruit and develop risk-smart leaders at every level and get them onto the shop floor. Every leader needs to become a futurist, rather than being focused on the quarterly financials. The benefits and risks of AI are not being correctly assessed by many senior leaders because many know so little about developments in technology and science. They don’t know what they don’t know.  They are not able to make the right decisions to protect their future business.

We Must Become Risk Smart

Companies still talk about “zero risk” as if it’s real. It’s not. Zero risk is an illusion. In fact, risk aversion is dangerous. It stifles innovation, increasing complexity and (paradoxically) risk. We must become risk smart. We have to admit risks and manage them intelligently. And quickly.

Simplification Is Survival

Remember, less is more. When we have simple systems motivation improves, errors fall, and productivity increases. Simple systems also allow us to “fail fast.” In times of uncertainty we will make lots of mistakes. These only become learning opportunities if we fail fast.

Stop Training And Start Educating

Most companies’ training programs just tick the compliance box, while changing little. Old behaviors remain. If you understand the 70/20/10 model for learning and development, your future looks bright. Your education programs must focus on providing the skills that will matter most. Emotional intelligence, risk-based decision making, critical thinking, and problem solving -- certainly not GMP compliance.


When problems and errors occur so many companies focus on the immediate correction. The “band aid companies” who allow high levels of repeat errors and mistakes won’t be around for much longer. The focus must be on prevention, not reaction. Designing out errors and mistakes in the first place and by brutally simplifying everything.

Change Management: Fast And Efficient

Unless your change management system can review and approve changes in less than an hour you are going to be in trouble. In this turbulent world agility is key. Your change management system must be quick (otherwise it won’t be used) and only approve changes that add value and reject the rest. Usually 80 percent!

Collaborate Like Never Before

I leave the most important and hardest to last. We will not meet future healthcare needs unless we all collaborate. Regulators, industry, payers and patient groups. The latter have been ignored for too long. Unless we collaborate we won’t make it. 

Closing Remarks

I still come across people and companies who are institutionally blind. They seem totally unaware and ill prepared for what is coming. Is it arrogance or ignorance? Who knows? For me it all boils down to simple economics. In 1960 healthcare represented less than 6 percent of the US economy. By 2013 it had tripled to 18 percent of GDP. In the UK the total proportion of GDP dedicated to health care has increased from 6.6 percent in 1997 to 9.6 percent in 2010.

If we as an industry fail to rise to the healthcare challenge the results are likely to be soaring, and unsustainable, burden on us all.

We’re all in this together. This is your opportunity to contribute. There are 7.5 billion people depending on us.

If you have any predictions or suggestions to add, please share them in the Comments section below.

About The Author:

Martin Lush is global VP of NSF Health Sciences (Pharma Biotech and Medical Devices), a global consultancy providing education, auditing, and remediation support for the pharmaceutical and medical device industry worldwide. With 35 years of hands-on experience in manufacturing, operations, and quality assurance, he helps clients do more with less. Respected for his simple thinking and simple solutions, Martin’s passion is helping clients prepare for a future world of brutal disruptions. He believes that just maintaining the status quo is no longer good enough. Follow him on LinkedIn or email him at