Chips, Clones, and Living Beyond 100: How Far Will the Biosciences Take Us?

237 Pages·2009·1.93 MB·English

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From the Library of Lee Bogdanoff
Praise for Chips, Clones, and
Living Beyond 100
“A great, useful, and timely book, which gives much insight into
biomedicine and takes away the fears that many may have. A must
for lay people who want to know how far bioscience has come and
where it will go, as well as for scientists in other fields.”
—Dr. Hans Vemer, Schering-Plough; formerly President of
Organon International Schering-Plough
“This book needed to be written. Financiers, executives, and policy
advisors will benefit greatly from this broad overview of the most
important developments in the bewildering field of biotechnology.
The combination of advanced technology insights and managerial
guidance about managing extreme uncertainty make this book truly
unique.”
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—Donald Kalff, Ph.D., Biotech Entrepreneur and Venture
Capitalist; former member KLM Executive Board
“The authors offer a splendid ‘tour of the horizon’ that considers
the breakthrough consequences of current and future develop-
ments in the biosciences. Readers can profit in many ways from this
book, whether in business, education, government, or at home.”
—Professor George S. Day, The Wharton School, University of
Pennsylvania
“As physics was to the 20th century, the biomedical sciences will be
to the 21st. The explosion of new knowledge in areas such as genet-
ics, neuroscience, stem cell biology, artificial organs, and regenera-
tive medicine promises to improve our lives, create new business
opportunities, and permit us to control many diseases while raising
important challenges for our social, ethical, and economic thinking.
The Schoemakers have given us an incredibly useful book to stimu-
late that thinking and to shed light on what the next two decades
might and should hold in store. 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
From the Library of Lee Bogdanoff
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“The growth of the biosciences is a global phenomenon. Singapore
is betting on it as its next growth engine via Biopolis. This book
offers a rich roadmap for the next wave of major biomedical
innovations.”
—Marvin Ng, DN Venture Partners, Singapore
“A stimulating and exciting look at how we got to the present state
of health care and where we can potentially go. This is a must read
for anyone interested or working in the health care arena, from the
layperson to the entrepreneur to the corporate executive. This book
is a unique perspective and a great read.”
—David Lester, Ph.D., President, ITHW Inc.; formerly Director,
Human Health Technologies, Pfizer Inc.
“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.”
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—Giancarlo Barolat, M.D. Board Certified by the American and
Italian Board of Neurological Surgery; 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 innova-
tion 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
From the Library of Lee Bogdanoff
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Chips, Clones, and
Living Beyond 100
How Far Wil l the
Biosciences Take Us?
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Paul J. H. Schoemaker, Ph.D.
Joyce A. Schoemaker, Ph.D.
From the Library of Lee Bogdanoff
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Dedication
We dedicate this book to the memory of Hubert J. P. Schoemaker, our
beloved brother and brother-in-law, who was a genuine pioneer of the
new biosciences. After finishing his Ph.D. in biochemistry at MIT in
1977 and working briefly for Corning Biomedical, Hubert joined a
small group of scientists and entrepreneurs in 1979 to found one of
America’s first biotech companies, Centocor Inc. It became the
leader in the exciting new field of monoclonal antibody technology,
moving gradually from diagnostics into therapeutics.
The company could be the poster child for the roller-coaster ride
typical of many biotech companies. Its stock dropped from $60 per
share to less than $6 per share when the FDA failed to approve its
promising drug Centoxin for septic shock in 1992. Through alliances
with Eli Lilly and other established pharma companies, Centocor
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rose from the ashes with an anticlotting medicine for coronary
disease (ReoPro), followed by a major blockbuster drug for Crohn’s
disease, rheumatoid arthritis, and other autoimmune diseases
(Remicade). Hubert lived through these ups and down as president,
CEO, and chairman. He oversaw the final sale of the company in
1999 to Johnson & Johnson for nearly $5 billion, after it had regained
its lofty stock price of around $60 per share.
Tragically, Hubert died from brain cancer in 2006 at age 55. Even
while battling this unfair and harsh illness, he founded and ran a new
company devoted to adult stem cells. He continued to operate at the
frontiers of science and business until his untimely death. Hubert’s
courage, leadership, philanthropy, humanity, and perseverance in the
face of great adversity will remain an inspiration for all those who
knew him personally.
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From the Library of Lee Bogdanoff
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Contents at a Glance
Foreword . . . . . . . . . . . . . . . . . . . . . . . . xii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . xiv
Chapter 1 Living well beyond 100. . . . . . . . . . . . . . . 1
Chapter 2 A short history of biomedicine . . . . . . . . 21
Chapter 3 Snapshot of the biosciences . . . . . . . . . 35
Chapter 4 Bio-driven convergence. . . . . . . . . . . . . . 57
Chapter 5 The business of biomedicine . . . . . . . . . 79
Chapter 6 Healthcare under stress. . . . . . . . . . . . 101
Chapter 7 Wildcards for the future . . . . . . . . . . . . 125
Chapter 8 Scenarios up to 2025 . . . . . . . . . . . . . 143
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Chapter 9 What it all means . . . . . . . . . . . . . . . . 163
Appendix A DNA, RNA, and protein . . . . . . . . . . . . . 177
Appendix B Cloning genes . . . . . . . . . . . . . . . . . . . 183
Appendix C Complexity of the genome . . . . . . . . . . 187
Glossary of biomedical terms . . . . . . . . 191
Acknowledgments . . . . . . . . . . . . . . . . 199
About the authors . . . . . . . . . . . . . . . . 201
Index . . . . . . . . . . . . . . . . . . . . . . . . . 203
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Contents
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 ptg
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
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Contents ix
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
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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
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