I’ve been directing or advising innovation and commercialization efforts in Silicon Valley for most of my career. While the popular stories we tell about innovation usually focus on eureka moments and brilliant individuals, anyone involved in successful innovation knows that getting a new product to market is often more about convincing smart people to back your idea, corralling lots of different agendas, aligning incentives, and navigating bureaucracies.
I was reminded of this very important difference between invention and impactful innovation when I attended the One Mind for Research conference at UCLA recently. One Mind for Research is a new nonprofit that serves as a catalyst for discovering and delivering breakthrough cures for brain disease, co-founded by Garen Steglin, a successful VC and CEO, and Patrick Kennedy, former Congressman and nephew of JFK, and now led by Pete Chiarelli, U.S. Army General (retired).This was a gathering of top university neuroscientists, celebrities like Glenn Close and Maria Shriver, foundations, industry senior executives, government officials, patients, and advocates.
A Burden on Patients, Employers, and The Economy
This is an area desperately in need of innovation. Brain diseases and trauma are a leading cause of disability globally, according to WHO; one in six American adults lives with a brain-related illness such as depression, PTSD, autism, bipolar disorder, or schizophrenia. Add an aging boomer population susceptible to stroke and Alzheimer’s and this enormous disease burden has far more wide-ranging effects than you might imagine.
Chronic brain disease is a burden not just to patients but to employers and the economy. PWC estimates that more than $500 billion is spent annually in the U.S. on healthcare related costs for brain disease. If we include the cost of disability, losses to the economy of people who can no longer contribute to their full ability or the people who are pulled out of the workforce to care for disabled loved ones, the total cost of brain disease in the U.S. this year will approach $1 trillion.
Two Decades Is Too Long To Wait for A Cure
Despite clear market “demand” for improved treatment for brain diseases, innovation in this area is proceeding at a glacial pace. I’ve learned this in a painful way. Several people very close to me have struggled with different forms of brain disease--in some cases for years--without clinically available tests for doctors to make a definitive diagnosis, much less prescribe a targeted course of treatment. The parable of the blind man and the elephant comes to mind as the patient visits different doctors in a cycle of hope and ultimate disappointment (and heartache) when the prescription didn’t work as planned.
Good doctors are left with no choice but to say, “I don’t know.” The gap between clinical practice and medical advances in this age of bionic brains, IBM's Watson, and $1,000 genomes is nothing less than shocking. There has got to be a better way. Searching for answers, I went to learn more about the state-of-the-art in brain disease treatment At the One Mind for Research conference.
The good news is that there is hope. Neuroscientists shared upbeat news that with brain imaging tools to map brain disease pathology, cheap genomes, and novel treatments, we are on the verge of major medical breakthroughs for brain disease in the next 5-10 years.
The bad news is that it could take another 12-17 years to get many of these breakthroughs to U.S. patients if we don’t rethink the way we commercialize medicine, from grants to clinical trials to training local clinicians to insurance coverage of novel treatments. Two decades is too long for patients and their families to wait. Michael Milken, Founder of FasterCures and a pioneer in the accelerating time-to-cure movement reports that it can take nine feet of paper (I’m not sure if this is literal but I’ll bet it’s not far off) and 18 months to get an NIH grant prepared and approved. Scientists need to focus on cures instead of paperwork, says Milken.
As an additional challenge, private industry is backing away when we need them to bring breakthrough cures to market. Some pharmaceutical companies are exiting drug development for the brain because it is “too hard.” And VCs in the valley tell me that faster ROI and less risk can be obtained from social media startups than life science labs.
Removing Barriers to Innovation
Of course it would be really easy to blame the FDA. However, this doesn’t fix the problem. Besides, the FDA is experimenting with new programs such as a Fast Track Drug Approval Program and they need support from government leaders to make creative strides in this area while protecting patient safety. But the issues extend far beyond the FDA.
I heard challenges to innovation at the conference and in my research that were at first glance unique, but upon reflection startlingly familiar:
Altruism Is Good, Profits Are Faster: Create incentives for a robust startup ecosystem for private industry like shared lab space and capital equipment to reduce investment risk, similar to the Silicon Valley/San Jose BioCenter.
Facilitate Commercialization: Partnerships between organizations conducting basic research and organizations capable of turning research into deliverable products (or treatments) often break down over misaligned incentives and a lack of commercialization options. The National Science Foundation’s iCorps project helps scientists to get their drug off the lab shelf and into the market is a good start but more is needed.
Break Down Information Silos: Key parts of the innovation process, medical disciplines, and disease funding are walled off from each other, with difficulty sharing information across domains.
Enable Big Data and Analytics: Disease pathology and genetic associations may not be readily apparent with small patient data sets. Scientists need large medical databases such as the VA’s Million Veteran Program, Allen Institute Brain Atlas, and others.
Create Cross-Silo Champions: Tech companies often have “can do” project managers (backed by senior management) or a company founder who have the uncanny ability to navigate a product to market quickly through (and sometimes around) organizational bureaucracies. Who will shepherd high priority treatments from lab to clinic?
Think Beyond the Drug Pipeline: New treatments involve engineering such as electromagnetic brain stimulation, surgical delivery tools, computer cognition games to rebuild neural pathways, and mobile health apps.
Reverse-Engineer: The traditional drug pipeline starts at the molecular target level in the lab and flows to the clinic. One doctor discovered that some of her clinical patients receiving a drug used for anesthesiology remarkably recovered from depression overnight. Such “outside-in” discoveries may yield unexpected insights into disease pathology and may yield new uses for old but forgotten FDA approved drugs.
Co-Create with Consumers: Applications like PatientsLikeme provide unprecedented levels of feedback on side effects by real patients. An Internet matching marketplace (akin to an online dating service platform for clinical trials) to link patients globally with large-scale clinical trials could also speed time-to-market.
Foster Public-Private Partnerships: Although we often think of the Silicon Valley Internet startup ecosystem as private industry, this would not have been possible without DARPA inventing the Internet. Trailblazing work by the University of California in areas such as stem cell research and partnerships with the VA and Military Medical systems for TBI/PTSD hold promise.
Let’s Get Cures to Patients Who Need It
Perhaps my biggest takeaway from this conference is the huge opportunity. One Mind for Research is targeting a “moonshot” in brain disease--if we can land a man on the moon we can find major cures in the next 10 years. It is also good to know that there are many smart, energetic people working on the problem. Tech, pharma, innovation communities and government leaders need to see this opportunity and join in.
My hope is that such breakthroughs are not inventions seeking innovation; let’s keep novel treatments from gathering dust on a lab shelf at a university. Pete Chiarelli, CEO of One Mind for Research sums it up best: "With tens of thousands of soldiers returning home with traumatic brain injury and PTS, the need for faster, better innovation in brain disease has never been greater."
To Learn More:
Adrian C. Ott is a corporate advisor and speaker on innovation and go-to-market strategy. She is the award-winning author of The 24-Hour Customer, which was named Best Business Book of the Year by USA Book News and Library Journal. During the 1990s, she led an innovation program for a F100 technology company and was recognized in the annual report for infusing the company with "new revenue streams, new technologies and new business models." Follow her on Twitter @ExponentialEdge.
[Image: Flickr user Patrick Wilken]