Disruptive versus incremental innovation in healthcare

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Disruptive versus incremental innovation in
healthcare
Andy Goldberg MD FRCS(TrOrth) Consultant
Orthopaedic Surgeon Royal National Orthopaedic
Hospital NHS Trust Deputy Director RD UCL
Institute of Orthopaedics Musculoskeletal
Science
twitter/medicalfutures
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?Better?
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Market cap 340Bn Largest company in the world
T/o - 65Bn, 14Bn Profits Making it 111th
company in size
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Market cap 340Bn Largest company in the world
T/o - 65Bn, 14Bn Profits Making it 111th
company in size T/o 350Bn with 30Bn Profits
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Disruptive Technology
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Adoption of Innovation
Everett Rogers, Professor of Rural Sociology,
Iowa (Rogers, Everett M. (1962) Diffusion of
Innovations)
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Adoption of Innovation
Everett Rogers, Professor of Rural Sociology,
Iowa (Rogers, Everett M. (1962) Diffusion of
Innovations)
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Adoption of Innovation
Everett Rogers, Professor of Rural Sociology,
Iowa (Rogers, Everett M. (1962) Diffusion of
Innovations)
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Adopters willingness to participate

• Awareness
• Interest
• Evaluation (evidence base)
• Tendency to risk

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Adopters willingness to participate

• Awareness
• Interest
• Evaluation (evidence base)
• Tendency to risk

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Uncemented Hips

• Meyer
• Burutaran
• L.S Barouk

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Uncemented Hips
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Uncemented Hips
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Uncemented Hips
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Stepwise Introduction of Technology

• Preclinical Testing
• First In Man
• Clinical Trials
• Post Market Surveillance

Malchau 1995 (modified)
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Stepwise Introduction of Technology

• Preclinical Testing
• First In Man
• Clinical Trials
• Post Market Surveillance

FDA MHRA
Malchau 1995 (modified)
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Are we joined up?

• FDA/MHRA
• Clinical Groups
• NICE
• Insurers/Commissioners
• Industry

Malchau 1995 (modified)
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New Proposal

• Industry has commercial pressures
• NHS funds research (circa 1Bn)
• Quid Pro Quo

Malchau 1995 (modified)
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New Proposal

• New Technology Panel (composed of stakeholders
  (ie regulators, clinicians, commissioners,
  industry and patients)
• Identify what evidence could be developed at the
  outset
• Joint funding of research (NHS Industry)
• Limited marketing authorisation granted to
  industry (to trial centres who pay for
  product)
• Full marketing authorisation granted after agreed
  time period

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QA Session
andy_at_medicalfutures.co.uk