nextgen oncology
- HanseaticHunter
- Jun 24, 2022
- 5 min read
Updated: Jun 27, 2022
A traditional branch of medicine is finally entering the digital age
The advance of immunotherapies and ASCO 2022
Current market reality in Germany
Oncologists are moving to the center of medical decisions
KImed’s nextgen oncology platform will enable them
Result: better patient outcomes
Along with heart disease, cancer is one of the leading causes of death. The hallmark of cancer treatment has been conventional chemotherapy. Courageous voices predicted it coming: the end of chemotherapy in cancer treatment. After over 30 years of molecular cancer research, the last 5 years have seen a dramatic shift. Now, health care systems worldwide spend considerably more on immunotherapies than on chemo.
Chemotherapeutic drugs are designed to target not only rapidly dividing cells, such as cancer cells, but also certain normal cells. With the advent of biotechnology, a new generation of cancer treatment has come to the forefront: targeted cancer therapies. Like conventional chemotherapy, targeted cancer therapies use pharmacological agents that inhibit growth, increase cell death and restrict the spread of cancer. Targeted therapies interfere with specific proteins involved in the growth of tumors. Focusing on specific molecular changes which are unique to a particular cancer, targeted cancer therapies can be more therapeutically beneficial for many cancer types, including lung, colorectal, breast, lymphoma and leukemia. Recent advances have made it possible to analyze and customize treatments to an individual's tumor. Furthermore, with the billions of dollars received from the covid-19 vaccines based on mRNA technology, which is most useful against cancer, an additional acceleration in precision medicine seems likely.
The globally biggest conference on new research findings in oncology is the annual conference of the American Society of Clinical Oncologists (ASCO). ASCO 2022 recently finished and both medical as well as financial analysts are busy dissecting the results. This is no easy task when there were over 200 sessions and 2,500 poster presentations. The capital market saw the biggest advances coming from cell therapy companies, while medically, Daiichi Sankyo/Astra’s Enhertu (trastuzumab deruxtecan) against breast cancer was groundbreaking.
Current market reality in Germany
However, we need to step back from this cutting edge of research highlights and enter into the reality of oncology practice on the ground. For decades the expansion of chemotherapies has had a regrettable economical side effect. Innovation needs to be economically rewarded in order to keep a positive self-reinforcing cycle of medical advancement going. Conversely, in oligopolistic markets where new entrants are hindered by regulation, exorbitant profit margins can last at the cost of overall patient care.
This is certainly the case for Germany, where we pride ourselves on our high standards of quality norms. We invented the DIN (Deutsche Industrie Norm) which was later adopted by ISO (International Organization for Standardization). In the area of chemotherapies, manufacturers are regulated by comprehensive pharmacy regulations. The oncologist orders a specific “cocktail” of chemo drugs for the individual patient and the pharmacy “mixes” it in its laboratory. Profit margins are often over 90% for the pharmacist. This in turn has led to unhealthy incentives (e.g. kick-backs) given to oncologists by pharmacists. Currently, many oncology practices, especially the large ones, are actually owned by healthcare services groups that originated from pharmacists.
The legal framework has finally shifted. In 2012, the pharmacy law was tightened in terms of drug safety leading to high requirements for pharmacist laboratories. In the same year, the law governing medical practices was also changed to the effect that outpatient clinics (MVZ – Medizinisches Versorgungszentrum), where most oncologists work, can only be owned by doctors, hospitals, dialysis service operators and non-profit organizations. While this was an improvement, loopholes in the definition of “hospital”, “non-doctoral dialysis operator” and “non-profit” continue to be exploited. Finally in 2020, a verdict by the highest court (BGH – constitutional court) ruled that any ownership structure must guarantee the independence of the medical decision by the doctor from any economic interests.
While entrenched interests by traditional beneficiaries of the system have delayed reforms, enforcement has improved with a few courageous whistle-blowers acting as catalysts. The most damaging methods now seem contained and competition based on quality of care is proceeding.
Oncologists are moving to the center of medical decisions
In many ways, the oncologist is now at the centre of patient management with wide-ranging medical decisions and all its economic consequences (e.g. exorbitant cost of some thereapies). This brings us back to cutting edge research. Due to the increasing number and the complexity of molecular therapies, oncologists can no longer easily decide on which new therapies may work without the right tools at their fingertips.
KImed’s nextgen oncology platform will enable them
This is where our newest project comes in. We recently founded a new company “KImed nextgen oncology” which has the single-minded goal of enabling oncologists to achieve better patient outcomes.
Initially, catering to the German market where artificial intelligence, “AI”, is “KI”, we established KImed as a technology provider enabling oncologists to master the next generation of therapies. This entails the following five services:
Digitalization: installing a single software platform across all activities; linking internal and external (e.g. pharmacies, labs, health insurers) interfaces; and, as the pinnacle, creating an AI module for decision support.
Data & process management: documentation and data preparation for the AI module and for studies; quality management with ISO certification.
Practice logistics: modern interior design including real estate management; equipment procurement; insurance, financial and payroll accounting, taxes.
HR Management: recruiting of top specialists; training and education; remuneration including incentive structures.
Post Work Management: AI-based outcome analysis; website, appointment booking; evaluation portals, patient feedback; connection to homecare network and lifestyle management.
Here a fitting testimonial from the oncologist of a leading German MVZ:
“For conventional chemotherapy, but especially for concomitant treatment (nutrition, pain therapy), there will still be a need in the future. But only those outpatient clinics will survive that, like us, can handle the overall logistical effort. In any case, the hospitals and manufacturer-dependent MVZs with far too much subsidized staff, but without data-based and networked documentation and communication cannot do it. In this respect, we are the ideal partner for hospital groups as well as for modern manufacturers and their expansion course. Due to the correspondingly better logistics, we can control patient referral much more intensively.”
Result: better patient outcomes
We work closely with such centers of excellence and intend to roll-out this concept. Patients receive all-round care at nextgen oncology and thus only has one main contact, which make a lot of things easier for them in difficult times. KImed’s nextgen oncology platform with its five-pronged approach builds the base to achieve this goal:
Finally, building an AI, a self-learning algorithm, to support the oncologist’s therapy decision is no easy task. As a first step, we aim to host the first ever all digitally run tumor conference in Germany. For non-medically inclined readers, a tumor conference is a regular meeting (at least weekly) of oncologists with other clinicians to discuss specific patients with the goal of determining the most appropriate therapy.
Closing quote: "...the future also brings wondrous new opportunities to cure disease."
The HanseaticHunter
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