Thought Leader: (Eco)systemic Change - Pharmaceutical Executive


Thought Leader: (Eco)systemic Change

Pharmaceutical Executive

We're using instrumentation from Carl Zeiss, the German company, and electronic equipment from IBM. This technology is at the threshold of being able to deliver virtual images of microscopic slides in such high quality that a pathology diagnosis can be established.

To prove this, we have planned a validation study to demonstrate that this new breakthrough technology is able to enter routine pathology. This digital or electronic form of image transmission, archiving, and education with the virtual microscope will revolutionize workflow in pathology. Currently, pathology is still conducted in the same way it was 150 years ago, with the microscope and staining techniques.

Do you have any other thoughts on how this evolving healthcare model will affect the pharma industry?

In the vaccine industry, the question of indemnity has led to a reduction in number; we only have five or six productive vaccine industries in the country, down from about 25 in the seventies. And we noticed the shortages of flu vaccine last year, and the question was, "Why do we have more Viagra in this country than flu vaccine?"

I think indemnity and litigation are two points of concern, and also profitability. We need a vital vaccine industry, but we also need a vital pharmaceutical industry. And our pharmaceutical industry also needs protection. This condemnation of the pharma industry as the bad guy is a danger.

Do you see the pharma and vaccine industries as separate?

I think they are nearly the same. There are firms—for example, Merck—that also are major vaccine manufacturers. Glaxo, in this country, has retreated from it. But they are still present in Europe, because there the litigation and indemnity question is resolved in a different way.

There are also state insurances or guarantees for recommended vaccinations. That insures the payers, producers, and physicians. If a doctor recommends a polio vaccination for the whole nation, you will have some individuals with side effects. And then society has to compensate those individuals, which is done through government payments by the taxpayer.

If you leave the industry vulnerable to these potential effects, and profit is low, they might pull out.

Wolfgang Klietmann, MD is a clinical pathologist and medical microbiologist for infectious diseases. He is an appointed lecturer and faculty member at Harvard Medical School and serves as vice president of the Harvard Business School Health Industry Alumni Association. Until 2001, Klietmann was on staff in the Department of Pathology at Massachusetts General Hospital. For five years, he headed a research group at the Max-Planck-Institute for Virus Research and served on the medical faculty at the University of Tuebingen (Germany). Klietmann was founder and physician-in-chief of a leading German institute of laboratory medicine, which was successfully bought out by the pharmaceutical industry. He is a member of the scientific advisory board of BioCal Technology.

Wolfgang's Heresies

1. The healthcare ecosystem is in disarray. The healthcare industry does not operate in isolation, but is in constant interaction with the world around it. In order to thrive, it must be responsive to changes in the economic, social, and political forces that affect business decisions. Any vision to revive the healthcare ecosystem must consider how changes to one part of the system affect the others and adjacent industries.

2. Consistency is the virtue of fools. The lethargy behind healthcare reform is due in part to a pervasive sense that the system is good enough for most. If nothing else, the healthcare system is at least consistent in its strengths and flaws. The medical discipline is itself deeply rooted in tradition, which gives the industry guidance amid the flows of time and change. However, stability and consistency are only valuable in moderation. In excess, they lead to blind rigidity and a stubborn refusal to recognize the need for change.

3. Outsiders will change the system. Our universities are hotbeds of unconventional thought, where inquisitive thinkers are perhaps more free to raise questions and propose disquieting answers that may not sit well with conventional wisdom. Those who question truth and authority are often seen as threatening; these doubters are often outcast from their societies, and branded heretics. However, now may be the time for heretics, who serve the vital function of preventing the ossification of a business or industry.


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