Perspectives
What lies ahead? How blockchain will improve public health
Linda Balkema
Hall & Partners Health
We’re only a few weeks into 2018 and have already been welcomed by shocking headlines of a “plummeting” life expectancy in certain parts of the UK. An outcry! It must be the cost burden on the NHS! In a reputation-saving effort, Boris Johnson attempts to come to the rescue and makes a plea for an extra £5bn injection, also dubbed the “Brexit dividend”. So far, Philip Hammond isn’t having any of it. “Obesity”, “chronic disease”, “a growing resistance to antibiotics”, “austerity” are all hurled into the air as factors contributing to lower life expectancies. But as an in-control millennial (yes, I can see you glancing at your health stats on your smartwatch while checking the price of Bitcoin... trendy), you may wonder why any of this is relevant to you…
For a minute, consider the market for falsified and counterfeit drugs. “Irrelevant!” I hear some of you shout. You’d never order medication online. You’re far too clever for that. Those dodgy websites, what a joke!
Unfortunately, the problem is that these drugs still make their way into the supply chain of our traditionally regulated systems, our pharmacies, clinics and hospitals.
You may remember in 2012 when counterfeit versions of Roche and Genentech's big-selling cancer drug Avastin were detected in the US. The US Food and Drug Administration found itself having to contact medical practices about the fake version which had been purchased through a foreign supplier. The NHS has also faced similar challenges with counterfeit drugs in the past.
Blockchain allows for full transparency of the drug-journey as it makes its way down the supply chain
With any pirated goods, the economic impact is enormous and creates a vast drain on the global economy. If drugs are made illegally, not only is tax avoided and governments deprived of revenues for public services, but the tax burden comes back to the public. Also, valuable resources are wasted on purchasing, inventory and transportation.
Not great when fighting austerity.
Interpol has previously raised alarm bells, saying that up to 30% of drugs sold worldwide are counterfeit, and over a million people die each year as a result. And the global crime networks are growing.
Luckily for many of us the problem is not so severe, but it’s still considerable. A 2016 report by the European Union Intellectual Property Office estimated that counterfeited drugs cost the pharmaceutical industry and Europe more than €10 billion each year. But in countries already stretched thin with limited resources for healthcare the problem is much worse.
The drug supply chain is comprised of a plethora of administrative transactions, communications and payments between many parties – making it prone to confusion and temperance, and difficult to keep oversight. To combat this and fight against counterfeit drugs, the Drug Supply Chain Security Act was enforced in 2013.
What is the Drug Supply Chain Security Act?
In short, it mandates full supply-chain traceability for prescription drug dispensing in the US.
But how can this be guaranteed?
This is where blockchain comes in – it allows for full transparency of the drug-journey as it makes its way down the supply chain. It has the potential to enhance drug safety because the journey can be fully tracked, traced and authenticated. Because of the full transparency on the chain, tampering with historical data becomes impossible – new actions can be added and viewed, but not deleted. Moreover, participants can trade and share information without having one central party controlling or owning the process; everyone agrees what is going into the chain. As a result, wasted costs associated with miscommunications and errors in the supply chain are heavily reduced and the possibility of counterfeit medication reaching our trusted institutions should be eliminated.
Last year, there was already a bit of noise about the application and opportunities for blockchain in healthcare. IBM is on the case, and their solution looks promising:
Like IBM, several others have already started looking at the possibilities of implementing blockchain. But the opportunity doesn’t start and end with healthcare and bringing costs down. Think about the potential for your patient records to be on a chain – confusion between doctors and different hospitals about previous medication could be avoided. This will all add up to a better service, less prone to administrative mistakes and health complications. Again, you might say you always go to the same doctor… but what about when you travel?
So next time you’re checking the value of Bitcoin, think about the mechanism that underpins it and the incredible value it can bring to us all. Expect the blockchain debate to become still bigger in 2018 – and even if you don’t think it will prevent life expectancy from dropping, if we all continue to live responsibly and keep a close eye on our health stats, who knows?