The global healthcare industry is enormous and the U.S. maks up a huge slice of the overall pie. Indeed, healthcare accounts for between 17% and 18% of the country’s GDP. Worldwide pharma revenue was estimated to be around $1.6 trillion in 2023, of which about half was generated in the U.S. Medtech revenue, meanwhile, stood at around $578 billion, with the U.S. accounting for almost 50% of that.
The sheer size of the industry is testament to its importance. As the world’s population ages, the need for affordable, reliable care is evolving, too. The landscape for chronic and acute diseases is constantly changing. Important developments across the sector are happening everywhere, but Columbia University has been a hotspot for important research.
In a conversation with Carri Chan—the John A. Howard Professor of Business and the Faculty Director of the Healthcare and Pharmaceutical Management Program at Columbia Business School—three leaders in the field discussed how they are challenging the boundaries of healthcare innovation.
Brent Stockwell, Professor and Chair of the Biological Sciences Department at Columbia University, for example, has been doing groundbreaking research in the field of cancer drug resistance. Many cancer patients, he explains, die because their cancer grows, evolves and becomes resistant to the drugs available for treatment, allowing it to spread throughout a patient’s body. As a result of this, Stockwell is concentrating his research on potential ways to treat these advanced, drug resistant cancers.
A foolproof cure for them is still a way off, but his work has contributed significantly to our understanding of the mechanisms of how these cancers work, paving the way for a future in which a cancer diagnosis might have very different implications than it does today.
Out of the Box to Save Lives
Andrew Marks, Professor and Chair of the Physiology and Cellular Biophysics Department at Columbia University, has spent much of his career concentrating on heart disease, which is the leading cause of death in the developed world.
In the United States alone, he says, there are a half a million new cases of heart failure every year. “Heart failure is caused when there are multiple heart attacks due to clogging of arteries that normally supply blood to the heart,” Marks explainns. “So if you could make a drug to treat heart failure, it's an automatic blockbuster,” he adds.
When the stent was first developed to reliably prevent heart failure, its success was therefore an overwhelming achievement. What initially wasn’t expected, however, was that in many cases, about six months after a stent was fitted, many patients would return to the doctor with what turned out to be so-called stent restenosis. In other words, the a stenthad fillsed up with vascular smooth muscle cells, Marks explains. Armed with his training in biology, he had an idea for what to do.
In the field of immunology, there’s a immunosuppressant drug called rapamycin, Marks said. “It works by stopping immune cells from growing. I had been trained in biology, and I realized that the immune cells had the same mechanisms for growing as the vascular smooth muscle cells,” he says. “So I took knowledge from the immunology world, applied it to the cardiology world, and decided that if you could take rapamycin and put it on a stent, you could prevent a stent from closing up.”
It’s the Think Bigger methodology in action, he admits. “I went completely out of the box from cardiology all the way to immunology,” he explains. “I used my knowledge from the immunology world to solve a cardiology problem.”
Improving the Quality, Not Just Length
The third panelist, Helen Lu, is the Senior Vice Dean for Faculty Affairs and Advancement, as well as the Chair of Faculty Promotion and Tenure Committee at Columbia Engineering. Her work focuses less on saving lives but more on enhancing the quality of life before someone gets to that point.
In the past six decades, medicine has added about seven years to the average lifespan, Lu explains, but it really has not improved the quality of life by the same degree.
As such, much of the work that Lu does is in the field of soft tissue healing: designing biomaterials and medical devices that can be used to repair damaged tissue. What she’s talking about is not something like a total knee replacement. Instead, she’s describing so-called regenerative materials that support the body’s innate ability to heal itself. One example of this is the ligaments that she’s designing for torn ACLs.
All three panelists agree that despite the huge leaps made in the sprawling field of healthcare over the past decades, major challenges remain. In terms of regulation, FDA approval timelines can be lengthy. Funding squeezes are also a major hurdle, and can slow down the pace of life-saving innovation. Early stage investment is critical in this respect.
If those challenges can be overcome, however, advances in the field—like the ones that the three panelists can take credit for—don’t only stand to enhance the wellbeing of individuals, but also of communities at large and generations to come.
