Chips, Clones, and Living Beyond 100: How Far Will the Biosciences Take Us?

“A stimulating and exciting look at how we got to the present state of health care and where we can potentially go. A unique perspective and a great read.”

David Lester, Ph.D., President, ITHW Inc.; formerly Director, Human Health Technologies, Pfizer Inc.

“The explosion of new knowledge in the biosciences will raise important challenges for our social, ethical, and economic thinking. The Schoemakers have given us an incredibly useful book to stimulate that thinking. One could not ask for a better guidebook to an exciting if challenging future.”

Professor Arthur L. Caplan, Director of the Center for Bioethics and Hart Professor, University of Pennsylvania

“What a fascinating book! The authors have really mastered all the aspects (social, human, scientific, and business) of the biomedical revolution that is taking place this century. Awesome.”

Giancarlo Barolat,M.D., Director, Barolat Neuroscience, Presbyterian St. Luke Medical Center, Denver; formerly Professor of Neurosurgery at Thomas Jefferson University, Philadelphia

“Wonderfully comprehensive, yet still digestible for non-scientists. Wish I had this book when we examined some health care innovation opportunities at GE; it would have provided a great foundation for the team.”

Patia McGrath, Global Director - Innovation and Strategic Connections, Corporate Marketing, General Electric

 

The key scientific discoveries of the 21st century are coming from the biosciences. These discoveries will impact our lives in ways we can only begin to imagine. Now, two leading experts will help you imagine those impacts--and prepare for them. Paul and Joyce Schoemaker preview the research innovations most likely to emerge in the coming years and reveal what they’re likely to mean for everything from human longevity to the health of society, from bioterrorism to personalized medicine.

Writing for every interested citizen and consumer, the Schoemakers illuminate the hottest technologies and most controversial issues associated with contemporary biotechnology--including stem cells, cloning, pharmacogenetics, DNA chips, proteomics, gene therapy, and much more. Then, drawing on Paul Schoemaker’s unsurpassed experience helping global organizations prepare for the future, the authors sketch multiple long-term scenarios for the biosciences…and reveal how they will impact your health, family, career, and the society you live in.

•           How long will you live? How long can you live?

            Beyond 100: breakthroughs made, breakthroughs yet to come

•           New business opportunities for the age of biosciences

            The future of pharmaceuticals, medical devices, diagnostics, disease management, and prevention

•           The economics, politics, and technology of the bioscience revolution

            What’s driving the biosciences--and what could halt them dead in their tracks

•           To 2025 and beyond: powerful scenarios and what they mean

            Making sense of the age of biosciences--so you can make better decisions for you and your family

 

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Living Well Beyond 100

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Table of Contents

Foreword xii

Preface xiv

 

Chapter 1 Living well beyond 100   1

Great progress made, much more to come 1

Medical challenges and promises 4

Living well versus living longer 7

Social challenges and promises 10

Can we afford old age? 11

Government and business 13

The journey ahead 17

 

Chapter 2 A short history of biomedicine   21

Improving hygiene 21

The power of immunology 23

                Monoclonal antibodies 24

The discovery of antibiotics 25

The DNA revolution 26

                Recombinant DNA and cloning 27

                Biotechnology 29

Unraveling the code 31

Conclusion 33

 

Chapter 3 Snapshot of the biosciences   35

DNA-based technologies 35

                Genomics 37

                Genetic testing 37

                DNA chips 39

                Pharmacogenetics 40

                Cloning 41

                Gene therapy 43

RNA-based technologies 45

                Antisense technology 45

                RNA interference (RNAi) 46

Protein-based technologies 46

                Vaccines 47

                Monoclonal Antibodies 48

                Proteomics 49

Cell-based and other technologies 50

                Stem cells 50

                Antimicrobials 51

Conclusion 52

 

Chapter 4 Bio-driven convergence   57

Converging technologies 58

                Telemedicine 58

                Remote diagnostics 59

                Biological drug factories 59

                Biochips 59

                Tissue engineering 60

                Imaging 61

                Multidirectional synergies 62

                Shifting industry boundaries 64

Healthcare and IT 65

                Medical information handling 65

                Medical data storage 66

                Computers and drug discovery 66

                Remote monitoring and the wired home 67

Reshaping bioinformatics 67

                Bioinformatics and gene banks 69

                Personalized medicine 70

                Systems biology and holistic medicine 70

                Biosensors 72

                Nano devices 72

Commercialization challenges 73

                Technological challenges: biocompatibility 74

                Regulatory challenges: clinical safety and efficacy 74

                Political challenges: privacy and ownership 74

                Social challenges: consumer advocacy 75

The road ahead 76

 

Chapter 5 The business of biomedicine   79

The pharmaceutical industry 79

                Diminishing drug pipelines 82

The biotechnology sector 85

Medical device industry 89

                Cardiovascular device segment 89

                Orthopedic device segment 91

                Neurological device segment 91

Medical diagnostics industry 92

                Laboratory testing 93

                Point-of-care (POC) patient monitoring and diagnosis 94

Prevention and disease management 95

Conclusions 97

 

Chapter 6 Healthcare under stress   101

Stress in developed nations 103

                Healthcare funding 104

                Major diseases of the developed world 105

                Cardiovascular diseases 106

                Cancer  106

Stress in developing nations 107

                Acquired Immune Deficiency Syndrome (AIDS) 109

                Malaria 111

Which technologies will succeed? 113

Illustrative cases 114

                AIDS and malaria 115

                Cardiovascular diseases 115

                Cancer 116

 

Chapter 7 Wildcards for the future   125

Trends versus uncertainties 125

Wildcards 127

Society and politics 127

                Public support of the biosciences? 127

                A major pandemic? 129

                Biotech rogue states? 130

Science and technology 131

                Raging success or major meltdown? 131

                Role of complementary industries? 132

                Intellectual property regimes? 133

                Qualified staff for healthcare and research? 133

Business and economics  134

                Economic growth and global power shifts? 134

                Venture capital and other funding sources? 135

                Climate change and resource scarcity? 135

A scenario framework 136

                The first overarching uncertainty: technological success 137

                The second overarching uncertainty: societal acceptance 137

                Multiple scenarios are possible 138

The role of stakeholders 141

 

Chapter 8 Scenarios up to 2025   143

Bio gridlock scenario 143

                The view from 2025 143

                How we got here 145

                The world we live in 150

                Analogous cases 151

Golden age scenario 153

                The view from 2025 154

                How we got here 154

                The world we live in 158

                Analogous case: information technology 160

 

Chapter 9 What it all means   163

You and your family 163

At work 168

Business and commerce 170

Society at large  172

 

Appendix A DNA, RNA, and protein   177

Molecules of inheritance 177

The structure of DNA 178

Cracking the code  179

Making proteins 180

Regulating gene expression 181

 

Appendix B Cloning genes   183

Restriction enzymes 183

Cloning procedure 184

 

Appendix C Complexity of the genome   187

Non-Coding RNAs 187

SNP variations 188

 

Glossary of Biomedical Terms   191

Acknowledgments   199

About the Authors   201

Index   203