What Medical Trends Can we Expect in 2020?

IDC’s MD, Stephen Knowles, gives his thoughts about the latest medical innovations and IDC’s focus for the year in the UK and China.

More Diagnostic Tools

The search for simple diagnostic tests for cancer continues to dominate the headlines with much progress being made. Researchers at Nottingham University have had positive results from a trial of a new blood test1 for detection of breast cancer, potentially up to 5 years before a lump appears. Expect to see more research and devices such as Owlstone Medical's Breath Biopsy systems and the clinical development of the CancerSEEK liquid biopsy test which has been licensed to Thrive Earlier Detection Corp in the US.

In other areas of IVD (in-vitro diagnostic), the trend will continue for the development of rapid point of care (POC) devices to avoid the delays and cost of sending samples to laboratories.

Key areas include POC blood, saliva and urine tests for cardiac markers, cholesterol, iron and disease pathogens. As the technology advances, expect to see more devices able to test for multiple markers simultaneously (xPOCT). The drive for increasing portability and affordability will also continue.

Personalised Medicine Moves Forward

There will always be a drive to find blockbuster therapies, drugs and devices that can work for a global patient population. But there is a growing awareness that for many drugs, diseases and conditions, the efficacy of the treatment can be increased and harmful side effects reduced if the treatment is adjusted to the needs of the individual patient. One example is the potential to reduce strokes in patients taking warfarin by adjusting dosage based on measured levels of CYP 450 enzyme. Other examples are in the treatment of cancers based on genetic biomarkers such as Herceptin treatment of 30% of breast cancers based upon the over-expression of the HER-2 protein. Other biomarkers and tailored treatments exist for variants of lung and colon cancers, as well as melanoma and myeloid leukaemia.

Other areas of research include MS, Parkinson's and Alzheimer’s disease. As personalised treatment for more conditions are shown to be effective, this will drive demand for the development of new IVD devices to test more patients for the relevant biomarkers.

The use of 3D printing is also taking off in medical devices, with personalised fittings for prosthetic limbs, dental implants and orthodontics. In the area of regenerative medicine, 3D printed scaffolds have been used to build structures for blood vessels and bones. One leading player in this area is Organovo in California, which has made samples of various tissues, including, kidney, intestines and skin for use in in-vivo testing of drugs. Developments in stem cell therapy are also leading towards growth of more complex organs such as lung tissue and livers from patients' own cells, potentially overcoming the risks of rejection by the patient's immune system.

Convergence of AI and Digital Health Technologies

We predict that convergence between digital health technologies, such as telehealth services and connected devices with wearable tech, and AI will really start to take off in 2020. Mainstream consumer tech giants such as Apple and Google in US and Huawei and Tencent in China continue to invest in this area. According to research by Data intelligence, the global telemedicine market is predicted to grow at 19% per year to $113bn in 2025.

Much of these services could be delivered through smart phone and smart watch apps, but many will need connected medical devices such as diagnostic devices, connected drug delivery devices (which monitor drug compliance) or for continuous monitoring of blood glucose levels in diabetes patients. AI is being increasingly used in these areas.

An image processing AI has already proven to be more accurate at diagnosing malignant melanomas than consultant dermatologists, although smartphone apps claiming to do this are still unproven and potentially dangerous. Expect more research showing AI diagnostics from a range of medical images.

Initial applications of AI tools are likely to be in support of doctors' decision making, rather than in place of it. Robots are also likely to be used more and more to streamline diagnosis and treatment, and this is also likely to require the development of new devices to facilitate effective patient interaction.

Focus on Cybersecurity for the Internet of Medical Things (IoMT)

With the increasing amount of digital patient data and growing numbers of connected medical devices, 2020 will see increased emphasis on the cybersecurity and data security of connected devices and systems. Both the FDA and the EU are aware of these issues and have stressed the responsibilities of manufacturers to manage these risks. When developing devices, therefore, it is essential that manufactures consider and plan data security and privacy at the outset.

New Surgical Procedures and Expanded Use of Robots

Minimally invasive procedures have transformed surgery in many areas, reducing recovery times and re-admissions. As new devices are developed, minimally invasive techniques can be expanded to a greater number of procedures. 2019 saw the FDA approval of minimally invasive mitral valve surgery to a wider population so expect this to really take off in 2020.

As highlighted in the last three years, the use of robots in surgery continues to grow, with precise minimally invasive procedures a big focus. Dutch company Preceyes has successfully trialled its robotic assistant for eye surgery, while 2020 should see the first trial of the CMR Versius system as a direct competitor to Intuitive Surgical's da Vinci system, which has over 5300 systems installed worldwide. Meanwhile in the area of orthopaedics two of the leading players have taken different approaches. Stryker's Mako robots feature integrated tools and a multi-degree of freedom articulating arm taking the place of the surgeon's hand, whereas Smith and Nephew's Navio handheld robotic system is designed to augment the surgeons manual capability.

Outside the operating room, 2020 should see some early developments for rehabilitation robots, such as for recovering limb usage in stroke patients, although commercially available products may be a few years away.

Drug Delivery Continues to Expand with Focus on Reusable Devices

With the continued global increase of diabetes, demand for injection devices for insulin and other therapies continues to grow. While currently most such therapies are delivered in disposable devices, increasing awareness of plastic waste in developed markets, coupled with expansion of diagnosis and treatment in developing markets, means reusable devices are likely to become the focus for many pharmaceutical companies. 2020 will see the launch of a number of IDC designed disposable and reusable injection pens for self administration of diabetes and other therapies.Inhaled therapies will continue to grow with more connected devices at the top end of the market, while for the mass market we are likely to see more dose counters as they are required in many markets.

IDC's Medtech Focus for 2020

With IDC's strong focus on the development of medical devices, the team has already been working on many of the areas likely to be breaking through in 2020. This year will see the launch of a number of IDC designed ShailyPen Axiom and Protean, disposable and reusable injection pens for self-administration of diabetes and other therapies. IDC has also collaborated with medical device companies to develop inhaler actuators with integrated dose counters.

IDC’s global alliances will also see the launch of developments in connected wearable devices, surgical robotics, kidney dialysis and oncology treatment systems, as well as assistive systems for stroke patients and other rehabilitation devices.

2020 is set to be a great year with IDC’s partnerships in China creating a lot of excitement; not least by offering a streamlined approvals process and an opportunity to launch innovative medical devices into the Chinese market.