251 286 - Biotech Bayern

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Siemens Healthcare:
Looking at the Future
ERICH R. REINHARDT
Member of the Managing Board of
Siemens AG, CEO Healthcare Sector
In the past hundred years, medicine has progressed
tremendously. Infectious diseases, for example, can be
healed with antibiotics, and also the possibilities to diagnose
and treat widespread illnesses like cardiovascular
diseases or cancer have improved a great deal.
Yet, there are still great challenges that face our public
health system today and will also do so in the coming
decades:
The world population is growing and the proportion of
older people is on the rise. At the same time, it is possible to
observe an increase in illnesses caused by today's lifestyle
such as cardiovascular disease, cancer, diabetes, and dementia.
Despite great efforts, we have so far not been successful
in putting a stop to the resulting increase in healthcare
costs. However, society has the aspiration to ensure that
everyone will have access to high-quality healthcare in
future as well. Consequently, this calls for an increase in the
efficiency of the healthcare system.
Improvement in procedures, for example by means of
healthcare IT solutions, seems to be one possibility to immediately
increase efficiency.
An even greater potential for improvement, however, offers
early diagnosis. Even today, many diseases are still diagnosed
relatively late, which reduces the chances of recovery
and multiplies the costs of treatment. In the case of cancer
of the colon, for example, only approximately 35 percent of
the patients are diagnosed at stage 0 to 1, when the
tumour is still localized and therefore surgery has a good
chance of success. If the tumour is diagnosed later, this
reduces the chance of successful treatment and the probability
of survival. For example, the probability of the
patient surviving a further five years at stage 1 exceeds
90 percent, at stage IIIB it is still something more than 60
percent, at Stage IV, however, it is less than 10 percent.
An equally big challenge is the choice of therapy, but here
is great potential for improvement. For lack of suitable test
methods, it is currently scarcely possible to predict whether
a patient will respond to a certain treatment or not. In many
cases, doctors need to try out different treatments before
they find the right one. This increases the patients' discomfort
and stress and gives rise to additional costs.
So how can these potentials be tapped best in order to
improve the quality of medical care?
A very promising approach is molecular medicine, i.e., an
improved understanding of the causes of illnesses and the
correlations between them at the molecular level. In
conjunction with knowledge-based applications that bring
together all information acquired by means of different
diagnostic methods, it is possible to compare them with
reference data of large populations. The aim of this is to
help diagnose diseases at a very early stage and, ideally, to
prevent them from breaking out at all or – if the disease has
already broken out – to select therapies in a more targeted
and personalized way.
What shape might such an approach assume in future?
What effects would it have on the course and the treatment
of an illness? Let us take coronary heart diseases
(CHD) as an example:
Today, approximately 60 percent of patients at risk of a
heart attack or stroke can be identified using classical
diagnostic methods (Body Mass Index, diabetic yes/no, s
moker yes/no, age, cholesterol levels and the ratio of
HDL/LDL cholesterol). Even so, approximately 40 percent of
all cases occur with patients who have a low risk according
to classical diagnostic criteria.