What drives medical device development ?

There is a popular saying that “Necessity is the mother of invention” but it doesn’t seem to hold water in the “Medical Technology” domain. In a country like India where the healthcare setup is failing, one can easily identify substantial number of “Needs” which can be addressed through technology developed using the currently available infrastructure. Then why is it so that there is a drought of indigenously developed medical devices to address these “Needs”.
The diagram of a funnel is often cited to depict the various steps involved in filtration of “Needs-Identified” in order to successfully launch a medical device in the market. But then there has to be a driving force for the filtration to take place and a closer look will reveal that the driving force is fuelled mainly by the gravity of “Greed” rather than that of “Need”.
It is well known that the so-called filtration process gets influenced by the ability of the device manufacturer to translate the idea into a profitable venture, unless one is into philanthropy. Surely, no identified “Needs” are less important; otherwise it wouldn’t have caught one’s eye at the first place. However, the gravity of the “Need” is determined by the “Return of Investment” involved in addressing the “Need” in question.
Numerous technologies have been developed by the academia through research grants from government but there have been no takers for obvious reasons. The problem is universal as someone has rightly stated about the recently passed US Healthcare Reform Bill that no number of reforms would succeed in improving the healthcare scenario unless people stop being greedy.

Licensing Strategy: A conflict of interest

In the “Healthcare Technology” domain, introspection of the process of “Technology Transfer” from academia to industry would reveal a conflict of interest between the two respective parties. In order to prevent the monopoly of a single player in the market, usually the academia insists on “Non-Exclusive Licensing” of the medical technology developed utilizing government funds. And it quite often happens that due to lack of healthy competition, instead of putting in efforts for further refinement of the technology, the licensee would try to command a price in the market, eventually making it unaffordable for the common man to reap the benefits of technology coming out of government funded research.
Though the government’s policy is clearly aimed at protecting the interests of common man, this is viewed as a losing proposition by the industry because a potential licensee would never like to go for a “Non-Exclusive Licensing” of the medical technology for obvious reasons. No firm would like to have a competitor possessing the same technology in the market. Also, it is quite possible that if the new technology is perceived as a threat to the market of an existing product, then the technology owner of the existing product would try to seek an “Exclusive License” of the technology in question and then kill it by not taking it to the market.
This turf-war between the licensee and the licensor makes the industry go on back-foot while scouting for new technology churned out by the academia and ultimately, it is the tax-payer’s money which gets wasted when the technology developed does not move from the lab to market.

Instead of waiting for the industry to come forward, the government should take pro-active steps in harnessing the benefits of the technology developed. In this regard, the Ministry of Health & Family Welfare (MoHFW) can take a cue from the Ministry of Defence (MoD) where all the critical requirements of the forces are met by public sector undertakings (PSU) like BEL, BDL etc. Something on similar lines should be worked out where medical technology developed by academia through public funding, be taken up for translation into a marketable product by government run bodies. Marketing of these products should not be a problem as it can be made mandatory for the government run hospitals to be equipped with such indigenously developed products. Fortunately, steps in this direction have been initiated as demonstrated in the case of the technology for a “Syringe Infusion Pump” developed recently in All India Institute of Medical Sciences [AIIMS, New Delhi]. The related technology development in AIIMS was funded by the Ministry of Information Technology and later transferred to West Bengal Electronics [WEBEL] for further refinement and commercialization. It is envisaged that such initiatives may also generate new jobs indirectly.