Micro customization

Recent news (1) that a gastric resident delivery mechanism can deliver reliable, sustainable doses of agents for the long term is important. Innovation in chemical agents has moved ahead of mechanisms that would deliver them at the right time, in the optimum dose, by the best route and to the most receptive site. The ability to optimally deliver the agent is likely more important than the agent itself. In the absence of such delivery mechanisms, manufacturers have stuck to the original blue print - mass manufacturing of pills in a singular dose that shows the best therapeutic index in the population. Personalized medicine, thus, has remained elusive and more importantly, outside the business models of manufacturers.

It may be changing. Ironically, providers have moved ahead of other participants in the healthcare value chain, in the implementation of personalized medicine. Recent advancements in Artificial Intelligence and the availability of abundant data have better positioned the providers to understand, treat and manage patients, individual by individual. If delivery mechanisms improve and become individually customizable, we can rapidly move into the next level of personalized medicine. Here, we can envision devices that can measure, decide and disburse micro doses to assure optimum delivery and complete compliance. Intelligent devices could be just round the corner, taking advantage of IoT. With embedded intelligence on board, such devices can not only operate as initially primed but also self learn and adjust over time. A couple of decades from now, medical professionals will likely view the current regime to be completely archaic.

More generally, any business that is driven by scale, a blind adherence to singular specifications, will have great difficulty to survive in the future. Technology is readily available, not just for mass customization but rather for individual intervention. This is a regime change that will affect every industry and every business. Getting ahead of this rapid transformation is a necessary condition for success.

(1) A gastric resident drug delivery system for prolonged gram-level dosing of tuberculosis treatment. Verma et al. https://stm.sciencemag.org/content/11/483/eaau6267