What can physicians expect in 2023? As 2023 is upon us, we are probably being realistic to expect continued inflation, a choppy economy, COVID-19 disruptions in health care, and on-going supply chain disruptions continuing into the year. Some leaders in healthcare systems are even predicting an “exceptionally turbulent 2023” [1]. While inflation appears to be stabilising, the higher cost of consumer goods is making it difficult for some people to pay for medical services, therapies, and devices. As a result, health care consumers might put off buying prescriptions or medical devices that can help them treat or monitor a condition.
On the flip side, but much harder to predict, there will be a number of significant medical advances, many of which will be incremental improvements, and a few of which will be major breakthroughs.
Here are some trends to watch:
Wearables and Patient Engagement
The lines between medical devices and consumer-targeted health devices are blurring. People are using fitness trackers and health-monitoring devices more than ever. Data generated by a wearable device could eventually provide medical care teams with a more holistic view of their patients, particularly when that information is integrated with traditional clinical data. It also could encourage consumers to modify their behaviour by providing feedback in real-time. However, wearables are vulnerable to patient compliance.
A second aspect to consider is patient engagement in healthcare. Patients or just healthy citizens are often asked to track their lifestyle, diet, and medications, but they frequently fail to do so. This can lead to poor outcomes, increased costs, and stress on the health system. Some organisations are turning to apps and other technology to help patients track their own health and share that data with their providers to have improved patient-centred care. This can be done through online communities where patients can share their experiences and support each other. There are also programs that provide incentives for patients to log their data and share it with their providers. Patient engagement can help improve outcomes, lower costs, and reduce the burden on providers. It has been hailed as the “next blockbuster drug”.
Precision Medicine Will Force Out the One-Size-Fits-All Approach
Precision medicine encompasses patients’ genetics, lifestyle, and environmental data to ensure the accuracy of personal diagnostics and treatment efficiency. The one-size-fits-all approach is based on the parameters of an average patient and overlooks a wide range of individual variables.
Cutting-edge informatics technologies and facilities are needed to effectively capture and analyse patients’ real-life data and generate accurate diagnoses and medical prescriptions. In 2023, innovative projects are expected to emerge in this niche, growing its worth to $5 billion and bringing the healthcare industry closer to the universal adoption of precision medicine.
Emerging precision informatics technologies will be secure, interoperable, and service providers, payers, pharmaceutical firms, and other interested parties. They will exercise various diagnostic patterns to cater to the needs of different organisations and their clients.
Wider Use of 3D Bioprinting Technology
Although 3D printing of bio-compatible implants is not a new method in 2023, this tech will definitely become more reliable and accessible for a wider spectrum of patients, with new materials and more sophisticated methods of prosthetics.
Specifically, it is expected that progress in 3D bioprinting technology can offer enhancement in the following areas:
- Reduce production time and costs for implants and bionic prostheses.
- More affordable customised bionic prostheses for knees, spine, skull, hips, etc.
- Custom or personalised design of surgical instruments and medical devices.
- New generations and types of implants, implant engineering, and implant materials, which are expected to work better, match better, and last longer.
- Fully-functional mechanical limbs, enhanced lightweight prosthesis designs, and improved levels of integration between the orthopaedic implants and human bones.
- More options of 3D-printable life-saving implants for cardiovascular and neurological patients.
Telepsychiatry for Mental Health
There is a great spectrum of factors affecting mental health and creating new challenges for healthcare professionals in 2023. COVID-induced limitations have fuelled a relatively new niche in psychiatry and mental health care—telepsychiatry.
Here are some of the most frequent mental health problems that will affect the U.S. population in 2023:
- Psychological issues related to returning to in-person work (or hybrid workstyles).
- Post-covid syndrome with mental disorder symptoms.
- Post-traumatic stress syndrome in healthcare employees.
- Anxiety and depression caused by COVID-induced social limitations and lockdown policies.
- Digital overload, multitasking stress, and professional burnout.
These new challenges require a modern solution including tele-behavioural health software that allows psychiatrists and psychotherapists to help more patients at a time.
Growth in Next-Gen Therapies
About 20 gene therapies and 10 CAR-T treatments are expected to be approved in 2023, and even more specialty therapies are on the horizon. The US Food & Drug Administration (FDA) has received more than 3,000 Investigational New Drug (IND) applications to study CGT in clinical trials [2]. Determining how to pay for high-cost gene-therapies is likely to be quite different than financing oncology drugs and other expensive therapies. Case in point: In 2022, the FDA approved two therapies that are priced at $2.8 million and $3.0 million, respectively.
Connected Digital Care
Remote patient care has enabled healthcare and real-world insights. Digital care has especially advanced for monitoring chronic diseases, such as diabetes or COPD, or for patients with complex needs such as those who have been newly diagnosed with cancer. Remote patient monitoring uses sensors, wearables, apps and other digital tools to collect and record data, and then sends that data to a patient’s healthcare provider. It can also send alerts when a condition changes or when a patient’s condition requires attention. Remote patient monitoring is a key part of the “internet of health.” As this technology is adopted more widely, it will allow healthcare providers to monitor a wider range of patients. This is particularly important in areas that have shortages of healthcare providers and limited access to care. Remote patient monitoring can help improve continuity of care and reduce the need for patients to travel to see a provider.
CRISPR Therapy for Blood Diseases
Next year might herald the first approval of a CRISPR gene-editing therapy, following promising results from clinical trials that used the CRISPR–Cas9 system to treat beta thalassaemia and sickle cell disease. The exagamglogene autotemcel (exa-cel) treatment works by collecting a person’s own stem cells and using the CRISPR–Cas9 technology to edit the faulty gene, before infusing the cells back into the person. Vertex is expected to apply to the US Food and Drug Administration in March 2023 for the approval of exa-cel in patients with beta thalassaemia or sickle cell disease.
Alzheimer’s Medicine
In early January, US regulators will announce whether a drug that slowed down the rate of cognitive decline in a robust clinical trial can become available to people with Alzheimer’s disease. Lecanemab is a monoclonal antibody that clears amyloid-β protein that builds up in the brain. The clinical trial included 1,795 people with early-stage Alzheimer’s disease and showed that lecanemab slowed mental decline by 27% compared with a placebo. However, some scientists think this is only a modest benefit and others are concerned about the safety of the drug.
Next-Generation Vaccines
Following the successful deployment of mRNA vaccines during the COVID-19 pandemic, many more of them are in development, and we will start to hear results in 2023. First-in-human trials for mRNA vaccines against malaria, tuberculosis and genital herpes will be initiated in the coming weeks. Another trial will test an mRNA-based vaccine candidate to reduce the rate of shingles.
In November, BioNTech and Pfizer began their phase I trial of an mRNA vaccine designed to protect against both COVID-19 and influenza. The combination vaccine contains mRNA strands encoding binding proteins for SARS-CoV-2, Omicron BA.4/BA.5 and four influenza variants. We expect results later in 2023.
Happy New Year!
References:
- https://www2.deloitte.com/us/en/blog/health-care-blog/2022/2023-outlook-for-health-care-could-margins-staffing-stall-progress-to-future-of-health.html
- Gene therapy pipeline 1Q2022-2Q 2025, CVS Health, February 2, 2022; Approved cellular and gene therapy products, FDA, September 19, 2022; The state of the industry, Alliance for Regenerative Medicine, January 26, 2021
- van Dyck CH, et al. Lecanemab in Early Alzheimer's Disease. N Engl J Med. 2022 Nov 29. doi: 10.1056/NEJMoa2212948. Epub ahead of print. https://www.nature.com/articles/d41586-022-03081-0
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