DRUG INFORMATICS - where are the opportunities for STM publishers?

What is drug informatics?

• According to OpenClinical, an international organisation created to promote awareness and use of decision support, clinical workflow and other computational and database technologies, it is now humanly impossible for the unaided healthcare professional to possess all of the knowledge needed to deliver medical care with the efficacy and safety made possible by current scientific knowledge.

• This situation will deteriorate further as a result of the vast increases in the volume and complexity of knowledge about disease mechanisms created by the genomic revolution.

• A solution is the adoption of rigorous methods and technologies for knowledge management.

• Drug informatics covers the area of overlap where these methods and technologies impact upon the use of drug information in a research, clinical or commercial setting.

What is the relevance to STM publishers?

• Information about drugs comes from many sources
  • Primary level: research lab of a pharmaceutical company or in a university or at a hospital during the course of a series of clinical observations

  • Secondary level: generated as a consequence of the use of data initially collected for non-clinical purposes such as pharmacy benefit management and reimbursement

  • Tertiary level: summarised as a journal article, a reference book, a database or increasingly as a precisely defined evidence-based clinical decision pathway.

• Traditional STM publishers would only recognise part of the third tier as being relevant to their business.

• The purpose of this report is to begin to define the larger market space - the increasing availability and quality of these new types of data create opportunities and may also threaten to undermine the value of traditional content offerings because they can be used to form much more effective tools.

What forces are driving the drug informatics marketplace?

• Problems with the R&D process: despite spending more than any other industrial sector on R&D, the pharma industry is grossly inefficient and its pipeline output stands at a record low even though the automation of the research process has resulted in a huge increase in research data output.

• High level of error: According to the 1999 Institute of Medicine Report To Err is Human, many medication errors result in preventable adverse drug events (ADEs), of which approximately 20% are life threatening.

• Products are unsafe: in June 2005, the New York Times reported that a top federal drug official had told a medical advisory board that the nation's drug safety system had ?pretty much broken down? and that there was room for ?a lot of improvement? in the government's approach to uncovering dangers in drugs already on the market.

• There are a number of high profile initiatives in the US and the UK to accelerate the development of better decision support systems for clinicians.

Future trends

• e-Prescribing will reduce the number of drug information vendors. Much of the information contained in standard drug information reference resources is in the public domain and with over a dozen vendors it is difficult to see how they will be able to differentiate their products in future.

• Patient-centric longitudinal data will drive the growth of the drug informatics market. The ability to link drug usage and cost data with patient-centric information such as outcome, adverse reactions, dosage, age, sex and so forth will enable healthcare providers and payers to evolve schemes of best practise for clinical care, prescription choices and cost management.

• Personalised medicine will enable publishers to add more value to their drug reference databases. It is becoming clear that an individual?s genetic profile can dramatically affect drug efficacy and toxicity so several pharmaceutical and biotech companies are working on diagnostic tools to id