In half of coronary artery disease cases, the presenting symptom is death. That’s why early detection matters. NHS doctors in England now have a new diagnostic weapon to fight the disease.
Used in the US since 2014, HeartFlow Analysis uses artificial intelligence to turn a CT scan of the patient’s heart into an interactive, 3D model. With its help, cardiologists can assess potential problems with the arterial blood supply and decide on treatment.
Tom Slater, joint manager of the Scottish Mortgage Investment Trust, explains: “Before HeartFlow, doctors either had to do invasive tests, including surgery, or other non-invasive tests that didn’t give them the data about potential blockages they needed. HeartFlow combines cutting-edge image recognition and fluid dynamics technologies to model the blood flow around the heart. It’s a significant advance. Heart disease is a leading cause of death, accounting for around 16 per cent of all deaths worldwide.”
Not only does the Californian company’s programme work, but according to the UK’s National Institute for Health and Care Excellence (NICE), it represents a £391 per patient cost saving to the NHS. Thus it satisfies Slater’s rule of thumb for medtech, biotech and other healthcare companies considered for Scottish Mortgage’s £19bn portfolio: “Does this company improve patient outcomes? Does it reduce the costs of the system?”
At present, about 17 per cent of Scottish Mortgage is invested in medically-related firms, compared to 12 per cent five years ago and 3 per cent 10 years ago.
The trust’s enthusiasm for the sector stems from a convergence of technological breakthroughs that have accelerated innovation. These have allowed companies with disruptive new technologies to attract investment on the strength of encouraging gains, including in the tackling of the most feared afflictions: cancer, heart disease and Alzheimer’s.
A principal game-changer, according to Slater, has been the improved understanding of the genetic and molecular basis of disease and the “precipitous fall” in the cost of gene sequencing.
“Biology is very, very difficult,” Slater says. “It’s really the progress made in the field of information technology that’s allowed us to get to this point where you can see progress. It’s the cumulative impact of advances in fields as diverse as mRNA therapeutics and machine learning, DNA sequencing and cloud storage. The toolkit we use for understanding disease has become a lot more powerful.”
Slater draws a parallel with less life-and-death industries, such as retail and media, where technology has opened opportunities for companies with better, cheaper products.
“Until now, you haven’t seen this same trend in healthcare. In fact, you’ve had the opposite: continuous cost inflation. When combined with an ageing population, the growing proportion of the nations’ GDP spent on healthcare was unsustainable. Now these exciting, deflationary technologies are converging to reduce costs and significantly improve outcomes for patients.”
That cost reduction is critical. Getting a new drug from lab to market costs on average around $1.3bn, according to a recent US study. Most of that goes on the nine out of 10 candidate treatments that fail somewhere between early clinical trials and regulatory approval.