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Peter Keeling

HHIT Series Episode 3: Precision medicine with Peter Keeling

Keeling has a background in the pharmaceutical industry, having worked for eleven years at GlaxoSmithKline. After spending a gap year at MIT, he became interested in the imbalance between the importance of diagnostics in clinical decision-making and the amount of resources allocated to it. 

“Diagnostics controlled 70% of the clinical decisions but only received 5% of the dollars. It always struck me that there was something wrong with that.”

He founded Diaceutics in 2005, with the goal of addressing the challenge of bringing diagnostic technology to market. 

“Diaceutics was my attempt to put my hands around that very particular challenge and say, ‘What would a diagnostic commercialisation company look like?’”

The company uses data and a lab network to drive the adoption of diagnostic technologies.

The Goal

The goal at Diaceutics is to work with pharmaceutical companies in launching “smart, targeted precision medicine drugs which are transformative to patient health”. 

Many of these drugs are becoming “significant clinical advances”, particularly in the case of the high incidence solid tumor cancers like breast and lung cancer.

But a significant and unrecognised problem exists where up to 64% of patients are not getting access to these drugs due to issues with testing.

“Bad testing is multifactorial: maybe it's the labs not running the right test, maybe the right variant of the test is not there or the sample is not collected.”

This leads to patients being denied the correct treatment. 

With 200 precision medicine drugs on the market now - and over 1000 in the pipeline - there needs to be a focus on improving the diagnostic ecosystem to efficiently connect patients with the right treatments. Precision Medicine now needs to pivot more to consider this huge clinical issue.

Diagnostic Journey

The patient's diagnostic journey refers to the process and experiences an individual goes through to diagnose and treat a medical condition like cancer. 

This journey is often “chaotic” and an “emotional rollercoaster” that can take several years to complete. 

A typical lung cancer patient will travel about four years from cough to the right drug. And in those four years, there would be anything up to ten different testing events: ten missed opportunities to redirect those patients onto the right drug. ” 

Diaceutics focuses on improving the diagnostic journey by mapping out the process and identifying opportunities to redirect patients to the right treatment faster. 

“Diagnostics are there to get that patient to their treatment and to that treatment outcome. Every one of these patients is quite often having a non-standardised journey, but it's a journey that we can intervene in and make better.”

Changing the System

The focus on pharmaceutical companies in the diagnostic journey is due to the challenge of driving adoption of diagnostic technology.

With costs ranging from $30 to $50 million per test, diagnostic companies often don't have the budget, which explains why so many diagnostics do not deliver on their original promise. Meanwhile payers and insurance companies only act on data and consequently are reactive or “sit on the fence” - and physicians are too consumed by their day-to-day tasks to worry about new diagnostic standards. 

The pharmaceutical industry, on the other hand, is motivated to introduce new drugs enabled by better testing and is consequently driving the change in healthcare. 

“They are the ones that are bending the arc of healthcare at this moment in time. Working alongside them allows us to redirect some of their dollars back into that broken diagnostic ecosystem.”

Mini MBA

Diaceutics has published a series of books called(opens in a new window)Precision Medicine Readiness Report, aimed at providing a comprehensive understanding of the patient diagnostic journey, the role of labs and precision medicine in healthcare. 

“In my view, these books give anybody who's interested a sort of mini MBA in how this ecosystem functions, or in many instances, does not function.”

The third and most recent edition is “forward-looking” and provides a vision of how the ecosystem can be improved, serving as an inspiration and roadmap for the industry to aspire to. 

“I firmly believe that all the technological components and the industrial components are there. But it does require integrator businesses like Diaceutics to bring them together.” Anyone interested in engaging in this thought experiment can download the books for free at(opens in a new window)Download the Latest Precision Medicine Readiness Report, Unlocking the Power of the Diagnostic Pathway (diaceutics.com)

Capital Hungry

Diaceutics won the European International Award for publicly listed companies, which was a recognition of their successful floatation on the market in 2019, despite the uncertainty around Brexit in the European and UK financial markets. 

“There were very few companies who dared to float their business at that moment in time. We actually secured a four times over-subscription to our business; on the back of that we raised over £40 million and our goal was £20 million.” 

They secured secondary fundraising in 2020, which demonstrated their ability to access capital quickly.

“The one thing I will say about the public markets is I think it's a good route to accessing money… For us as a capital hungry business working alongside pharma, they want to know that you're well capitalised.”

The award serves as a validation of Diaceutics status as a player in the industry and provides a positive reputational boost to the brand.

Patient-driven change

Keeling believes we are in “a middle era of precision medicine”. This is characterised by conversations among industrial companies on how to improve the field. 

Real transformation, when it comes, will be driven by consumers.

“We can book our airline tickets ourselves now, we can see our bank account details online. The next era of precision medicine will allow patients to access and change their own diagnostic journeys.”

The pandemic proved that people could do their own Covid-19 testing. 

There's no difference between testing for COVID and testing for cancer - the technology is the same. Yes, the answers are different and they have different meanings. But we are on the verge of the patient taking control of precision medicine - and that's where it all changes. ”