Frugal Innovation should be seen as a supplementary strategy for affordable healthcare, says ZS India official

The pandemic has ushered in a massive change in drug development and clinical trial management processes and has highlighted the need for diversity and inclusion in clinical trials, says Mohit Sood, Regional Managing Principal, ZS India. In an e-mail interaction with businessline, Sood also spoke about how ZS — a management consulting and technology firm focused on global healthcare with more than 12,000 employees in 35 locations worldwide — sees India that stands out with its huge talent pool and vibrant healthcare delivery system.

Excerpts:

India has made great strides in the healthcare sector. However, the country’s potential for frugal innovation in healthcare is still largely untapped, and there is a need for greater investment in R&D to harness this potential and create innovative solutions that can benefit not only India but also other countries facing similar challenges. With its vast talent pool and growing start-up ecosystem, India has the potential to become a global leader in frugal innovation.

Frugal innovation in healthcare involves developing affordable and effective solutions that can be easily implemented in resource-limited settings. Such innovations are currently led by non-profit organisations, social enterprises and start-ups that aim to address the healthcare needs of low-income populations in developing countries, but there is also growing interest from established healthcare companies.

A comparative case study of nine frugal innovation examples in the Indian healthcare sector identified seven success factors: High quality of care; high asset/resource utilisation; high clinical volumes; clinical efficiency; a patient-centric approach; accessibility; and service specialisation. These success factors can be used as a framework for other healthcare organisations to adopt frugal innovation practices.

Although frugal innovation is targeted at low-income settings with limited resources, its relevance is not restricted to low- and middle-income countries. For western societies, while innovation has predominantly focused on advanced features with high-priced products, frugal innovation can offer a new perspective on how to create affordable and sustainable solutions that can benefit the population especially in times of economic uncertainty. It is anticipated that there will be a myriad of challenges in the future such as pollution, the growing number of elderly people, and non-communicable diseases. Reverse innovations have the potential to react to this development. It can also foster creativity and resourcefulness by reducing environmental waste. This would require a shift in mindset and a willingness to learn from and collaborate with innovators from diverse backgrounds. Even so, it is important to note that frugal innovation should not be seen as a replacement for high-quality healthcare, but rather as a complementary approach to increase access and affordability.

In this context, experts foresee the growth of FI in western markets. One example is the electrocardiogram series MAC of GE that was originally developed for low-income countries like India. The portable, low-cost device is now popular among physicians and sold all around the world.

What does Covid, and by extension, the development and rollout of vaccines in record time mean for drug development and clinical trial management processes as we know them?

The pandemic has heralded a massive change in drug development and clinical trial management processes. The urgent need for effective treatments and vaccines showcased an unprecedented collaboration between researchers, governments, and pharmaceutical companies, leading to the development and deployment of vaccines in record time. This display of synergy highlights the potential for such partnerships in future. Advances in technology, such as the use of messenger RNA (mRNA) catalysed researchers to circumvent traditional steps in vaccine development and bring them to the market in record time.

Pfizer’s pandemic response exemplifies this shift towards external partnerships, reduction of bureaucracy, and purpose-driven culture. The pandemic has also highlighted the importance of diversity and inclusion in clinical trials, which has led to greater efforts to ensure that clinical trial populations are more representative going forward. Decentralised Clinical Trials (DCT) have also emerged as a result of the pandemic and are here to stay.

Health equity is a focus area for policymakers around the world. How can technology make a difference here, particularly in the Indian context?

India has one of the largest healthcare industries in the world. Notably, it is also India’s largest industry in terms of both employment and revenue due to rising government spending as well as other initiatives like public-private partnerships. More importantly, India has a competitive advantage — thanks to its large pool of highly skilled medical professionals, affordable healthcare, and clinical research, which not only make it a global centre for research and development (R&D) activities but also draws in patients from all over the world.

Along with significant R&D investments, innovation-based solutions like telemedicine, health information systems, mobile health apps and health monitoring devices (rather, the Internet of Medical Things, or IoMT) have the potential to address India’s healthcare challenges and make health equity a reality. Governments, too, have a pivotal role to play. The expansion of India’s healthcare industry is also a result of the government’s efforts to achieve universal health coverage through programmes like Ayushman Bharat and the National Health Stack. Millions of people, particularly those in rural areas, should have easier access to high-quality healthcare services as a result of these efforts. It must be noted that health inequities are exacerbated by obstacles to technological access, which can only be removed via a deep understanding of the interplay between social, cultural and economic realities.

Can you give us an idea of some of the interesting themes/projects that your Indian team is working on?

India has ZS’s largest employee base globally. We are a 8,000+ strong team with plans for robust growth over the next 3-5 years. Our team here works with more than 200 clients. Our focus has always been on delivering impact where it matters, and the work that we do here is end-to-end — from early research, drug development, to commercialisation and patient support capabilities. Some of our recent projects include developing a technology platform for a large biopharma company to improve patient engagement and support across all its Asia-Pacific affiliates. We recently helped another biopharma company to reduce clinical trial timelines by approximately 30 per cent through the use of data and analytics.

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