The final session at BIG was entitled Turning Pharma on its Head:  The Next Big Thing.   There was discussion of particular technologies and immune therapies but again one of the conundrums was how to bring to market pre-symptomatic therapies, the difficulty of diagnosing wellness and to posit when wellness will progress to disease.  Commercial models are there in other sectors for a 'maintenance' approach to health and there are some interesting examples within healthcare (eg the use of statins).  However, if we are going to have a successful paradigm shift from a largely reactive healthcare system to a preventative one, collective and cross-industry dialogue is needed.  Scientists, investors, regulators, reimbursement agencies, HCPs, patients, and dare I say it lawyers(1) need to come together and develop constructive models.

Much food for thought as I spend my last few hours on the beach in Aruba!