The politics of health: how elections will impact on life sciences

The global landscape for medical technology, biotechnology and life sciences is on the cusp of seismic change, as the confluence of geopolitical tensions, economic uncertainty and evolving social values has created a complex web of challenges and opportunities for these sectors around the world.

The broad life science industry too is in the midst of a period of significant transition. While the shadow of the pandemic recedes, its effects linger in the form of a market correction and an evolving healthcare landscape.

This, coupled with looming patent expirations, the impact of new drug pricing regulations and tighter universal regulation of medical devices presents a complex environment for both large and small life science companies. Amidst these challenges lies an undercurrent of excitement fuelled by groundbreaking innovations in advanced therapeutics, artificial intelligence and digital engagement strategies.

Navigating this new reality will depend significantly on the policy decisions of governments in major advanced economies. With elections this year in the US, the UK and India — all major players in the life sciences industry — what changes and benefits can we expect to see for companies and their investors, healthcare providers and for patients?

The looming shadow of economic uncertainty

A key concern for businesses is economic stability. The UK, under a new Labour government, will likely see increased public investment in healthcare infrastructure, potentially boosting domestic medtech and life sciences industries.

Last February, the Labour Party published its ‘Prescription for Growth’ — an official plan for the reinvestment and revitalisation of the NHS alongside the country’s life science industry. The strategy is aimed at keeping the sector competitive in a country that has recently been struggling to maintain relevance in the global medical device and clinical trials scenes.

At the same time, Labour has promised to end the rolling NHS junior doctor, nurse and senior consultant strikes that have crippled the NHS amid sluggishly rising rates of pay for staff and international competition to identify and hire the most highly skilled medical staff. Presented by the new Secretary of State for Health, Wes Streeting, the plan set the tone for the new government’s determination to make good on promises to an industry on edge.

As part of that plan, Labour has pledged to strengthen the Office for Life Sciences while creating a more certain funding environment and a more streamlined funding process. The implementation of new, 10-year budgets for key R&D institutions to attract long-term investment is aimed at ending what Labour saw as the short-termism of its Conservative predecessor in government.

The 2024 US election: pharma in the crosshairs

In the US, both main parties are pledging to reform the pharma industry and, while their approaches may differ, both Donald Trump and now Kamala Harris are expected to focus on drug pricing and market competition, signalling potential upheaval for the industry, whoever wins.

The Democrats’ Inflation Reduction Act (IRA) — particularly its Medicare drug price negotiation provision — is being touted as a win against ‘Big Pharma’s price gouging’. While the industry has criticised this as ‘price control’, the election of the incumbent vice-president would signal consolidation of the IRA, putting further pressure on drug prices.

Despite criticising the IRA in the past, Trump is also prioritising a reduction in drug costs. His previous ‘most favoured nation’ executive order — later withdrawn — aimed to leverage international prices to lower US drug costs. While drug pricing isn’t as central to his current campaign, his stance suggests a potential willingness to implement similar measures to the Democrats, if elected.

One area where the candidates disagree sharply is market competition. Harris supports ‘march-in rights’ to allow public access to patented drugs at lower prices, a stance vehemently opposed by the industry, which fears it will stifle innovation.

Conversely, Trump champions free market competition and biosimilars. His 2018 law bolstering the US Federal Trade Commission’s (FTC) oversight of biosimilar deals aimed to increase competition for expensive biologics. While this has benefited some companies with robust biosimilar pipelines, others, like AbbVie, have faced market share erosion for blockbuster drugs like Humira.

In India, the recent re-election of Narendra Modi as Prime Minister for a third consecutive term will fast-track his stated determination to make the country the world’s third-largest economy, up from fifth. Medtech, biotech and pharma will all be affected by Modi’s ‘made in India’ policy which aims to supercharge the country’s manufacturing base to help boost growth and create more jobs.

Projected revenues in India’s medtech market this year are expected to top US$8.71billion. With an anticipated annual growth rate of 7.61%, they are predicted to reach US$12.57bn by 2029. Yet despite this rapid growth — a result of increased government investments in healthcare infrastructure and rising demand for advanced healthcare solutions — India’s performance is dwarfed by the US, whose medtech sector is expected to generate US$210bn this year.

Biopharma companies on both sides of the Atlantic, meanwhile, are prepared for a protracted recessionary environment in the coming 12 months — while venture capital funding remains above pre-pandemic levels, securing financing now requires stronger clinical data and longer negotiation periods. Private equity firms, increasingly partnering with venture capitalists, offer an alternative source of funding, as seen in KKR’s recent investment in Catalio Capital Management.

Artificial intelligence (AI) — through both machine learning and generative AI — is revolutionising the industry, with companies like InSilico Medicine and Relay Therapeutics leading the charge, accelerating the drug development process. AI promises to drive incremental but significant efficiency gains across operations, including clinical trial design, patient recruitment, manufacturing, supply chain management, competitive intelligence, and sales and marketing.

Meanwhile, new cell therapies are showing promise in oncology. Allogeneic therapies are gaining traction, and the application of CAR-T in autoimmune diseases is expanding. However, manufacturing bottlenecks and safety concerns, such as secondary T-cell malignancies, need to be addressed.

Across all areas, success will depend on companies being able to navigate market uncertainties, adapt to evolving regulations, harness the power of AI and embrace innovative engagement strategies. Those which can effectively leverage these trends will be better positioned to unlock the next stage of value creation and shape the future of health care.

The ethical minefield and its impact on innovation

Beyond economic considerations, governments will grapple with increasingly complex ethical dilemmas that directly impact the trajectory of these industries. Advancements in areas like gene editing, reproductive technologies and artificial intelligence raise profound questions about their application and potential consequences. In the contentious issue of abortion, the tension between reactionary policies of populist governments and rapidly advancing technologies has blurred the lines, challenging established ethical and legal frameworks.

Shifting demographics and the prioritisation of healthcare spending

Globally, governments face the dual challenge of aging populations and declining birth rates. This demographic shift will force difficult choices regarding healthcare spending priorities. Will governments prioritise geriatric care and technologies aimed at managing age-related diseases or will they focus on preventative care and technologies promoting the health and wellbeing of younger generations?

The potential for a government-led initiative to incentivise childbirth through improved maternal health care and childcare support underlines this critical dilemma. The outcome of this debate will have significant implications for the types of technologies and research that receive government support and funding.

The potential of emerging markets

While established markets grapple with these challenges, emerging economies, particularly in South-East Asia and South America, present a compelling alternative. These regions often boast rapidly growing populations, increasing healthcare expenditure and a burgeoning middle class with rising healthcare demands.

Governments in these regions are actively seeking to attract foreign investment and develop their domestic healthcare industries. Companies willing to navigate the complexities of these markets, including regulatory hurdles and infrastructure limitations, could find significant growth opportunities.

*Ivor Campbell is Chief Executive of Angus-based Snedden Campbell, a specialist recruitment consultant for the medical technology industry.

Top image credit: iStock.com/bizoo_n