Pharmaceutical Market Europe • September 2021 • 12

DARWIN'S MEDICINE

BRIAN D SMITH
DARWIN’S MEDICINE 
PAWLEY’S PEEPHOLES

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If we look carefully, we can see into the future

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It’s not often that my enthusiasm for Charles Darwin intersects with my love of another famous author. But this week it did. I was running a workshop about what pharmaceutical and medical technology markets will look like in the medium term when I found myself quoting Darwin alongside John Wyndham, the author of ‘Day of the Triffids’ and other science fiction classics. It was an odd juxtaposition but it has lessons for how you might lead your business for the future, so bear with me while I try to share those lessons.

Can Darwin predict where sectors are headed?

Darwinian evolution is a scientific explanation of how complex adaptive systems change. It applies to biological systems, which inspired Darwin, but also to business environments, which fascinate me. If you have any kind of science background, as many readers of this column do, you will know that good scientific theories both explain the past and predict the future. The entire life sciences business sector is built on using scientific explanations to predict what will happen if we intervene in a patient’s health. That’s so obvious we barely think about it.

But can we use Darwinian explanations of business environments to predict where, for example, the pharmaceutical, medtech and other life sciences sectors are headed? The answer is yes, but not in the way you might like to. You can’t use evolution to tell you what your sales will be next year. Not because the science is weak but because the industry is so complex. We just don’t have models clever enough to reflect reality, just as our models of the weather fail once we look beyond a couple of weeks. But that doesn’t mean evolution isn’t useful to business people. It can tell us where to look for signs of the future emerging, just as climate models tell us where to look for nascent tornados.

Peepholes into the future

Knowing where to look for the future is where Darwin intersects with Wyndham. The latter wrote a wonderful short story called ‘Pawley’s Peepholes’ about rather vulgar tourists from the future, coming to gawp at the present. And, of course, that allowed the present to glimpse the future. It’s a great story and I recommend it but its value to me was as a metaphor. I used it to explain to the workshop that instead of trying to use evolutionary science as a forecasting machine, it’s much better as a peephole into the future. So, biologists and ecologists use evolution to glimpse a future of raised global temperatures, reduced biodiversity and, if we’re not careful, food and water shortages. In the same way, management scientists of the Darwinian persuasion, of which I’m one, can use it to gain imperfect but useful glimpses into the future of complex, changing industries such as ours.

Value, intelligence and leaps

So let’s get practical. Evolutionary science allows one to anticipate how the selection pressures of an environment are changing. This enables a second-order prediction of the consequences. For example, if we think a habitat will get drier, we can be reasonably sure that drought-resistant species will thrive at the expense of thirsty species. In my book ‘Darwin’s Medicine’, I identified six major shifts in the life sciences environment and used those to predict, among other things, speciation of business models in pharma and medtech. This turned out to be true, as you can read in my column ‘Back to the Future’ (PME February 2021). So that’s a big-picture, strategic way of using Darwinian evolution to guide the adaptation of your business to a changing environment.

But there are more immediate uses too. For example, one of the six shifts, the Value Shift, predicted that payers would change how they define value, but was vague about exactly how that would happen. That’s a cue for strategic planners to look for signs of it happening and, lo and behold, look at how China is now demanding value comparisons against best in class, not also-ran competitors. That’s a ‘peephole’ into future payer strategies. In the same way, the ‘information shift’ told strategists to look for the emergence of telehealth in developing economies. If you want a peephole into that future, take a look at what Indonesia is doing to cope with the demands of COVID-19. Likewise, the ‘holobiont shift’ alerts us to look for unusual alliances designed to create novel value. Use Google to take a peep into what GE Healthcare and SOPHiA are doing.

Directed vision

Anticipating the future is self-evidently important to leading a long-term business, but it’s hard. Not because we can’t see what’s happening but because we can see so much happening. We need to be able to differentiate the noise in the market from signs of an emerging future. And that’s what evolutionary science gives us: peepholes into the future.

This column is also available as a podcast here or search ‘Darwin’s Medicine’ on your podcast provider.


Professor Brian D Smith works at SDA Bocconi and the University of Hertfordshire. He is a world-recognised authority on the evolution of the life sciences industry and welcomes questions at brian.smith@pragmedic.com