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From Blood Sugar to Big Data – Fighting Diabetes and Cardiovascular Disease in the Developing World

2018-11-29 13:06 Thursday

Imagine a world in which patients leave the doctor’s office with no lingering doubts about the care they’ve received, because their treatment has been recommended and approved by an intelligent machine. The machine is not limited by incomplete information, or outdated knowledge; it is constantly “learning” from new evidence that presents itself in real time, and utilizing artificial intelligence to account for all of the complex variables specific to the individual patient. We’re not far away from that scenario, according to Shailendra Bajpai, the Head of Disease Management and Stakeholder Engagement at Sanofi Emerging Markets Diabetes and CV.

Dr. Bajpai has a wide range of responsibilities at Sanofi, one the world’s largest pharmaceutical companies, helping promote the optimal use of its diabetes and cardiovascular disease products in developing countries. He has been instrumental in forging alliances with NGOs, government authorities, and other key stakeholders, engaging with researchers and policymakers, with the goal of maximizing value for patients and healthcare practitioners, improving access to medical treatments, and educating the public about their benefits.

A physician specializing in cardiology, endocrinology & metabolism, Dr. Bajpai got his start in academia, notably for the All India Institute of Medical Sciences as a Post-Doctoral Fellow, before moving on to industry. He has served in diverse roles for regional and multinational organizations spanning medical affairs, clinical research, strategy, due diligence, education and advocacy, related to diabetes, cardio and metabolic diseases, neuropsychiatry, as well as other fields. He has also authored journal articles that address some of the most pressing public health issues of our time.

Dr. Bajpai spoke at the 3rd Healthcare Asia Pacific Summit 2018 in June, 2018, detailing the increasingly value-centric landscape for clinical development, and followed up with Duxes in an exclusive interview. His broad base of knowledge and experience has equipped him with a unique perspective on the healthcare industry, at a crucial time when technological improvements and emerging markets offer unprecedented opportunities for growth.

A major focus of Dr. Bajpai’s is optimizing “integrated care”, or in his words: “Complementing our products with new technology and strategies to maximize the benefits for both physicians and patients.” Integrated care is a comprehensive approach, taking the patient’s cultural environment, state of mind, support network and medical condition into account, rather than treating them as distinct phenomena. There are three approaches that Dr. Bajpai outlined for delivering integrated care in the developing world.

Integrated care is a comprehensive approach, taking the patient’s cultural environment, state of mind, support network and medical condition into account, rather than treating them as distinct phenomena.

The first method is utilizing behavioral science, assisting physicians by identifying patient behaviors, willingness or unwillingness to take a certain medication for instance, and then implementing supportive policies that maximize health outcomes and general wellbeing. This often comes in the form of positive interventions, such as patient education programs. The second is the use of technology, primarily algorithm-driven medical devices, which in his field can help patients monitor blood sugar and adjust doses for diabetes medication. Notably, Sanofi is collaborating with Google to develop a “virtual screening” patient-centric ecosystem for practitioners and caregivers, making use of connected devices and cloud technology. The final method is in building a community and providing peer support for patients through a variety of means. Dr. Bajpai is currently running pilot programs in China, and other countries, in which community volunteers who have suffered from the same illness as patients share their knowledge and experience.

Dr. Bajpai’s primary area of specialty is diabetes, and in his role at Sanofi he has worked tirelessly at helping patients, practitioners, and government agencies in developing countries manage what has become a grave public health crisis. He contends that there is a widespread misconception about the global prevalence of diabetes. Whereas the outbreak of diabetes in developed countries has received ample coverage, three quarters of the diabetes burden is actually in the developing world, which contains eight of the top ten countries for diabetes incidence.

“Rapid globalization has led to urbanization and radically changing lifestyles. Altered diets, rising stress, sedentary lifestyles, smoking, and increased alcohol intake, have given rise to complex public health problems, including higher rates of diabetes and cardiovascular disease”, he explained.

Dr. Bajpai contends that there is a widespread misconception about the global prevalence of diabetes … Three quarters of the diabetes burden is actually in the developing world, which contains eight of the top ten countries for diabetes incidence. “Altered diets, rising stress, sedentary lifestyles, smoking, and increased alcohol intake, have given rise to complex public health problems, including higher rates of diabetes and cardiovascular disease”, he explained.

Dr. Bajpai notes that diabetes is accompanied with a two to three times higher cardiovascular disease burden, indicating that the two phenomena are closely related. Despite the scale of the problem, developing countries spend far less on addressing diabetes, due to the scarcity to resources. A lack of multi-disciplinary care is yet another challenge; patients with diabetes need access to nutritionists, psychologists, and other specialists in order to best manage their symptoms. To address these concerns, he works closely with policymakers in numerous countries – China, Indonesia, Vietnam, Brazil, and Russia, among others, to improve access to many of the cutting-edge technologies being developed. It is Dr. Bajpai’s hope that intelligent, data-oriented medical devices which can help developing countries overcome shortages in manpower and resources.

Clinical research for diabetes and cardiovascular disease is undergoing a transformation, as Dr. Bajpai is apt to note. Researchers are utilizing pragmatic, real-world evidence in new and profound ways, extracting meaningful conclusions from a “big data lake” that has been exhaustively compiled in recent years. Big data not only helps with R&D and patient care by detailing which treatments are most effective, it also provides the basis for predictive statistical modeling.

Models for the spread of diabetes, for instance, free Dr. Bajpai from having to painstakingly consult doctors and researchers on a piecemeal basis. Sanofi has initiated surveys across the developing world, which directly input the doctor and patient experience into the growing data pool. Through “machine learning”, an algorithm assisted by artificial intelligence takes all known data into account, and can provide answers to a range of pertinent scientific questions. Regulators across the developing world are increasingly open to algorithm, data-driven models for clinical research, having observed them in practice, and Dr. Bajpai believes that acceptance for new research paradigms will further increase as the technology continues to improve.

Sanofi has initiated surveys across the developing world, which directly input the doctor and patient experience into the growing data pool. Through “machine learning”, an algorithm assisted by artificial intelligence takes all known data into account, and can provide answers to a range of pertinent scientific questions.

Thanks to efforts underway in Southeast Asia, healthcare companies such as Sanofi will have access to important developing markets. Dr. Bajpai is optimistic about progress to regulatory harmonization in the form of the ASEAN Common Submission Template (CSDT) for Medical Devices, which dramatically simplifies the product registration requirements for medical device providers, classifying all devices into four categories according to risk. He notes that further work is needed, especially in the area of data collection, but believes that this crucial step could be a tipping point for healthcare in the region.

For the tens of millions of people afflicted with diabetes, the stakes are high. Even rapid improvements to the quality and accessibility of care, won’t meet all of their needs instantly. But they can take comfort in knowing that help is on the way, not only from dedicated professionals such as Dr. Bajpai, but also from the best technology has to offer.

For further information, please contact:
Ms. Cindy Cui
Tel.: +86 21 5258 8005 Ext. 8253
E-mail: cindy.cui@duxes.cn