Ethics Case Studies in Biodesign

Case 5 - Practical Issues in Prioritizing Needs

You have noted a large set of ‘unmet medical needs’ over a range of medical specialties.
Your team narrows the list to several of these items by consolidation and elimination of specific needs on the list. Among the criteria used for determining the priority of these needs, as a guide to a final choice for pursuit of a solution, are:

• existing competing solutions
• the likelihood of finding a significantly better or unique solution
• the size of (number of physicians/patients comprising) the "market"
• the passion of the team for finding a solution in this "space"
• the enthusiasm of specific advocates for a given problem
• the likelihood of obtaining funding for taking the solution forward
• the potential for maximal financial reward

As you get to final categories you see that one of the needs addresses to a condition for which there is no good therapy now however the number of patients with this rather severe condition is not a large. Another item on the list enables marked improvement in a common cosmetic procedure. The team considers several points in comparing and contrasting these needs:

• the physical and psychological value to the patient if the solutions work as designed
• the funds needed to develop the area and get to market
• the approval process for each area of solution
• the method of payment/reimbursement for the eventually available device
• the size of the market
• the uniqueness of the solution
• the solutions as a licensing opportunity or a company building opportunity

You have only so many 3 to 7 year cycles of invention and product development in your professional lifetime. You have to consider your professional responsibilities as well as your family’s financial future.

• Which of these categories do you want to work on for the next period of your career?
• In your opinion, what are the most crucial factors in the decision to select one of the "needs" for developing a solution?