A taste of their own medicine – GSK disrupted by 3D printing
GSK needs to carefully evaluate incorporating 3D printing in its supply chain before disrupters steal its market share.
Recent controversies regarding spiking prescription costs have brought increased attention to pharmaceutical companies’ profit-making activities. 
These problems aren’t going away.
Health care costs are expected to continue rising at an average rate of 5.3%.  Greater emphasis is being placed on improved outcomes which is largely impacted by preventative medication and adherence, care is becoming increasingly more personalized, and payers are becoming increasingly willing to pay for better outcomes, which combined encourages companies to increase prices. [3, 4, 5]
Some disruptors have recognized the opportunity to deliver improved outcomes at reduced costs with 3D printing. Take Apreica Pharmaecuticals and their new epilepsy medication Spritam. Epilepsy is a notoriously difficult condition for providers to treat effectively.  The wide range of severities and ages treated necessitates personalized dosages, but only a limited range of doses are available.  The high doses of active ingredients conflict with patients’ needs for swallowable and easily digestible pills, which discourage adherence. 
With 3D printing, the pill is built layer-by-layer allowing for more porous and potent pills over the more conventional methods using compression, punches, and dies.  Built in this way, the medication becomes more effective and patient-friendly by drastically improving the time to disintegrate.  The benefits of becoming more patient-friendly can not be overstated as it is critical to improving adherence of preventative medications which improves outcomes and decreases overall health care spend. 
3D printing doesn’t only benefit the patient. Current production assemblies require extensive and expensive machinery which could be replaced by 3D printers at a much lower price.  Incorporating this technology also reduces the reliance on specialized labor and costly procedures to prevent contamination that hurt profitability.  Further, it makes just-in-time development feasible. Companies have previously batch produced a small set of dosages of the medication, but mass production is not conducive to the specialized and precise need for this medication. By consolidating production in a programmable printer, a more precise dose of active ingredients can be inserted into the capsule on a patient by patient basis.
But reducing the need for large time and capital investments reduces the barrier to entry, which improves competition and ultimately pricing. How are the pharma powerhouses coping with the threat of disruptors like Aprecia?
GSK is the only well-established pharmaceutical company to demonstrate an interest in exploring 3D printing technologies for its supply chain. GSK has started by launched a series of competitions for employees to incorporate innovative ideas in its operations. One such competition focused on garnering 3D printing ideas from its customer-facing employees. [9, 10]
Recognizing that the benefits and risks associated with this technology are still largely unknown or not fully quantifiable, GSK is focused more on assessing which drugs are most ripe for 3D printing technology. Skeptics claim that mass production of some medications will likely still be economical, think ibuprofen, and GSK is focused more on determining what qualities make a successful 3D printing candidate and what materials and systems they need in place to ramp up. 
Preparing for years to come, GSK has initiated partnerships with researchers, including faculty at the University of Nottingham, to begin studying the technology itself and novel methods to produce drugs. One publication has been produced to date, detailing their success in developing a UV inkjet 3D printed tablet, with the expectation that the partnership will continue over the next several years. 
GSK should be commended for being the only pharmaceutical behemoth to actively investigate 3D printing as a manufacturing tool. However, if they want to remain competitive, they will have to expedite their learning process and more rapidly engage in developing 3D printing techniques. Aprecia holds more than 50 patents for its technique and pharmaceuticals, which it claims will provide a competitive advantage to 2033.  Aprecia has hit the ground running, gathering patents and FDA approval. Unless GSK steps up their partnerships and research to begin patenting their own techniques, when disruptors step into their core competency drugs, they won’t have the time, resources, or legal backing to regain their market share.
Disruptors aside, GSK is overlooking a critical opportunity to reach untapped markets. Drugs are frequently are abandoned in the R&D process because the target market is too small to make production profitable for the company.  Often these patients are some of the most complex and in greatest need of effective treatments. GSK and others should be reviewing these discarded drugs to determine if they have profitability potential with 3D printing. This could be a great social responsibility initiative and first step to improving the currently negative public opinion of the industry. Will companies use 3D printing technology as an opportunity to drive ethical pricing and social responsibility, or will it just be another the newest way to boost margins?
- Daniel Kozarich, “Mylan’s EpiPen Pricing Crossed Ethical Boundaries,” Fortune, September 27, 2016, http://fortune.com/2016/09/27/mylan-epipen-heather-bresch/, accessed November 2017.
- CMS, “NHE Fact Sheet”, https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html, accessed November 2017.
- Sun Le, et al. “Validating the Modified Drug Adherence Work-Up (M-DRAW) Tool to Identify and Address Barriers to Medication Adherence.” Pharmacy: Journal of Pharmacy Education and Practice3 (2017): 52. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622364/
- Osayi E. Akinbosoye, et al. “Improving Medication Adherence and Health Care Outcomes in a Commercial Population through a Community Pharmacy.” Population Health Management6 (2016): 454–461. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296931/
- Aurel O, Iuga and Maura J McGuire. “Adherence and Health Care Costs.” Risk Management and Healthcare Policy7 (2014): 35–44. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934668/
- Abdul Wahab. “Difficulties in Treatment and Management of Epilepsy and Challenges in New Drug Development.” Pharmaceuticals7 (2010): 2090–2110. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4036655/
- Aprecia Technologies, “3D Printing,” https://www.aprecia.com/zipdose-platform/3d-printing.php, accessed November 2017.
- Marcus Ehrhardt, “Is pharma ready for the future?,” Strategy + Business, November 30, 2015, https://www.strategy-business.com/article/00363?gko=746a4, accessed November 2017.
- Michael Petch, “Just say whoa. GlaxoSmithKline and the future of 3D-Printed pharmaceuticals,” September 13, 2016, https://www.autodesk.com/redshift/3d-printed-pharmaceuticals/, accessed November 2017.
- GSK, “Current needs for innovative solutions & new product development“, https://innovation.gsk.com/new-product-ideas/needs, accessed November 2017.
- Elizabeth A. Clarke, et al. “3D printing of tablets using inkjet with UV photoinitiation.” International Journal of Pharmaceutics1 (2017): 523-530. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pubmed/28673860
- Aprecia Technologies, “ZipDose Formulations,” https://www.aprecia.com/zipdose-platform/zipdose-technology.php, accessed November 2017.
- Wendy Lipworth and Ian Kerridge. “Why Drug Shortages Are an Ethical Issue.” The Australasian Medical Journal11 (2013): 556–559. PMC. Web. 15 Nov. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858608/
Student comments on A taste of their own medicine – GSK disrupted by 3D printing
I had never heard of 3D printed pills before, so this was a super interesting article! You’ve provided a lot of evidence around the benefits of 3D printing for both pharmaceutical manufacturers as well as patients. I’m wondering if this technology has the potential to disrupt the broader industry value chain, for example on the part of players like contract drug manufacturers who are currently responsible for the majority of the drug production that occurs globally — some market research sources estimate that outsourcing accounts for two-thirds of global pharmaceutical manufacturing. It’s possible that 3D printing could now begin to disintermediate these players, much in the same way that the pharmaceutical industry moved towards outsourcing development and manufacturing.
The idea that 3D printing can be incorporated into the pharmaceutical industry and change the supply chain is fascinating! Pharmaceutical companies should be quite concerned about FDA approval of 3D printing and the ability for medications in the future to be printed out. However, I take this idea one step further and worry about how this supply chain disruption could impact how patient to doctor to prescription could work in general. Once a “recipe” for medications is available for 3D printing in a standardized way, I wonder whether a model of 3D printing one’s medication in a physician’s office, or even at a patient’s home would be a possible way of delivering care. I worry that the current model of the pharmaceutical industry is this supply chain were to be realized would lead to much lower costs for patients/the medical field but would destroy many aspects of the value proposition that pharmaceutical companies provide. However, such a model could also improve how patients are able to actually receive (fill out) their prescriptions and could generally improve medication adherence and medical outcomes.
I had no idea pharmaceutical companies were considering 3D printing as a drug delivery and adherence solution! Pill Pack is another company that is working to address the problem of patient adherence / compliance. Part of their value proposition is that 50% of Americans don’t take their medications as prescribed so this is clearly an issue that warrants attention and innovation and I think GSK’s approach is quite novel. This will most certainly increase the price of each pill and to a certain extent, I see the value added that justifies the price increase but I’m skeptical that this is the right kind of solution in today’s cost-conscious healthcare landscape. I don’t think 3D printing addresses the core challenge of getting patients to take the pill (solving for compliance) and I think the challenge of patient-specific dosing can be managed at lower costs without the added expense associated with 3D pill printing – I’m skeptical it solves a core enough issue in drug manufacturing to work long term but I’m curious to monitor how this plays out, thank you for posting!