Self-injection is becoming commonplace in managing chronic diseases. Patients are more informed ‘consumers’ and demanding convenient therapies and ‘discreet’ drug delivery devices like auto-injectors in preference to prefilled syringes and exposed needles. Therapies are also becoming more complex and can be targeted to specific indications rather than whole diseases. This requires more targeted diagnostic tests and treatment delivery solutions, combined with new disease management tools – or at least better monitoring. Advances in multiple areas are pushing the boundaries of what we deem possible today – and developments in material science, electronics and software are happening faster than ever and making inroads into pharmacotherapy. We can track and monitor our activities and the ‘state’ of our bodies more closely and frequently than ever before. But how can we extract the full meaning out of all the data we are able to collect? And how can we use this in the further advancement of ‘drug therapy’? What advances are in store for us over the next 20-30 years? It’s not hard to imagine that we will technically be able to arrive at a fully integrated healthcare system combining constant monitoring and instant diagnostics to provide a full picture of any healthcare issues. DNA sequencing could help us understand who is more likely to suffer from certain health issues which could be specifically monitored for. Upon diagnosis of any disease – or even when the first indicative symptom is detected – further analysis of genetic make-up could define a targeted therapy manufactured specifically for a specific patient. Drug delivery would become very individual, with low-volume drug manufacturing and administration – potentially even at a single dose level. This could also extend to lifestyle monitoring. General health and wellbeing could be continuously monitored and diet regulated to ensure your body has all the nutrients and vitamins it needs. We could not only monitor how well a therapy is working to treat a chronic condition but also how wellbeing is affected. Slow release/ultra-long-acting formulations would be able to stay in the body for extended periods (think weeks, not days) and continuously release drugs at therapeutic levels, with the release being triggered by disease indicators within the body – effectively, a self-regulating therapeutic system. However, any advance into patient-specific therapy will put immense pressure on manufacturing methods – current high-volume bulk manufacturing would no longer be appropriate as each patient may need a personalised version of the same therapy. Would that extend to drug, formulation and delivery device? Most likely, yes. With low-volume manufacturing and personalised delivery, a certain kind of device will be required. The physical qualities of any given therapy will vary and be highly dependent on person-specific attributes, as well as the disease, and may even need to change as part of a course of treatment. And as this variation is not only dependent on the condition but also patient specific, a new family of devices will be required. Devices will need to be as flexible, responsive and ‘programmable’ as the therapy itself – as they will have to respond to patient-specific requirements for things such as volume, viscosity and (in the case of injection) needle depth. If we look at drug delivery in 2040, how different will it be? We can observe the changes likely to affect it, we are just not yet able to create a full picture of how we would address all the ‘consequences’ of personalised drug delivery. We need to construct a long-term strategy to develop devices that will one day be used to deliver highly personalised therapies. We need to ensure that we continuously monitor the advances of personalised diagnostics and therapies – and build an understanding of the requirements for the delivery systems they will need. The future of drug delivery needs to start now… More Information On PharmaTimes