“Monolithic” NHS should back Northern Ireland Randox’s pioneering blood testing techniques

Randox  the global medical diagnostics company with principal research and manufacturing facilities in Crumlin Co Antrim, Dungloe Co Donegal, Bangalore, India and Washington DC has just been singled out for favourable mention by the Times science columnist Matt Ridley. He writes that its leading edge blood diagnostic techniques for cancer are not being adopted quickly enough by “a sclerotic NHS”.

Randox was established in 1982 by its Managing Director, Dr Peter FitzGerald in Crumlin, and has since expanded globally. (see Wikipedia)

Randox manufactures more clinical diagnostic products than any other company in the world. It invests more than 16% of profits into R&D, and almost a quarter of its staff are research scientists and engineers. [4]

Following the development of Randox Health – the first public facing division – the company became the title sponsor of the Randox Health Grand National.

One minor key note.

Police have suspended all contracts with a drug-testing company amid allegations of data manipulation.

Randox Testing Services (RTS) in Manchester was investigated after two scientists were arrested on suspicion of tampering with data.

Police minister Nick  Hurd told MPs: “The police have suspended all contracts as I understand it with Randox.

“Randox are co-operating with us fully on the priority, which is to identify the priority cases [and] get the retesting done as quickly as possible.”

The extracts from Ridley’s article give the gist but he article is well worth reading in full (£).

The leaders of the Northern Irish company Randox, a world-leading pioneer in blood diagnostics with proteins, tear their hair out at how little they are able to benefit their home market, as opposed to overseas. They have tests that could save lives and money on a grand scale by earlier and fewer treatments. But the monolithic NHS cannot find it within its budget silos to buy such tests. Elsewhere in the world innovations that save lives and money are much more welcome.

The NHS is failing to order life‑saving tech.

British companies are at the forefront of the diagnostic revolution yet too much of what they invent ends up sold abroad

…there is  little doubt that a revolution in diagnostics is happening. Until now, the slow process of culturing infectious agents to identify them has not changed much since the days of Louis Pasteur. It is becoming increasingly possible to identify the precise virus, bacterium, drug-resistant strain, antibody or telltale molecule that defines exactly what is wrong with somebody, quickly and without invasive procedures or lengthy cultures in distant labs. Yet Britain is lagging behind comparable countries in joining that revolution.

Proteins, small molecules or DNA sequences, even if present in minuscule concentrations, can now be picked out by new techniques that combine biochemistry and electronics in ever more ingenious ways. Clever algorithms analysing multiple molecular tests promise even more precision. (Disclosure: I am an early-stage investor in a start-up working in the DNA diagnostics field.)

The day when somebody can be told whether they have the genetic combination that makes them react poorly to warfarin or some other drug is coming fast too. The earlier detection of cancer through non-invasive blood tests is also coming, but a bit more slowly. Early treatment of cancer not only saves lives, it saves money. Stage one treatment for most cancers is a third to a quarter as costly as stage four.

In other words, guessing at a diagnosis based on symptoms, or relying on distant laboratories, is being replaced by simple, sometimes handheld, devices in the clinic.

There is a problem for Britain in this diagnostic revolution. For mainly historical reasons, the National Health Service can sometimes be profligate in the way it treats diseases, giving in too readily to the blandishments of drug companies with very slightly better, but much more expensive, versions of a treatment. However, it is the opposite with diagnostics. The NHS is notoriously resistant to ordering “tests”, and is exceedingly parsimonious when it comes to buying new blood-diagnostic tools.

… “the NHS is too inflexible when it comes to adopting new IVD tests. Typically, solutions are still thought of as pharmaceuticals and consideration is not given to how IVDs could be adopted in the system to improve outcomes”.

In the main pathology field of clinical chemistry and immunoassay testing (80 per cent of all testing) only one new test has been widely adopted by the NHS in the past ten years: high-sensitivity troponin for detecting myocardial infarction, or heart attack. That was adopted because a dominant private-sector provider effectively stopped producing an older test. The NHS realises the test is very useful, but industry insiders say that left to its own devices, it might not yet have adopted even this test.

Randox now has a complementary test for heart attack management, based on fatty acid proteins, but although there is significant international interest the firm is struggling to get the NHS to adopt it. The fatty acid proteins are released into the bloodstream by damaged heart cells within 30 minutes, whereas troponin is released only when heart cells die after several hours. Combined with troponin, the test would more rapidly identify the one fifth of patients with chest pain in accident and emergency who need treatment and the four fifths who can be safely sent home, freeing up beds and saving about £225 million a year.

Stem cells, gene therapy and gene editing promise a new generation of medicines for treating disease. However, proteomics and genomics are transforming diagnosis into a cheap, rapid and accurate process that is probably going to have an even bigger effect on most people’s health. The UK is good at inventing this stuff and selling it to the world, but terrible at applying it for the benefit of its citizens.