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August 14, 2018

The Future of 3D Printing in Healthcare - Expert Insights from GE Ventures and Boston Children's Hospital

Commentary
Hanna Phelan
&

The rise of precision medicine, the movement of customized healthcare for all, is driving the growth of medical 3D printing.

We are seeing 3D printing slowly making its mark from surgery planning, customized prosthetics and implants, 3D printed drugs, cells, and tissues. Hearing aids and dental implants are already established 3D printed devices largely thanks to their small size and relative ease of production using desktop printers.

It can’t be denied that 3D printing in healthcare is still an emerging technology - the new kid on the block. It's up there with blockchain, augmented reality, virtual reality - longing to prove itself. As with all emerging technologies, it is surrounded by numerous question marks as the market slowly learns more and begins to adopt them. So, with a little help from our friends at GE Ventures and Boston Children’s Hospital, we set out this week to answer some of your burning questions. Here’s what we found:

The industrial opportunities throughout 3D printing in aerospace, transport, energy and medical expand every year. As a transformative technology in healthcare, additive manufacturing not only brings improvements for medical devices, but entirely new approaches across life sciences and patient care. New products are emerging, but also new business models.” - Jessica Zeaske, Director of Healthcare Investments, GE Ventures

What is Currently Being 3D Printed Right Now?

Prosthetics, Implants, anatomical models, drugs, cells, and tissues. You name it.

What Is The Clinical Impact Here?

The clinical impact is far reaching, and dependent on what you 3D print. Surgeons are 3D printing patient specific anatomical models using the patient’s CT and MRI scans to practice on them and plan surgeries prior to stepping into the operating room.

“At BCH we have produced about 400 3D prints over the last 4 years. Our main use cases right now is for surgery planning. When you compare say a spinal surgery with and without a 3D print you find that the surgery time goes down, the sedation time goes down, and blood loss in the OR goes down with the 3D print. This is because the surgeon is prepared before the surgery with all the things that could go wrong, and the time taken do things go down - the surgery effectively turns into a rehearsed play.” - Sanjay Prabhu, MD, Paediatric Neuroradiologist, Director - Image Analysis Lab, Clinical Director - SIMPeds3D Print, Boston Children's Hospital

Bioprinting, where the “ink” used is a biological material, has the potential for an outstanding clinical impact. By using a patient’s own cells as the ink, the risk of rejection by the immune response is cut out. Prellis Biologics are focusing on creating 3D printed tissues with blood vessels, which is not a small feat. They have already developed a process for 3D printing lymph node organoids that are capable of immune responses and the generation of human antibodies. Their next 3D printed product line to be developed are islets of langerhans, the insulin-producing part of the pancreas. This can free T1D from insulin shots. Pandorum Technologies has created India’s first 3D printed liver tissue (organoid) that efficiently recapitulated human liver tissue at the structural and functional level. Current use cases include medical research for drug metabolism and disease modelling. They are currently working on bioengineering human cornea that can potentially be implanted.

3D printed customized implants such as knee and hip implants allows exact fit for the patients joint leading to reduced pain and recuperation time compared to traditional off-the-shelf implant systems that come in a limited range of sizes.

3D printed drugs allows personalised dose manufacturing and the incorporation of polypills into one pill thus promoting medication adherence. FabRx have developed a technology to formulate and manufacture 3D printed medicines with any drug compound.

How Do The Economics Look?

3D printing has the ability to optimise supply chains and cut costs. Middle men - traditional manufacturers who run single batches for each prosthetic - are being cut out of supply chains. As a result patients are getting their 3D printed prosthetics faster and at a fraction of the price.

“3D printing is one of the technologies that has the potential to be a game changer in terms of allowing us to provide precision, customized care, on demand, at a lower cost. It is particularly applicable in paediatrics where we kids have a wide variation in underlying disease conditions. so the need for customised devices / implants / prosthesis is necessary. Moreover, kids grow so they will periodically need new customised devices to match their growth cycle. The ability of 3D printing to cut out multiple parties in the value chain, ultimately leads to reduced costs that if otherwise done by a traditional manufacturer would be very expensive” - Jean Mixer, Vice President Strategy and Digital health, Boston Children's Hospital

What Are The Reg Saying?

The US FDA regulation on 3D printing is still a work in progress although it is progressing. Last year they published guidance on the 3D printing of medical products in response to the technology’s growing adopting by the healthcare industry. Some landmark moments include Aprecia receiving first-ever FDA-approved 3D printing medicine – Spritam for epilepsy in August 2015. In March 2018, Materialise became the first company to receive FDA clearance for 3D printed anatomical model software intended for diagnostic use.

Is This Reimbursable?

Not right now. There currently are no reimbursement codes or processes yet developed. In order to achieve “code-ble” status by the American Medical Association 3D printing needs to keep on proving it improves patient outcomes. Dr. Prabhu of Boston Children's noted that they are part of special interest group in the RSNA developing such a reimbursement code.

What does the Future Look Like?

The holy grail of 3D printing in healthcare lies with being able to print organs on demand. We are quite a while ago from that, with current scientists being unable to print cells thicker than a dollar bill, due to an inability to print functioning vascular systems for the cells. However, once we overcome these challenges patient lives will be changed forever.

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