Surgical robots
Present situation worldwide and in Switzerland
Medical robotics provides a good example of the growing use of ever more advanced technologies in healthcare. Human skills and computer-assisted technologies are combined to improve the quality of medical treatments. Artificial intelligence is harnessed for diagnosis, clinical findings are analysed in greater detail, and smart medical products are used to achieve therapeutic improvements. Next to surgical procedures, medical robotics covers therapies, drug administration and physiotherapy. The most noteworthy commercial success in this field is Intuitive Surgical’s Da Vinci surgical system. Since 2000, more than three million surgical procedures have been carried out using the system, and the company’s market capitalisation is valued at around 60 billion USD. Overall, the medical robotics industry is known for its high profit margins. However, it is important to keep in mind that no randomised controlled trials have yet shown improved clinical outcomes. To date, this has not had any negative repercussions. Various important healthcare players have recently entered the market, among them Johnson & Johnson and Medtronic. New, complex technologies that interact directly with the physical environment need years or even decades to mature. As soon as they become established, however, they can become significant long-term economic drivers. Their wider economic impact consists in the fact that they give rise to high-precision industries operating as key suppliers.
Implications for Switzerland
As is the case all over the world, Swiss citizens are demanding better medical care at lower costs. These contradictory demands are currently manifesting among others in the guise of decreasing reimbursements for often performed treatments, which has been one of the main drivers for robotic solutions. Over the past ten years, the demand for intravitreal injections to treat retinopathies has increased sharply, while reimbursements fell from 630 CHF per injection in 2017 to 150 CHF in 2018. Ophthalmic surgeons are not willing to risk treatment quality, and hospitals are less motivated to carry out the procedure, even though it stops the progression of blindness for 10% of the population. The obvious solution is the use of robotised procedures, allowing highly qualified medical practitioners to carry out more interventions with usual quality yet at lower costs. The same applies to several other medical procedures, e.g. echocardiography and catheter ablation. Yet the robotisation of such procedures faces significant hurdles both from a research and from an industrial standpoint.
Despite clear trends in the number of robot-assisted interventions, the sector’s high profitability and the prospect of long-term economic benefits, Switzerland has been slow to identify medical robotics as a major driver. Stronger public and industrial investment in medical robotics would benefit Switzerland both medically and economically. Any other approach would be tantamount to increasingly outsourcing our healthcare to Silicon Valley and to Asia.