Drones are Taking Off in Healthcare

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Brendan Shaw takes a look at the rise of drone technology in medical product delivery and its implications for the future of healthcare.

 

What was once thought of as science fiction even a few years ago is rapidly becoming a commercial reality.

While we have not yet seen regular direct-to-patient deliveries of medicines by drones, we are certainly seeing direct-to-clinic, or direct-to-health care professional deliveries, with increasing regularity.

 

Growth in use of drones in medical product delivery

Various medical product delivery ventures using drones have taken off in recent years.

Since 2016, Zipline has been delivering blood products to clinics in Rwanda via winged drones. The blood is packed in cold packs and loaded on to the small pilotless planes that can fly up to hundreds of kilometres to local clinics where they are needed for emergency blood transfusions. The company is also helping deliver yellow fever vaccines in Ghana.

The first time a government contracted a commercial drone company to roll out vaccination services was with a delivery performed by Swoop Aero, delivering vaccines in Vanuatu in 2018. The delivery of cold-chain vaccines at low temperature from the west side of the island of Erromango to a village medical clinic on the east side of the island went without a hitch.

Another company, Matternet, has been running drone deliveries of diagnostic tests and blood samples between clinics in cities in Switzerland in partnership with Swiss Post since 2017.

In 2019, a successful test was conducted by several companies, including pharmaceutical company Merck, Sharp & Dohme and drone manufacturer Volans-i, to fly a drone carrying cold-chain supplies in the Bahamas over open water beyond the operator’s line of sight.

The first delivery of insulin by drone, also requiring cold-chain storage of course, was performed in 2019 when a drone flew over water to the Aran Islands off the coast of Ireland in a trial conducted by the National University of Ireland, Galway.

Other bigger players are starting to get involved in a convergence of different industries and technologies to create new business.

Amazon has announced plans to introduce drone deliveries for a range of products but has not yet broken into delivery of medicines and vaccines. However, with its 2018 purchase of online pharmacy chain, PillPack, one only wonders how long it might be before Amazon seriously looks at combining the online pharmacy business with its drone delivery service.

UPS has been investing in the technology for some time with its Flight Forward initiative, obtaining FAA approval in the US in 2019 to fly drone deliveries.

Most recently, in a classic example of a crisis triggering innovative new ideas, drones have been rapidly recruited to help deliver health products during the COVID-19 outbreak:

  • Antwork Technology’s drones have been operating in China, becoming a critical part of the testing and quarantine infrastructure, ferrying test samples during the COVID-19 outbreak between hospitals in Hangzhou in Zhejiang province,
  • UPS announced it would establish a medicine drone delivery service in partnership with CVS and Matternet to deliver medicines to retirees in Florida during the lockdown, and
  • Even the sometimes technology-shy NHS in the UK has just announced it will be using drones to fly medical supplies to the Isle of Wight during the COVID-19 outbreak.

 

Opportunities from drone delivery of health products

While it might sound like just playing with toys or new technology, the use of drones to deliver medical products brings several potential advantages to healthcare.

Drones have already demonstrated that they can deliver medicines in a fraction of the time that other supply chain delivery services do.

In Vanuatu the delivery time for vaccines could be cut from days to hours in some cases, with one case where a two hour delivery by boat is cut to 20 minutes by Swoop Aero’s drones that can fly at 100 km/h and cost $4 a delivery.

In Rwanada, Zipline’s blood delivery drones have cut the time to get urgent blood supplies down from a three-hour round-trip car drive to a 15 minute direct delivery by drone. This has already saved lives.

Similarly, researchers at the Karolinska Institute in Sweden have found that drones could save lives by providing defibrillators 16 minutes quicker than emergency service vehicles, on average, potentially saving the lives of heart attack patients.

Unlike ground transport, drones do not get delayed in traffic jams, congested streets or city crowds and can fly over washed out roads, steep mountains and open water faster than traditional means of transport. This can ensure timelier delivery of samples, blood products, medicines and vaccines, particularly important for those products requiring refrigeration.

 

The economics of drone delivery in medicine

Another potential reason for using drones in the health care supply chain in the future is cost.

Amazon’s figures already show that the cost per delivery from drones is cheaper than other ground-based forms of delivery, although these will vary depending on the country and use.

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While there might be economies of scale from larger delivery batches in trucks and other ground or water transport, the speed and automation of drone delivery, with its absence of delivery drivers and truck running costs, may well increasingly give drones the cost advantage over other delivery options in a variety of settings.

Quite apart from the straight cost per unit of drone delivery, another reason why drones may play a larger part in health care delivery is in streamlining the efficiency of the medicine supply chain.

Supply chains with multiple steps in distribution often involve costs. Wholesalers and distributors add their mark-ups and margins on medicines which can increase the price of medicines for health systems and patients, sometimes substantially. For example, one study by the IMS Institute for Healthcare Informatics found that wholesale distribution and retail costs account for a significant portion of the total cost of medicines in a sample of countries.

 

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Drones have the real possibility that, at least in some cases, they will be able to eliminate these distribution costs by, quite literally, flying over the top of them. This may, of course, raise challenges for more traditional workforces and businesses involved in the wholesale and retail distribution of medicines in some countries, but the potential economic savings are there.

This is not to say that the economics of drone delivery for health systems is a done deal.

For example, one recent study in the Lancet found that, in the case of Rwanda, given current technologies and cost structures, drone deliveries of laboratory samples were less cost-effective than charity motorbike riders over shorter distances. Over longer distances, the drones were more cost-effective, particularly as drone technology improves and costs fall. However, others have said it is difficult to compare such economic studies across countries and contexts and that there may be real benefits already from use of drones in healthcare.

Ultimately, rather like what is happening in other industries such as renewable energy and mobile technologies, with increased efficiency and falling technology costs drones may well become an increasingly affordable option for more customers in health systems around the world and develop new business opportunities.

 

Looking to the future

To date, drones have not been widely adopted in delivering healthcare supplies, perhaps because the full costs of acquiring and using drones in healthcare is unknown.

But with time, greater familiarity, improving technology and falling costs over time, combined with the shock of the COVID-19 outbreak forcing health systems to try new ideas, one can envisage more opportunities for drones to play a greater role in healthcare delivery. These might include:

  • More widespread delivery of medicines to clinics in difficult, resource-constrained settings like low-income countries or remote regions
  • Personalised delivery to patients who can pay for service delivery direct to them, perhaps using smartphone location technologies so that a drone can find the customer at a point in time wherever they are
  • Delivery of medicines and equipment to patients and health care professionals in emergency situations in congested urban areas
  • More mainstream use in disaster relief efforts where widespread medication or vaccination is required in multiple communities in a hurry, where normal functioning supply infrastructure has been destroyed, or in ‘lockdown’ situations due to a health crisis like the current COVID-19 outbreak, and
  • Linkups with the emerging telemedicine/telehealth technology, such that a doctor can prescribe a medicine, and have it delivered direct from warehouse to a patient wherever they are.

I will stick my neck out and predict that drone technology is going to become much more prevalent and much cheaper in medical product delivery in the near future and this will probably happen quicker than we think.

Watch this space.

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