Not every technological advance causes a revolution immediately. Some are discovered and rediscovered and lay fallow until it is the right scientific and cultural moment. Steam engines were devised in first century Greece, but nothing was done with it until the 18th century. And printing books was possible with a screw press, dating back to 1 A.D. Rome, but mass production was not practical until Gutenberg invented moveable type in the 15th century.
The most exciting recent breakthrough in printing has been the advent of 3D printing, also known as additive manufacturing. With a 3D printer and the right materials, theoretically, you can make virtually anything, from tools to toys. It has enormous potential for the industry but whether that potential will be realised is not clear.
Current and Future Healthcare Applications
Currently, the healthcare industry is using the technology for prosthetics, implants and devices. Last year, engineers at the University of California, San Diego 3D-printed a liver-like tissue that could replace animal and human testing in pilot studies. This could save time and money; to produce one US Food and Drug Administration-approved drug with animal and human studies take 12 years and almost $2bn.
Working 3D-printed replacement organs are in the works. Think what a 3D-printed liver could do for cancer or alcohol-addicted patients in a California rehabilitation centre or hospital.
Over 10 years, 3D printing is expected to grow from a less than $1bn industry in 2014 to almost $9bn. Medical applications are expected to represent $2bn of that figure. Frost & Sullivan thinks the healthcare 3D printing pie will be even bigger: $6bn.
The Promise for Custom Pharmaceuticals
Another promising, still mostly potential healthcare application is pharmaceuticals, medications, drugs. For almost a year Aprecia Pharmaceuticals Company has been producing its anti-seizure epilepsy drug Spritam, a version of levetiracetam, using its proprietary Zip Dose Technology 3D printing platform. By January 2016 the company had raised $35m to commercialise the drug.
MultiplyLabs is taking pre-orders for its 3D-printed customised multivitamins and supplements, which makes them smaller and quicker to dissolve. And Lee Cronin, a chemist at the University of Glasgow, has been working on a similar pill-printing system since before he gave a TED talk on the subject in 2012.
In February 2017, a related Cronin experiment was launched into space to test if specific chemical compounds for use in the 3D printing of medications can be created digitally “on demand from a minimal set of chemicals.” If so, astronauts could create medications while exploring space or colonising Mars. On Earth, it could mean there would be no shortage of anti-overdose drugs such as naloxone or maintenance meds such as buprenorphine in a New York emergency room or a California rehabilitation centre.
So customization and printing on demand are two of the advantages of 3D-printing medicine.
The advantages of Spritam is that the pill is easier to swallow because the 3D printing process means the pill can deliver a larger dose of the medication in a smaller pill, and the resulting pill dissolves much more easily. So far, Spritam is the only 3D-printed pill with FDA approval to be produced commercially, but if proponents have their way, it is not even the tip of the iceberg. Just this month scientists from the University of Nottingham, working with GlaxoKlineSmith, have 3D-printed a Parkinson’s med using “inkjet [printing] with UV photoinitiation.”
The promise is that everyone can have their own 3D pill printer at home and custom manufacture their own prescriptions, using “prescribed” software and chemical “ink,” with dosages tailored to their exact needs. Perhaps even orphan drugs – drugs that no one manufactures because too few people need them to make their manufacture profitable – could thus be manufactured by or for individuals, at the corner pharmacy if not in the home. Profiteering price increases of out-of-patent drugs – such as Martin Shkreli and Turing Pharmaceuticals did with pyrimethamine – might cease.
Cronin has even grander dreams, tailoring drugs to each patient’s genome with some sort of home kit, “to work out what disease you are going to get as a function of nature plus nurture – and then create the drug to cure it.”
Maybe non-addictive forms of opioids could be devised, or a true anti-addiction medication based on ibogaine or other psychotropic drugs, eliminating the need for substance abuse treatment at a Miami or California rehabilitation centre.
Risks of Criminal Use
But the likelihood is that with such technology it would be easier to make illegal drugs, too, or to modify illegal drugs just enough to evade the law. Expert home chemists already can do such tweaking. A 3D chemical printer could make this far easier. For this reason, some would like to nip such 3D printing in the bud.
Cronin holds out some hope of making the chemical “ink” for his printer tamper-proof, something like how non-Apple apps will not work on an Apple device. But Apple’s unhackable phone was hacked without that much effort, and a 3D printer or “chemputer” is probably just as vulnerable in the long run. The more conventional 3D printer has been used to make guns. The question is whether that is reason enough to attempt to try to suppress the technology, or if it’s even possible.
J.D. Tuccille of Reason cautions that attempts to prevent such misuse by criminals or “underground recreational drug fanciers” will only harm legitimate users. It would be tragic if only drug dealers reap the benefits, and not Texas or California rehabilitation centres or hospital patients.
The dangers and benefits may both be overblown, at least in the short term. According to the paper “Medical Applications for 3D Printing: Current and Projected Uses” by C. Lee Ventola, the potential of new technologies is often exaggerated by everybody – from proponents to critics, government and industry, researchers and the media – as is the timeline. Cronin anticipates such home 3D pill printers are years away. Whether the technology will actually have such wondrous results remains to be seen.
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