Scientists are developing an x-ray pill you can swallow for colonoscopy

Less invasive technology is clearly the future. It will allow more cases to be diagnosed and treated early leading to better care and cure.

Failure to publish the results of all clinical trials is skewing medical science – The Economist

Truth

A recent article published in The Economist highlights the fact that more than half of all the clinical trials are never published.

In any situation, if we only know half of the truth, distorsions ocurr and could lead to inappropriate and harmful decisions. A US law was passed in 2007 to encourage pharmaceutical companies to register them on a website and give follow-up on the results.

But this is not always precisely executed. After the legal maximum of a year was up, the percentage of clinical trials which had had their results published:

– 17% of those paid for by industry;

– 8% of those sponsored by the National Institutes of Health;

– 6% of those paid for by other government agencies/academic institutions.

The quantity of missing trials is huge and hiding poor results is not what we expect from scientists.

It has to change as hidden or missing data could lead to the use of inappropriate drugs in some patients. There is hope: the website Alltrials (launched by Ben Goldacre) and the charity behind this initiative are leading the movement toward more transparency. The charity “Sense About Science is working on an index, to be published later this year, that will rate pharma firms according to the extent of their commitment to publish all trials”.

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Allergan & Teva – Two sides of one table

Deals

Allergan (former Actavis) is restructuring its operations with the divestment of its generics business to Teva for approximately USD 41 billion in cash and stock ($33.75 billion in cash and Teva shares valued at $6.75 billion, giving it a 10% stake in Teva).

But it’s not done. According to an interview with the Financial Times, the CEO, Brent Saunders, is eager to sign another mega deal with the proceeds from the sale mentioned above. Allergan can then be put on the list of serial deal makers.

On the other side of the table, Teva is about to join the club of the biggest pharmaceutical companies. According to a Business Insider UK article, “Allergan’s generic business is generally seen as a better fit than Teva’s previous target Mylan because it will improve Teva’s distribution channels and because Allergan is strong in so-called biosimilar drugs.”

In the generics market, Teva will stay one step ahead of Novartis Sandoz division (estimated proforma 2014 sales of USD 15.7 billion for Teva-Allergan vs. USD 8.5 billion for Novartis Sandoz division).

In this context, Teva will probably drop its pursuit of rival Mylan, which in turn will be able to focus on buying Perrigo.

Additional links:

Allergan signals appetite for new mega deal after $41bn disposal – Financial Times (Subscription required)

A $40.5 billion deal with Allergan will make Teva one of the biggest drug companies on the planet – Business Insider

Teva to Buy Allergan Generics for $40.5 Billion – WSJ

The Last-Minute Phone Call That Spurred Teva-Allergan Deal – Bloomberg

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Therapeutic Financing Rounds in 2015: Gene Therapy Outpaces Antibodies in Early Stage Investment

Great stats and insights on financing rounds up to now

Next Phase Newsletter

By Michael Quigley, Director of Research, LSN

mike-2

It is no secret that 2015 has been a highly active year for deal-making in the life science space.  However, what is often overlooked is exactly where in the space those deals are taking place. Life Science Nation’s financing rounds database contains detailed information on over 250 of these rounds that have taken place since January 1 of 2015. We track this data from a variety of sources however as many companies and investors chose not to disclose this information this should be viewed as a sample of the entire data set of financings. With this article will highlight what our data tells us about the rounds that have taken place thus far in 2015 for therapeutics companies around the globe.

The first cut worth examining is the types of technologies that received funding.

f1 Figure 1 | Source: LSN Financing Rounds Dataset |…

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The Venture Funding Boom In Biotech – Life Sci VC

One of my favorite blogs recently posted an excellent article on the funding boom currently taking place in the biotech sector.

I think that this article really deserves a read. Why? Because it goes deeper into the fundamentals of the industry destroying some myths about the figures, very often misunderstood by the crowd.

According to Bruce Booth, despite the gigantic amounts invested in the sector:

– it is not always VC funding;

– it is not equally distributed;

– it is not linked to an increasing number of biotech companies getting financed;

– it is not leading to an increase in the the number of new companies created.

Moreover, after this analysis, the author wonders about the current situation (overfunding?) and what would happen in the next few months when investors would switch to other sectors… Another crucial question also emerges: will the number and quality of new ventures be sufficient to refresh the current ecosystem?

 

Additional material:

Venture Capital Investing Exceeds $17 Billion For The First Time Since Q4 2000 – PWC – July 2015

Torrid pace of VC investing in H1 sets a new biotech record – FierceBiotech – July 2015

Biotech Investing Hits An All-Time High–But Is It A Bubble? – Forbes – July 2015

Biotech: The Forgotten Bubble – Barrons – July 2015

Should The Biotech Bubble Be Feared? – Bloomberg – June 2015

 

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Pager is an “Uber/Amazon for Healthcare” – Forbes

Several new innovative and internet-linked services are emerging every day.

Several years ago, Amazon was selling books online, then it became a one-stop shop for many other things; Google expanded its traditional search engine business into a variety of other activities; Apple as well as other mobile phone producers launched smartphones only few years ago.., we can go on forever with examples.

Healthcare is one of the last area reached by digitalization. But the trend is now more than settled.

Recently a new startup named Pager raised USD 14 million for making your medical appointments instant and for a flat fee during extended hours (from 8:00am to 10:00pm).

A Forbes article drew some parallel with Uber for taxi ordering:  “The service finds and verifies doctors for its network and bills you automatically over a linked credit card”. However the CEO, Gaspard de Dreuzy, compared the company with Amazon instead: “Pager is focused on delivering a broader range of care options on demand than exist today. It could be a tele-consult via phone or messaging, or an in-person visit in the home, or a referral to the right specialist. We like to think of ourselves as the Amazon for healthcare.”

The service is only currently available in New York, but the company will soon expand its operations with the funds raised.

Other companies like ZocDoc or Doctors on Demand are also facilitating life for patients or people looking for health services quickly.

Below an pic from WSJ (see the related article in the Additional material section):

OnDemandDoctors-WSJ2015

Additional material:

Startups Vie to Build an Uber for Health Care – WSJ – August 2015

The Best Digital Business Models Put Evolution Before Revolution – Harvard Business Review – January 2015

There’s Now A Seamless For When You’re Feeling Sick – Huffington Post – December 2014

9 Healthcare Tech Startups To Watch – InformationWeek Healthcare – December 2014

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Why Are We Failing To Fund Mental Health Research?

Insightful post on the reasons of mental health underfunding.

Snackable Science

Everyone is affected by mental illness in some capacity, either directly or through those that we know. Around a quarter of the population experience a mental health condition each year and this high prevalence has considerable repercussions, both socially and economically. Indeed, many would be surprised to hear that on top of obvious human suffering, mental illness is estimated to cost the UK an eye-watering £105 billion a year once healthcare expenses and lost productivity have been taken into account.

With mental illness disrupting the lives of so many and harming the economy to such an extent, I was genuinely surprised to hear of the funding gap that exists in mental health research. Compared to other diseases that place a similar burden on society, publicly funded research into mental health is disproportionately low. Cancer research provides some of the strongest evidence of this effect, receiving around 20% of total UK research expenditure, almost four times more than the amount invested…

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With Big Data & Digital Health – New Collaborations are Emerging in the Pharma Industry – PWC

TeamWork

A newly published report by PWC reveals novel collaboration models for improved value of medicines

“Driven by empowered consumers and connected technology, the New Health Economy is shifting business incentives from volume to value with a focus on health outcomes beyond the clinic.”

Big data together with EHR (electronic health records) and wearables drive patient empowerment. Today, more and more, people have their say in treatment choices. Actually, health benefits and prices are crucial criteria for decision, especially as patients face today higher out-of-pocket expenses than ever before. We all well know that expensive treatments are financially disastrous for patients as mentioned in one of my previous posts.

Currently, increased focus is put on drug cost effectiveness as we switch progressively from a fee-for-service to an outcome-based world. Every treatment should be precisely calculated in order to be sure that it is optimized for all stakeholders from all points of view. In this context, already last year, PWC highlighted the beginning of a new system: the New Health Economy, where outcomes and quality are rewarded (instead of volume). It is the continuum of what has been started by Michael E. Porter several years ago.

All these changes have essential meanings. Therefore business models need to adapt to current trends: digital is unavoidable; purchaser perspective is necessary; patients need to become partners; regulatory changes have to be anticipated.

Adapting business models is fantastic but not sufficient. Novel collaborations are needed to optimize them for long-term success. All the stakeholders have to be integrated and blended by the biopharma companies: government agencies, insurers (payers as a whole), new entrants, consumers. Beyond collaborations, a consensus on the value of new medicines should be agreed on. Additionally, consumer and patient health information should be leveraged to improved personalization and precision of treatments.

In one word, several changes will flow the industry and challenges will pave the way to success. But it will become much more exciting to develop drugs in this context than ever before!

Report: PWC-21st-century-pharmaceutical-collaboration-July2015

 

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Digital Health Expected to Save US Healthcare System > $100 Billion Over Next 4 Years – Accenture

A new survey done by Accenture showed that Digital Health could have a huge impact on healthcare costs, especially in the US

A wonderful infographic has been designed to show the key points from the study (see below). There is no need to say more about it.

The link to the article.

 

Additional material:

2015 Global health care Outlook – 2015 – Deloitte

The future of healthcare—there’s an app for that – 2012 – Bain & Company

The digital dimension of healthcare – 2012 – Global Health Policy Summit Working Group

 

Accenture-Colossal-Clash-Infographic

How to get vaccines to the right place at the right time

Gaining control of health care waste in order to improve care delivery is crucial. Supply chain, tracking and logistics have to be optimized in order to limit waste.

ideas.ted.com

Half the vaccines that are manufactured each year don’t make it to their destination — they get lost or damaged as they travel between the factory and the local health clinic. It’s not just a tremendous waste, it’s a killer: Each year, 1.5 million children in the developing world die for no reason other than a failed vaccine delivery. Neuroscientist and TED Fellow Catharine Young is working on a tool she thinks can help: Vive, an app that tracks and monitors vaccines on their journey, while gathering data to improve deliveries in the future. As she prepares to pilot the app in her native South Africa, Young shares six insights on this simple but potentially life-saving idea.

1. The biggest obstacle to getting vaccines to patients: shoddy infrastructure. “Vaccine delivery is a race against time anywhere, but in the developing world, you have limited functioning vehicles, limited electricity to keep vaccines cold, limited road infrastructure,” says Young. “Obstacles…

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Partnering with patients in the development and lifecycle of medicines – TIRS

Infusion

A wave of new articles on patient-centric drug development flooded the news during the last weeks

It is not a new concept. A task force was started back in 2003 by ISPOR on this topic and several thinkers proposed this vision even before.

One of the more comprehensive article on this topic is the Call for Action written by several experts in the field both in the industry and academia as well as people coming from patient associations, together for the development of a master framework for systematic patient involvement.

Several stakeholders are committed to the success of a specific medicine: researchers, developers, industrials, regulators, insurers, doctors,… but very often they all forget about the main and the most important among them: the patient. He or she is the one taking the drug, benefiting from care or even cure in some cases but also suffering from side effects.

At each stage of development, involving and engaging the patient will bring advantages (pages 8 and 9 of the article gave great figures about them):

– Early research: better prioritization, improved resource allocation, clinical trial protocols reflecting patient needs, superior recruitment rates.

– At launch and beyond: more appropriate benefit-risk assessment, focus on drugs of value to patients, improved treatment adherence.

A part from e-patients blogs, dedicated societies emerge in order to make coordination effort toward common goals like the Society for Participatory Medicine: “Participatory Medicine is a model of cooperative health care that seeks to achieve active involvement by patients, professionals, caregivers, and others across the continuum of care on all issues related to an individual’s health. Participatory medicine is an ethical approach to care that also holds promise to improve outcomes, reduce medical errors, increase patient satisfaction and improve the cost of care.”

In conclusion: “It is essential that all stakeholders participate to drive adoption and implementation of the Framework and to ensure that patients and their needs are Embedded at the heart of medicines development and lifecycle management.”

 

You probably remember the fascinating talk given by e-patient Dave in 2011 during TEDxMaastricht. Dave deBronkart said as an introduction that patients need to be much more involved in order to drive better healthcare as well as superior patient outcomes. The future is now!

 

Additional material

What’s Next for Patient-Focused Drug Development? FDA Announces Final PFDD Meetings, and BIO Recommends Broader Use of the Benefit-Risk Framework – 2015

Partnering with patients in the development and lifecycle of medicine – 2015 – Therapeutic Innovation & Regulatory Science

Integrating the patient perspective in the assessment of benefits and risks of medicines – ISPOR 2014 Workshop

Finding the patient in the drug development process – F. Lewis-Hall (Pfizer) – ISPOR 2013

Toward Patient-Centered Drug Development in Oncology – 2013 – NEJM

 

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The Integration of Care for Mental Health into Primary Care – American College of Physicians Position Paper

MentalHealthStigma

Integrate mental health into primary care to deliver better outcomes for the patients

A new position paper (subscription required) published by the American College of Physicians is focusing on the integration of mental health care into primary care in order to improve outcomes

Mental health disorders have been estimated to be a major burden by 2020 by WHO.  They are “linked to increased physical illness, higher mortality rates, poorer treatment outcomes and higher healthcare costs”.

Mental health conditions are not always properly diagnosed because of stigma and financial barriers such as insurance coverage gaps. These are the reasons behind the “call for the use of the primary care delivery platform and the related patient-centered medical home model to effectively address these conditions” as stated in the position paper. Health care providers will have to be trained to ask difficult questions, diagnose and treat these diseases.

 

Additional resources

Use data to challenge mental-health stigma – 2015 – Nature

Treat ‘whole person’ by bringing behavioral health into primary care: docs – 2015 – Reuters

The Global Burden of Mental, Neurological and Substance Use Disorders: An Analysis from the Global Burden of Disease Study 2010 – 2015 – Harvey A. Whiteford

Global Burden of Neurological and Mental Disorders – 2014 – Brain Facts

 

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Can Finance Cure Cancer? Andrew W. Lo Talk at the University of Geneva – June 29th 2015

I had the chance to attend this refreshing talk about what finance could do to help drug development. My summary of the talk is shown below.

CanFinanceCureCancerAWLGenevaJune2015