Advances in Oncology Drug Discovery – Sachs Conference Talk by Roche pRED Head of Oncology DTA, William Pao

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A fascinating talk about cancer drug discovery was given by Dr. William Pao, Head of Oncology Discovery and Translational Area (DTA) at Roche Pharmaceutical Research and Early Development (pRED) during the Sachs 16th Annual Biotech in Europe Forum.

He started to explain what is cancer, for us to gain more insights:

  • cancer is a genetic disease: tumors can harbor over 400 somatic mutations
  • cancer is heterogenous: there are more than 200 types of cancers and a single patient tumor displays intra and inter-tumoral heterogeneity
  • cancer can metastasize: once spread, it is virually incurable. Metastatic cancer survival at 5 years is extremely low (between 4 and 28%)

Based on those considerations, treatment is becoming much more complex today with a blend of chemotherapy, targeted medicines and immunotherapies. A right combination could extend survival by several months.

But how to develop drugs with increased efficacy against the smart strategies used by the disease (such as tumor angiogenesis)? According to Dr. Pao, 3 elements are necessary:

  • understanding disease biology as well as druggable targets in the complexity of cancer molecular pathways
  • developing fit-for-purpose molecules allowing to create the right drug with the right format against the right target
  • personalizing healthcare with the administration of the right drug to the right patient at the right time

Beyond a better understanding of the disease, using more than a single strategy to target the cancer:

  • Host directed with cancer immunotherapy. This approach is particularly challenging as some patients do not respond to it (innate or acquired immune escape) and other patients may fully benefit with long term survival
  • Tumor directed with targeted medicines

External innovation, collaborations and partnerships, is fully leveraged in order for Roche to complement existing capabilities in the field (immunotherapy examples: CuraDev, Pieris, BluePrint; targeted medicines: Tensha, C4Therapeutics).

As a conclusion, Roche is well positioned to address the cancer challenges and, since the beginning of innovative cancer treatments, the company has always been perceived as the leader of the therapeutic area.

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Missing points in his talk were considerations of patient’s quality of life (extending life does not always go with good quality of life because of treatment’s side effects) and drug pricing (adding more and more drugs to the treatment cocktail costs a lot of financial resources, not only paid by the health insurance but also by the patient).

 

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DNA methyltransferase 1 has a role in the establishment and regulation of tissue-specific patterns of methylated cytosine residues. Aberrant methylation patterns are associated with certain human tumors. www.enzymlogic.com. Work done with the molecular visualization VMD program developed at the University of Illinois: www.ks.uiuc.edu/Research/vmd/

Top 15 Pharma companies – Q1 2016 performance wrap-up

Wall Street

The Q1 2016 earnings season is now over. It is always nice to take a step back and compare the big names of the pharmaceutical industry.

Below you will find the key figures published by the most important companies in the industry.

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Effect of price caps and reference pricing on generics entry – GABI

PillboxNew

A fascinating article on GABI Online and study written by researchers on the effect of price caps and reference pricing on generics entry. Another study is also available here.

The key points (quotes from the article):

Question: how the use of a price cap along with reference pricing affects the entry of generics after patent expiry?

Answer(s):

  • For reference pricing to stimulate generics entry, the price effect needs to be sufficiently small relative to the demand effect.
  • If price cap regulation is introduced, the negative effect of reference pricing on generics entry can be reversed, and that reference pricing is more likely to result in cost savings than under free pricing.
  • If the price cap is sufficiently strict, introducing reference pricing may actually increase the number of generic drugs on the market.
  • The reason for this is that binding price cap regulation reduces the brand-name price difference between reimbursement schemes with and without reference pricing. Generics makers may therefore obtain higher market shares under reference pricing. Reference pricing is more likely to stimulate generics entry and facilitate cost savings when prices are regulated than in the free pricing equilibrium.

These studies show the price dynamics in the pharmaceutical markets and the impact of price control tool ont generics entry.

 

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Economic crisis, health systems and health in Europe – WHO European Observatory

austerity

How did European Countries cope with the economic crisis and its impact on their national health system?

The last report published by the WHO European Observatory on Health and Health Systems on the impact of the economic crisis on health and health systems allows to take a step back and look at the deterioration of health care in the context of an economic crisis over the last few years in several European countries. It is a desk reference where it is easy to pick the country or the countries that are of interest. Austerity measures have a huge impact on the quality as well as quantity of care in specific countries. Too much cost cutting leads to catastrophic situations, like in Greece.

The structure of the report:

– In the 1st part of the report, 9 countries were chosen for in-depth analysis: Belgium, Estonia, France, Greece, Ireland, Latvia, Lithuania, Netherlands and Portugal. These are probably the most impacted by the economic crisis.

– In the 2nd part of the report, all the countries are covered with regards to their response to the crisis. For each country analyzed in this part, economic trends are evaluated as well as policy responses. Changes are then detailed by category: adjustments to public funding for the health system (budget cut, reforms, subsidies, insurance premiums, cost-containment measures,…), variations to health coverage (population, benefits, user charges,…), revisions to health service planning, purchasing and delivery (price of medical goods, salaries and motivation of health sector workers, payment to providers, overhead costs, provider infrastructure and capital investment, priority setting to change access to treatments, waiting times, prevention,…).

 

Additional resources:

Health and Financial Crisis Monitor – Always up to date

Systematic Review on Health Resilience to Economic Crises – 2015 – PLOSOne

Health, Austerity and Economic Crisis – 2014 – OECD Health Working Paper n. 76

European economic crisis and health inequities: research challenges in an uncertain scenario – 2014 – International Journal for Equity in Health

Effects of the economic crisis on health and healthcare in Greece in the literature from 2009 to 2013: A systematic review – 2014 – Health Policy

Impact of Austerity on European Pharmaceutical Policy and Pricing – 2013 – Deloitte Centre for Health Solutions

Financial crisis, austerity, and health in Europe – 2013 – The Lancet

Global Health and the Global Economic Crisis – 2011 – American Journal of Public Health

 

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WHO urges Europeans to work together to counter high drug prices – Reuters

More collaboration, more transparency & more value for money

DoctorsPatientsThere is a lot of fragmentation in European healthcare systems. Some of them have very comprehensive methodologies to assess the value of medicines, others are lacking these processes. Moreover, drug supply and prices are negotiated between stakeholders without making discounts and rebates publicly available.

Assessing the economic benefit of drugs is crucial today.

The last link is very interesting as it will land you on the page of the European Observatory on Health Systems & Policies website where you could find resourceful reports on health systems currently established in Europe.

Reuters article    WHO website    European Observatory on Health Systems & Policies website

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The Value Of Cancer Care In The US Compared To Europe – Health Affairs

More value in Europe…

pillsDespite sharp increases in spending on cancer treatment since 1970 in the United States compared to Western Europe, US cancer mortality rates have decreased only modestly. This has raised questions about the additional value of US cancer care derived from this additional spending. Researchers Samir Soneji and Jae Won Yang calculated the number of US cancer deaths averted, compared to the situation in Western Europe, between 1982 and 2010 for twelve cancer types. They also assessed the value of US cancer care, compared to that in Western Europe, by estimating the ratio of additional spending on cancer to the number of quality-adjusted life-years saved. Read the abstract