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Going for multiple shots on goal
May 2012
SHARING OPTIONS:
As the first part of this series began with the single word,
“Viagra,” this installment begins by invoking another blockbuster drug:
Lipitor. The Pfizer giant, introduced in 1996, quickly eclipsed other
cholesterol-lowering medications produced by competitors.
But the world hasn’t seen a drug with similar impact,
introduced and marketed at a sweet spot in pharmaceutical history. And the
industry might not see another.
According to an article that appeared on Forbes’ website on November 30, 2011—the
day that Lipitor went off patent—a number of disparate factors contributed to
Lipitor’s success.
“There may never be another drug like it,” says Forbes’ Matthew Herper. “That’s because
of fundamental shifts in our understanding of biology, because of demands made
by patients, doctors and society on new drugs and because new drugs now have to
compete with super-cheap generic versions of every medicine ever invented.
Already, eight of 10 prescriptions are for generics, and the drug industry is
focusing on higher-priced, specialty products for patients who are not helped
by existing options. Good luck creating a new cholesterol drug as potent, safe
for most people and widely tested as Lipitor.”
To put the vast reach of the drug in perspective, Herper
adds that the drug has lowered the cholesterol of tens of millions of people
since its launch, and has racked up more money in annual sales than Major
League Baseball.
Lipitor launched an era where it seemed that there could one
day be a pill for every concern. However, that era brought with it massive
advertising buys and equally massive drug scandals where side effects brought
down blockbusters such as Vioxx.
The edge of the cliff
Michael Keech, senior vice president in the Global
Lifescience Practice at Celerant Consulting, explains that the approaching
patent cliff has significantly impacted what he sees as the three stages of
drug development.
He says those three phases—discovery, preclinical and
clinical development—proscribed drug development until recently. Big
moneymakers coming off patent challenge this paradigm and threaten to upend
multibillion dollar businesses.
“Between now and perhaps 2015 to 2016, about $170 billion to
$200 billion in drugs are due to come off patent,” Keech says. “That’s forced
organizations to think about how to reposition their drugs.”
He says, too, that companies are increasingly looking at
more than one application for various compounds in the beginning of
development, or to take “multiple shots on goal.”
“There are a few reasons to repurpose for practical
reasons,” he adds. “If a drug is already on the market, there is an existing
safety profile. If we have that safety and efficacy information on a drug that
perhaps did not meet its clinical trial endpoints, we save money because
reformulation is still cheaper than starting over.”
From a business standpoint, too, shareholders are receptive
to the idea that companies are looking back into their own pipelines to bring
to market new drugs, or new indications for old drugs.
“Shareholders like the idea of the company spending less
money in development,” Keech says.
The biggest companies, or those with the most foresight and
resources, have dedicated business units to just this purpose. Called something
akin to a “new indication discovery unit,” Keech mentions household names such
as Pfizer, Novartis, Bayer, Lilly and GlaxoSmithKline (GSK) as those who devote
minds and fund to this purpose.
Generic drugs only stand to gain in this environment.
Given the flurry of acquisitions and mergers in recent
years, it’s clear that big drug companies have an insatiable appetite for
smaller ones.
Keech says that smart companies will begin to implement a
proactive business plan 48 to 72 months before a big-grossing drug goes off
patent. Clearly, he says, a number of players have taken a deep dive into the
generics business within the past several years. He mentions big players such
as AstraZeneca, GSK and Sanofi, which are working the generic business and also
pursuing joint ventures in increasing numbers. Teva and EndoPharma are also
aggressive in this space.
“Companies are seeking to backfill these projected losses in
the next four or so years by acquiring smaller companies and novel products,”
Keech concludes. “All of what you’d consider the top 10 drug companies have a
strategy in place that makes them well positioned to weather this with new
strategies.”
He gives the example of Lipitor as a hard-to-replace
blockbuster.
What, then, should drug companies be doing to ensure a soft
landing?
Keech says the companies should plan for the loss of patent
protection years in advance of the actual event. They should, as part of this
strategy, work closely with companies that manufacture authorized generic
versions of their compounds.
As Pfizer did with Lipitor, the company entrenched itself
with marketing and within the hearts and minds of patients to keep as much
branded product flowing as possible.
However, with price pressures from current healthcare reform
efforts, generics will increasingly become the preferred drugs for prescribers
and health insurance plans alike. As the population ages and prescription drug
use increased, the pressure for generic versions of blockbuster compounds will
continue to increase.
Neither Pfizer nor Roche responded to several requests for
interviews for this story.
Keech also says the environment is ripe for companies that
have new technologies which might not necessarily involve lab benches and
beakers. Great minds in the space are now also meeting at events that have as
their focus the discussion of drug repurposing.
Fast-forward
technology
Cecelia E. Cauwenberghe of business research and consulting
firm Frost & Sullivan said much the same in this space last month—that in
the past five years, rapid innovation in the biopharmaceutical space has helped
to temper the effects of rising development costs and stagnant product output. Companies always need new projects to fill pipelines and keep investors
content, and to pick up the slack when candidates have not met their benchmarks
in clinical trials.
The development stakes are high for drug companies.
Recently, Targacept announced it will slash almost half of its workforce due to
a recent failure of a compound in Phase III trials. The compound, TC-5214,
which was being developed in partnership with AstraZeneca, repeatedly failed to
prove that it was better than a placebo in treating depression. The
Winston-Salem, N.C.-based Targacept has no U.S. Food and Drug Administration
(FDA)-approved drugs to its credit yet, but is working with AstraZeneca on a
compound targeted to Alzheimer’s disease. But for the near-term, that promise
doesn’t help the 65 people who’ll be packing their desks at Targacept.
According to the experts, the new plan of attack must be to
maximize technology. And numerous businesses—not merely pharma companies and
research organizations—are looking to do just that.
On the other hand, as a step forward, the pharma industry is
focused on exploring the full potential of a broad spectrum of compounds and
pro-drugs at earlier stages—that is, those in preclinical development—with the
aim to provide additional opportunities and diminish risk.
As mentioned last month, Translational Life Sciences is
working on a crowdsourcing model to develop the blood pressure medicine
lisinopril for multiple sclerosis. The model, which was introduced in beta form
on Jan. 31, seeks to enlist collaborators to design Phase II trials of this
indication. Founder Dr. Tomas Sablinski, a transplant surgeon by training,
calls the idea for his company “a Linux of drug development, in a sense.”
Biovista, also mentioned last month, is well known in drug
development and the repositioning space.
Another interesting opportunity to use existing information
in a new way is taking shape at a company known as Cellworks. Founded by
experts in software and semiconductors, the company seeks to develop models to
mine vast repositories of known information about drugs, protein interactions
and genetics to predict what will work in humans.
Cellworks is a private, venture-backed biopharmaceutical
therapeutic design and development company based on platform predicting
clinical outcomes. The model will offer the pharmaceutical community innovative
best-in-class therapies that are substantially de-risked, yet have a
dramatically increased probability of success.
Founders Pradeep Fernandes and Taher Abbasi base their work
on the notion that it takes an average of 12 years and $1.2 billion for a drug
to travel from the research lab to the patient. These astronomical and rising
costs are, they say, in part due to the high failure rate inherent in drug
discovery—less than 10 percent of drugs that begin preclinical testing ever
make it to human testing, they say. From there, the funnel to the patient
narrows even further with only one in five drugs that enters human testing
achieving approval for treatment.
“Our model takes molecularly targeted therapies and measures
their impact on specific diseases,” says Fernandes. “We can also theoretically
mix and combine doses in computer models.”
For new medicines to continue to reach patients, today’s
drug developers must find new avenues that increase the likelihood a drug will
make it from discovery to approval, and in a perfect world, predict clinical
outcomes upfront.
The company has a pipeline of preclinical programs targeting
autoimmune disorders and epithelial-based tumors. Its lead compound, CWG952, is
ready for clinical development for the treatment of rheumatoid arthritis. It
also seeks to enter the oncology space in the near future.
Cellworks was founded in 2005 with a novel approach of
designing therapies based on technology emulating human physiology and
predicting clinical outcomes. In 2009, Cellworks closed a $7.5 million Series A
financing. The company has facilities in both California and India.
The company’s founders say their strategy was to begin
slowly, growing collaborations and broadening and deepening their experience in
demonstrating that their algorithms could accurately crunch massive amount of
data to spit out likely compounds for success in treatments. Since then, they
say they’ve pursued roughly 40 collaborations with partners both large and
small, running a range of academic medical centers and researchers across the
country, but will seek a few commercial partnerships on the horizon.
The speed at which their model works is noteworthy, given
the notion that traditional drug development can take more than a decade. Some
data sets can be processed in less than an hour, rather than months. In the
arthritis work the company has done, the founders say that more than a million in-vivo equivalency studies were
crunched to produce results in days. They were able to evaluate three drugs not
used before in that indication, combined them in sub-therapeutic levels and
found success in animal tests. All three drugs were previously FDA-approved.
“We have the building blocks,” says Abbasi. “We can now
expand these compounds into other areas, with fewer side effects.”
Sanford-Burnham Medical Research Institute at Lake Nona in Orlando is also
working on the library concept.
Using a comprehensive listing of clinically approved drugs
that was made available through recent efforts by the National Institutes of
Health as a starting point, the organization is creating the Sanford-Burnham
Drug Repurposing Collection, which can be leveraged against the group’s
strengths in stem-cell biology, phenotypic cell-based screening and
high-throughput chemical biology.
The library will be made available to local nonprofit
research institutions such as the Salk Institute, the Scripps Research
Institute, the University of California at San Diego and its affiliated
children’s hospital, Rady, as a resource to further advance translational
medicine for rare diseases.
Dr. Layton Smith, the director of drug discovery at
Sanford-Burnham, points out that this private, independent research group is
100-percent focused on basic sciences, not on education or patient care. Smith
estimates that the group will have, by summer's end, a library of about 2,000
to 3,000 small molecules and stem cells ready for researchers to use to prove
the efficacy of their compounds and move on to FDA approval. Many will have not
only FDA approval, but also the nod of European and Japanese authorities.
If a molecule is patented, the group looks for vendors to
work with, or synthesizes a version of the molecule themselves to complete the
inventory. As with Cellworks, the group promises to compress the time needed to
run screens from molecules in the library.
Smith also points out that the setup of the center for pure
research for this purpose gives it a “boutique” capability, cutting time and
drawing together the technology and talent to make this approach to drug
discovery happen.
“We hope people get excited about this approach,” he says.
Cellworks
Sanford-Burnham Research
National Institutes of Health
Salk Institute
Scripps Research Institute
University of California at San Diego
Rady Children’s Hospital Code: E051229 Back |
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