Af­ter years of short­ages, Mer­ck an­nounces plans for a new fac­to­ry for an old life­sav­ing drug

Four years af­ter Sanofi left them as a pop­u­lar blad­der can­cer drug’s on­ly pro­duc­er, Mer­ck is in­vest­ing in a new fa­cil­i­ty that could help ame­lio­rate the wide­spread short­ages that pa­tients, doc­tors and man­u­fac­tur­ers have faced for near­ly a decade.

Mer­ck said they will build a new plant at their Durham, NC vac­cine man­u­fac­tur­ing cen­ter to pro­duce BCG, an im­munother­a­py that has been used for decades to treat blad­der can­cer. The fa­cil­i­ty won’t be an im­me­di­ate so­lu­tion — Mer­ck said it will take 5 to 6 years to con­struct and even then, the batch­es will on­ly grow grad­u­al­ly — but the com­pa­ny, one of the world’s largest pro­duc­ers of vac­cines, said it will even­tu­al­ly triple their cur­rent pro­duc­tion and meet de­mand.

Julie Ger­berd­ing

“As de­mand for this med­i­cine has in­creased over the last sev­er­al years, we rec­og­nized the need to do more,” Julie Ger­berd­ing, EVP and chief pa­tient of­fi­cer, said in a state­ment. “While this new fa­cil­i­ty will take a num­ber of years to com­plete, we look for­ward to the day when we can meet the needs of all pa­tients whose physi­cians have pre­scribed TICE BCG for them.”

Orig­i­nal­ly de­vel­oped as an in­oc­u­lant for a dead­ly in­fec­tious dis­ease and used since the 1970s to treat blad­der can­cer, the vac­cine is com­prised sole­ly of an at­ten­u­at­ed strain of tu­ber­cu­lo­sis-caus­ing bac­te­ria. But that strain can be dif­fi­cult to man­u­fac­ture and short­ages be­gan in 2011 af­ter an FDA in­spec­tion found 58 in­stances of mold at a Sanofi plant in Toron­to af­ter a flood. The French gi­ant pulled out in 2016, just as Mer­ck en­coun­tered some of its own man­u­fac­tur­ing is­sues. Doc­tors found them­selves ra­tioning sup­ply of a drug that, in pa­tients who have a par­tic­u­lar but com­mon form of the can­cer, can have re­sponse rates above 70%.

Be­cause of how dif­fi­cult it is to man­u­fac­ture and be­cause dos­es sell for on­ly $100 to $200, BCG didn’t rep­re­sent a sig­nif­i­cant com­mer­cial op­por­tu­ni­ty and no oth­er com­pa­ny stepped up to fill the short­age.  It’s a prob­lem that has played out with oth­er gener­ics, lead­ing to ei­ther short­ages or in­flat­ed prices.

Ken Fra­zier

“When the prices of drugs get too low — par­tic­u­lar­ly drugs that are gener­ic drugs — then you don’t have a mar­ket in­cen­tive to put the cap­i­tal up to build fa­cil­i­ties like we need for ad­di­tion­al amounts of this BCG drug,” CEO Ken Fra­zier told CN­BC last year.

Al­though some on­col­o­gists have pushed Mer­ck to pro­duce more of the drug, oth­ers not­ed that BCG is not a sig­nif­i­cant prof­it gen­er­a­tor for them and said they had al­ready done con­sid­er­able work, in­clud­ing by dou­bling pro­duc­tion of the prod­uct pri­or to this week’s news. In ad­di­tion to pre­scrip­tion use, Mer­ck al­so makes BCG for clin­i­cal tri­als. This year that in­clud­ed tri­als for Covid-19, as re­searchers test­ed the the­o­ry that it could boost in­nate im­mu­ni­ty to a new virus.

Da­ta Lit­er­a­cy: The Foun­da­tion for Mod­ern Tri­al Ex­e­cu­tion

In 2016, the International Council for Harmonisation (ICH) updated their “Guidelines for Good Clinical Practice.” One key shift was a mandate to implement a risk-based quality management system throughout all stages of a clinical trial, and to take a systematic, prioritized, risk-based approach to clinical trial monitoring—on-site monitoring, remote monitoring, or any combination thereof.

Pfiz­er's big block­buster Xel­janz flunks its post-mar­ket­ing safe­ty study, re­new­ing harsh ques­tions for JAK class

When the FDA approved Pfizer’s JAK inhibitor Xeljanz for rheumatoid arthritis in 2012, they slapped on a black box warning for a laundry list of adverse events and required the New York drugmaker to run a long-term safety study.

That study has since become a consistent headache for Pfizer and their blockbuster molecule. Last year, Pfizer dropped the entire high dose cohort after an independent monitoring board found more patients died in that group than in the low dose arm or a control arm of patients who received one of two TNF inhibitors, Enbrel or Humira.

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Top gene ther­a­py deals, M&A pacts in 2020 high­light an­oth­er big year in one of the hottest fields in bio­phar­ma

Chris Dokomajilar at DealForma has been crunching the numbers on gene therapy deals over the last 2 years and came away with a few key observations.

Both the upfront cash and deal totals last year backed off a bit from the record high hit in 2019, but the totals are still running well ahead of anything we’ve seen in the years prior to 2019/2020.
2020 R&D partnerships came in at 23 deals, with $1.1 billion in disclosed upfront cash and equity and more than $8.5 billion in total deal value. Looking at 2019-2020 M&A, Dokomajilar found: 9 Acquisitions, with over $11.1 billion in disclosed upfront cash and equity and more than $13.4 billion in total M&A value.

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Bob Nelsen (Michael Kovac/Getty Images)

ARCH an­nounces largest fund yet, rais­ing $1.85B to back men­tal health, cell and gene edit­ing ap­proach­es

Nearly a year ago, as the pandemic encroached and the stock market cratered, Flagship and ARCH Venture announced three mega-funds worth a combined $2.6 billion. They wanted, ARCH’s Bob Nelsen said, to restore confidence “that there was money out there and a lot of it” to invest in biotech.

Since then, the stock market has returned — almost frighteningly so — and Nelsen has kept raising and spending cash. On Thursday, he announced a new fund, worth $1.85 billion. It’s the largest pot yet for a VC famous for its deep pockets.

Covid-19 roundup: EU and As­traZeneca trade blows over slow­downs; Un­usu­al unions pop up to test an­ti­bod­ies, vac­cines

After coming under fire for manufacturing delays last week, AstraZeneca’s feud with the European Union has spilled into the open.

The bloc accused the pharma giant on Wednesday of pulling out of a meeting to discuss cuts to its vaccine supplies, the AP reported. AstraZeneca denied the reports, saying it still planned on attending the discussion.

Early Wednesday, an EU Commission spokeswoman said that “the representative of AstraZeneca had announced this morning, had informed us this morning that their participation is not confirmed, is not happening.” But an AstraZeneca spokesperson later called the reports “not accurate.”

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Janet Woodcock (AP Images)

Ad­vo­ca­cy groups don't want Janet Wood­cock to head the FDA, blast­ing ‘reg­u­la­to­ry fail­ures’ in opi­oid cri­sis

It turns out the controversies around Janet Woodcock’s regulatory legacy weren’t limited to Sarepta’s eteplirsen.

A coalition of advocacy groups dedicated to the opioid crisis urged Norris Cochran and Xavier Becerra — the acting and designated HHS secretary, respectively — to keep her reign as interim FDA chief a “very short transition.” During her lengthy tenure as CDER, they add, Woodcock presided over “one of the worst regulatory agency failures in U.S. history.”

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Dean Li kicks off Mer­ck­'s post-Roger Perl­mut­ter era by team­ing with Arti­va and its off-the-shelf CAR-NK tech

Even though Dean Li has now officially taken over for Roger Perlmutter as R&D chief, Merck’s appetite for dealmaking continues to be ravenous.

Li struck his first big deal at the helm Thursday morning, hammering out a collaboration with Artiva Biotherapeutics that could earn the biotech nearly $1.9 billion when all is said and done. It’s a quick rise and validation for Artiva, which just last June launched with a $78 million Series A.

Take­da earns win for its TKI in­hibitor in tiny lung can­cer group — but GI side ef­fects could be an ear­ly red flag

Japanese drugmaker Takeda has made a big push in recent years to build a hand in oncology, particularly in the next-gen cancer space. One of those candidates, tyrosine kinase inhibitor (TKI) mobocertinib, recently earned the FDA’s interest in a small section of untreated lung cancer patients, but will severe GI side effects be a roadblock?

Takeda’s oral mobocertinib posted clinically significant objective response rates in a Phase I/II adaptive trial drugging metastatic non-small cell lung cancer patients with EGFR exon 20 gene mutations who had previously undergone platinum-based chemotherapy, according to data presented Thursday at the virtual World Conference on Lung Cancer.

Covid-19 roundup: Con­tro­ver­sy around colchicine per­co­lates af­ter study fail­ure; As­traZeneca's meet­ing with EU was 'con­struc­tive,' but did­n't solve much

A group of researchers at the Montreal Heart Institute has spelled out what they had called positive results suggesting that colchicine, an inexpensive oral anti-inflammatory drug commonly used to treat gout, could prevent Covid-19 complications in newly diagnosed patients.

The study failed its primary endpoint. But the latest scientific debate around treatments for the coronavirus is just beginning to brew.

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