BioReg­num: The mob is back. And what's to stop them from go­ing af­ter the en­tire bio­phar­ma in­dus­try?

John Car­roll, Ed­i­tor

My­lan to­day is at the cen­ter of the lat­est on­line mael­strom to erupt over drug pric­ing and ac­cess to ther­a­pies. And while it hun­kers down to see if it can wait out the storm that has erupt­ed over the EpiPen, the one man who can do it the most dam­age is rid­ing to its res­cue.

En­ter Mar­tin Shkre­li, for­mer biotech CEO and the most wide­ly hat­ed in­di­vid­ual in bio­phar­ma his­to­ry. Shkre­li spe­cial­ized in taunt­ing the dig­i­tal lynch mob that formed af­ter he raised the price of an an­cient drug called dara­prim by more than 5000% af­ter snatch­ing it up for a song. And he kept the crowd stirred by reneg­ing on a promise to roll back the price.

The Shkre­li de­fense — re­lax, in­sur­ance can pay for most of it — won’t fly. But that didn’t stop him from rolling it back out any­way.

“My­lan’s a good guy,” Shkre­li told CBS. “They have one prod­uct where they’re fi­nal­ly start­ing to make a lit­tle bit of mon­ey and every­one’s go­ing crazy over it….That’s up to in­sur­ance to pay for them,” he replied to a ques­tion. “It’s $300 a pen. $300. My iPhone is $700…. It’s $300 and 90% of Amer­i­cans are in­sured.”

This is some­thing like hav­ing a se­r­i­al killer ap­pear as a char­ac­ter wit­ness at your mur­der tri­al.

Mar­tin Shkre­li at the De­vel­op­ments in the Pre­scrip­tion Drug Mar­ket: Over­sight hear­ing, 2016

My­lan got in­to this po­si­tion by fol­low­ing the same strat­e­gy as Shkre­li, buy­ing an old prod­uct and jack­ing up the price, but fol­lowed a less risky ap­proach by tak­ing some time to do it. It blew up in­to a scan­dal in any case. And now the com­pa­ny is tak­ing the place of Valeant, which fol­lowed the same ap­proach and got shred­ded by the fall­out.

My­lan, Valeant and the rest of Big Phar­ma rou­tine­ly en­gaged in price goug­ing for the sim­ple rea­son that they can. No law ex­ists that pre­vents it. But hop­ing that the mob won’t sud­den­ly ap­pear at its door — along with Shkre­li — isn’t a vi­able strat­e­gy any more.

Bio­phar­ma needs to swear off this ad­dic­tion to price goug­ing and en­gage in some roll­backs, start­ing with My­lan. Com­pa­nies can pub­licly state that they’re op­posed to it and will stop the prac­tice, be­cause it is un­eth­i­cal. And if they don’t take the pledge, they can bear the con­se­quences. Oth­er­wise, every­one can face off against the grow­ing clam­or for drug pric­ing re­form in Con­gress.

This is an in­dus­try cri­sis. And the in­dus­try needs to re­spond. This whole pric­ing struc­ture for drugs is un­sus­tain­able in the US. It’s nice to ex­per­i­ment with new ap­proach­es like pay­ing for the right out­comes, but change has to hap­pen now. The al­ter­na­tive is to face con­trols on pric­ing for new and im­por­tant drugs, where com­pa­nies have a very good ar­gu­ment for charg­ing some very high rates.

Some­thing’s got to give.

BiTE® Plat­form and the Evo­lu­tion To­ward Off-The-Shelf Im­muno-On­col­o­gy Ap­proach­es

Despite rapid advances in the field of immuno-oncology that have transformed the cancer treatment landscape, many cancer patients are still left behind.1,2 Not every person has access to innovative therapies designed specifically to treat his or her disease. Many currently available immuno-oncology-based approaches and chemotherapies have brought long-term benefits to some patients — but many patients still need other therapeutic options.3

Pfiz­er’s Doug Gior­dano has $500M — and some ad­vice — to of­fer a cer­tain breed of 'break­through' biotech

So let’s say you’re running a cutting-edge, clinical-stage biotech, probably public, but not necessarily so, which could see some big advantages teaming up with some marquee researchers, picking up say $50 million to $75 million dollars in a non-threatening minority equity investment that could take you to the next level.

Doug Giordano might have some thoughts on how that could work out.

The SVP of business development at the pharma giant has helped forge a new fund called the Pfizer Breakthrough Growth Initiative. And he has $500 million of Pfizer’s money to put behind 7 to 10 — or so — biotech stocks that fit that general description.

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Gilead re­leas­es an­oth­er round of murky remde­sivir re­sults

A month after the NIH declared the first trial on remdesivir in Covid-19 a success, Gilead is out with new results on their antiviral. But although the study met one of its primary endpoints, the data are likely to only add to a growing debate over how effective the drug actually is.

In a Phase III trial, patients given a 5-day dose of remdesivir were 65% more likely to show “clinical improvement” compared to an arm given standard-of-care. The trial, though, gave little indication for whether the drug had an impact on key endpoints such as survival or time-to-recovery. And in a surprising twist, a 10-day dosing arm of remdesivir didn’t lead to a statistically significant improvement over standard of care.

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Ken Frazier, AP Images

Why Mer­ck wait­ed, and what they now bring to the Covid-19 fight

Nicholas Kartsonis had been running clinical infectious disease research at Merck for almost 2 years when, in mid-January, he got a new assignment: searching the pharma giant’s vast libraries for something that could treat the novel coronavirus.

The outbreak was barely two weeks old when Kartsonis and a few dozen others got to work, first in small teams and then in a larger task force that sucked in more and more parts of the sprawling company as Covid-19 infected more and more of the globe. By late February, the group began formally searching for vaccine and antiviral candidates to license. Still, while other companies jumped out to announce their programs and, eventually and sometimes controversially, early glimpses at human data, Merck remained silent. They made only a brief announcement about a data collection partnership in April and mentioned vaguely a vaccine and antiviral search in their April 28 earnings call.

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Mark Genovese (Stanford via Twitter)

Gilead woos fil­go­tinib clin­i­cal in­ves­ti­ga­tor from Stan­ford to lead the charge on NASH, in­flam­ma­to­ry dis­eases

With an FDA OK for the use of filgotinib in rheumatoid arthritis expected to drop any day now, Gilead has recruited a new leader from academia to lead its foray into inflammatory diseases.

Mark Genovese — a longtime Stanford professor and most recently the clinical chief in the division of immunology and rheumatology — was the principal investigator in FINCH 2, one of three studies that supported Gilead’s NDA filing. In his new role as SVP, inflammation, he will oversee the clinical development of the entire portfolio.

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Stephen Isaacs, Aduro president and CEO (Aduro)

Once a high fly­er, a stag­ger­ing Aduro is auc­tion­ing off most of the pipeline as CEO Stephen Isaacs hands off the shell to new own­ers

After a drumbeat of failure, setbacks and reorganizations over the last few years, Aduro CEO Stephen Isaacs is handing over his largely gutted-out shell of a public company to another biotech company and putting up some questionable assets in a going-out-of-business sale.

Isaacs —who forged a string of high-profile Big Pharma deals along the way — has wrapped a 13-year run at the biotech with one program for kidney disease going to the new owners at Chinook Therapeutics. A host of once-heralded assets like their STING agonist program partnered with Novartis (which dumped their work on ADU-S100 after looking over weak clinical results), the Lilly-allied cGAS-STING inhibitor program and the anti-CD27 program out-licensed to Merck will all be posted for auction under a strategic review process.

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Hill­house re­casts spot­light on Chi­na's biotech scene with $160M round for Shang­hai-based an­ti­body mak­er

Almost two years after first buying into Genor Biopharma’s pipeline of cancer and autoimmune therapies, Hillhouse Capital has led a $160 million cash injection to push the late-stage assets over the finish line while continuing to fund both internal R&D and dealmaking.

The Series B has landed right around the time Genor would have listed on the Hong Kong stock exchange, according to plans reported by Bloomberg late last year. Insiders had said that the company was looking to raise about $200 million.

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Fangliang Zhang (Imaginechina via AP Images)

The big mon­ey: Poised to make drug R&D his­to­ry, a Chi­na biotech un­veils uni­corn rac­ing am­bi­tions in a bid to raise $350M-plus on Nas­daq

Almost exactly three years after Shanghai-based Legend came out of nowhere to steal the show at ASCO with jaw-dropping data on their BCMA-targeted CAR-T for multiple myeloma, the little player with Big Pharma connections is taking a giant step toward making it big on Wall Street. And this time they want to seal the deal on a global rep after staking out a unicorn valuation in what’s turned out to be a bull market for biotech IPOs — in the middle of a pandemic.

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Federico Mingozzi (Spark)

Spark touts an­i­mal da­ta for a so­lu­tion to AAV gene ther­a­py's an­ti­body prob­lem

Among all the limitations of using an adeno-associated virus as a vector to deliver a gene — still the most established modality in gene therapy given years of trial and error and finally success — the presence of neutralizing antibodies, whether pre-existing or induced, looms large.

“When I think about the immune responses in AAV, I try to sort of layer them,” Federico Mingozzi, the CSO at Spark Therapeutics, told Endpoints News. “The antibody is the first layer. It’s the first block that you find when you’re trying to do gene transfer.”