CBO warns of al­most 60 few­er new drugs over three decades with Medicare drug ne­go­ti­a­tions bill

As drug pric­ing leg­is­la­tion be­gins to gain steam on Capi­tol Hill mov­ing in­to the fall, the Con­gres­sion­al Bud­get Of­fice is of­fer­ing an up­dat­ed look at the ef­fects that House Speak­er Nan­cy Pelosi’s drug pric­ing bill, known as HR 3, would have in chill­ing bio­phar­ma R&D over 30 years.

Nan­cy Pelosi

CBO said in a new re­port Thurs­day that its up­dat­ed mod­el used to es­ti­mate the ef­fects of HR 3 would, in part, al­low for wide­spread Medicare ne­go­ti­a­tions on drug prices, lead­ing to a 15% to 25% re­duc­tion in ex­pect­ed re­turns for drugs in the top quin­tile of ex­pect­ed re­turns.

Last Feb­ru­ary, the CBO es­ti­mat­ed that Medicare ne­go­ti­a­tions un­der the same bill would re­duce prices by be­tween 57% and 75%, rel­a­tive to cur­rent prices.

The lat­est es­ti­mates could lead to 2 few­er drugs in the first decade, 23 few­er in the sec­ond decade, and 34 few­er in the third decade, CBO said. While that to­tal of 59 few­er new drugs over three decades would like­ly re­sult in the loss of mean­ing­ful new drugs, the to­tal doesn’t align with in­dus­try lob­by­ing group PhRMA’s es­ti­mate in May that HR 3 could re­duce by 90%+ the num­ber of med­i­cines de­vel­oped by small and emerg­ing biotechs, or 61 few­er drugs over 10 years.

But where­as PhRMA says such a change could threat­en ac­cess to med­i­cines, the CBO stopped short of try­ing to tease out ex­act­ly what the loss of those drugs might mean, par­tic­u­lar­ly as the FDA ap­proves plen­ty of me-too or slight­ly im­proved ver­sions of cur­rent­ly mar­ket­ed drugs each year.

“The il­lus­tra­tive pol­i­cy’s ex­act im­pli­ca­tions for the health of fam­i­lies in the Unit­ed States are un­clear. CBO has es­ti­mat­ed nei­ther which types of drugs may be af­fect­ed nor how the re­duc­tion in the num­ber of new drugs will af­fect health out­comes. In ad­di­tion, the pol­i­cy may lead to low­er prices and in­creased us­age for drugs al­ready on the mar­ket. CBO has not de­ter­mined the over­all ef­fect of the pol­i­cy on health out­comes,” the re­port says.

The re­lease of the re­port al­so comes as it seems un­like­ly that the Sen­ate will take up HR 3 in its en­tire­ty, which passed the House in 2019.

Ron Wyden

Sen­ate fi­nance com­mit­tee chair Ron Wyden (D-OR), who’s craft­ing his own leg­is­la­tion, ear­li­er this sum­mer vowed to in­clude some form of Medicare ne­go­ti­a­tions in the Sen­ate’s pack­age, which like­ly won’t need Re­pub­li­can votes to make it in­to law.

And while the CBO lays out its ex­pect­ed new drug loss­es over three decades, the gov­ern­ment agency al­so made clear how dif­fi­cult it can be to pre­dict what drugs will prove pos­i­tive in mul­ti­ple stages of clin­i­cal tri­als and win ap­proval.

“The ef­fects could be small­er if ex­pen­di­tures in late-phase hu­man tri­als are larg­er, for ex­am­ple. Al­ter­na­tive­ly, the ef­fects could be larg­er if the cost of cap­i­tal is larg­er,” the CBO said.

Biotech and Big Phar­ma: A blue­print for a suc­cess­ful part­ner­ship

Strategic partnerships have long been an important contributor to how drugs are discovered and developed. For decades, big pharma companies have been forming alliances with biotech innovators to increase R&D productivity, expand geographical reach and better manage late-stage commercialization costs.

Noël Brown, Managing Director and Head of Biotechnology Investment Banking, and Greg Wiederrecht, Ph.D., Managing Director in the Global Healthcare Investment Banking Group at RBC Capital Markets, are no strangers to the importance of these tie-ups. Noël has over 20 years of investment banking experience in the industry. Before moving to the banking world in 2015, Greg was the Vice President and Head of External Scientific Affairs (ESA) at Merck, where he was responsible for the scientific assessment of strategic partnership opportunities worldwide.

Credit: Shutterstock

How Chi­na turned the ta­bles on bio­phar­ma's glob­al deal­mak­ing

Fenlai Tan still gets chills thinking about the darkest day of his life.

Three out of eight lung cancer patients who received a tyrosine kinase inhibitor developed by his company, Betta Pharma, died in the span of a month. Tan, the chief medical officer, was summoned to Peking Union Medical College Hospital, where the head of the clinical trial department told him that the trial investigators would be conducting an autopsy to see if the patients had died of the disease — they were all very sick by the time they enrolled — or of interstitial lung disease, a deadly side effect tied to the TKI class that’s been reported in Japan.

No­var­tis' sec­ond at­tempt to repli­cate a stun­ning can­cer re­sult falls flat

Novartis’ hopes of turning one of the most surprising trial data points of the last decade into a lung cancer drug has taken another setback.

The Swiss pharma announced Monday that its IL-1 inhibitor canakinumab did not significantly extend the lives or slow the disease progression of patients with previously untreated locally advanced or metastatic non-small cell lung cancer when compared to standard of-care alone.

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No­var­tis dumps AveX­is pro­gram for Rett syn­drome af­ter fail­ing re­peat round of pre­clin­i­cal test­ing

Say goodbye to AVXS-201.

The Rett syndrome gene therapy drug made by AveXis — the biotech that was bought, kept separate, then renamed and finally absorbed by Novartis into its R&D division — has been dropped by the biopharma.

In Novartis’ third quarter financial report, the pharma had found that preclinical data did not support development of the gene therapy into IND-enabling trials and beyond. The announcement comes a year after Novartis told the Rett Society how excited it was by the drug — and its potential benefits and uses.

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Peter Nell, Mammoth Biosciences CBO

UP­DAT­ED: Jen­nifer Doud­na spin­out inks a Mam­moth CRISPR deal with Ver­tex worth near­ly $700M

When a company gets its start in gene editing pioneer Jennifer Doudna’s lab, it’s bound to make headlines. But three years in, the fanfare still hasn’t died down for Mammoth Biosciences. Now, the Brisbane, CA-based company is cheering on its first major R&D pact.

Mammoth unveiled a nearly $700 million deal with Vertex on Tuesday morning, good for the development of in vivo gene therapies for two mystery diseases. The stars of the show are Mammoth’s ultra-small CRISPR systems, including two Cas enzymes licensed from Doudna’s lab over the past couple years, Cas14 and Casɸ.

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AstraZeneca CEO Pascal Soriot (Raphael Lafargue/Abaca/Sipa USA)

A com­bo of As­traZeneca's Imfinzi and chemo wins where oth­ers have failed in piv­otal bil­iary tract test

Looking to run with the big dogs in the PD-(L)1 class, AstraZeneca’s Imfinzi has a tall hill to climb to compete in an increasingly bustling market. An aggressive combo strategy for the drug has paid off so far, and now AstraZeneca is adding another notch to its belt.

A combo of Imfinzi (durvalumab) and chemotherapy significantly extended the lives of first-line patients with advanced biliary tract cancer over chemo alone, according to topline results from the Phase III TOPAZ-1 study revealed Monday.

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Sean Ianchulev, Eyenovia CEO and CMO

Re­cent court de­ci­sion push­es FDA to re­ject and re­clas­si­fy drug-de­vice com­bo, crush­ing shares

Back in April, the FDA lost a crucial court case in which its broad discretion of regulating medical products that might satisfy the legal definitions of either “drug” and/or “medical device” was sharply curtailed.

In addition to the appeals court ruling that Genus Medical Technologies’ contrast agent barium sulfate (aka Vanilla SilQ) should not be considered a drug, as the FDA had initially ruled, but as a medical device, the agency also was forced to spell out which drugs would transition to devices as a result of the ruling.

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An­gion's or­gan dam­age drug strikes out again, this time in high-risk kid­ney trans­plant pa­tients

After flopping a test in Covid-19 earlier this year, Angion’s lead organ damage drug has now hit the skids again in kidney transplant patients.

Angion and partner Vifor Pharma’s ANG-3777 failed to beat out placebo in terms of improving eGFR, a measure of kidney function, in patients who had received a deceased donor kidney transplant and were at high risk of developing what is known as delayed graft function, according to Phase III results released Tuesday.

(Photo courtesy Pfizer)

FDA's vac­cine ad­comm votes al­most unan­i­mous­ly in fa­vor of Pfiz­er's Covid-19 vac­cine for younger chil­dren

The FDA’s Vaccines and Related Biological Products Advisory Committee on Tuesday voted 17-0, with one panelist abstaining, that the benefits of the Pfizer-BioNTech Covid-19 vaccine outweigh the risks for children between the ages of five and 12.

The vote will likely trigger a process that could allow the shots to begin rolling out as early as next week.

The vaccine, which is one-third of the adult Pfizer dose, proved to be about 90% effective in a placebo-controlled trial in which about 1,500 kids in this age range received the vaccine, and only about 12% of those receiving the vaccine had any adverse event. All serious adverse events in the trial were unrelated to the vaccine.