For 3rd time, the FDA and its new com­mis­sion­er dropped safe­ty is­sues and tri­al de­mands, clear­ing the path for snubbed ther­a­py

Ther­a­peu­tic­sMD $TXMD was slammed on May 8 when the FDA for­mal­ly re­ject­ed its ap­pli­ca­tion for a vagi­nal pain med­i­cine dubbed TX-004HR. Reg­u­la­tors want­ed more safe­ty da­ta, which would have re­quired a new study and years more work.

Then, one day lat­er, Scott Got­tlieb won con­fir­ma­tion as the new com­mis­sion­er of the FDA, and that may have made a huge dif­fer­ence in the biotech’s for­tunes.

This morn­ing Ther­a­peu­tic­sMD, which had said it would ap­peal the de­ci­sion, says the FDA has re­lin­quished its de­mands and will al­low them to re­sub­mit their ap­pli­ca­tion in a mat­ter of weeks. In­stead of a pre-ap­proval study, reg­u­la­tors say they will now be sat­is­fied with a post-ap­proval tri­al.

The biotech’s stock rock­et­ed up 116%.

Once rare, these sud­den about-faces by the FDA have be­come al­most rou­tine this year, with Ther­a­peu­tic­sMD lin­ing up as one of three com­pa­nies to win a huge re­prieve — sig­nal­ing a much more tol­er­ant at­ti­tude at the FDA in light of Pres­i­dent Don­ald Trump’s man­date to push more drug ap­provals faster as a way of bring­ing down phar­ma costs in the US.

All three had ap­pli­ca­tions re­ject­ed be­fore Got­tlieb’s ar­rival.

Robert Finizio

Am­i­cus Ther­a­peu­tics got this trend start­ed in Ju­ly — two months af­ter Got­tlieb took the head of­fice — when the FDA dropped its de­mand for a safe­ty study of its Fab­ry dis­ease drug mi­gala­s­tat, which bat­tered the biotech’s shares. In a fol­low-up, the FDA put the drug on its fast track pro­gram to speed up the new re­view.

Four months af­ter Got­tlieb showed up at his new of­fice at the FDA, Eli Lil­ly an­nounced that the FDA had re­versed course on its block­buster ap­pli­ca­tion for baric­i­tinib, al­so re­ject­ed on safe­ty grounds. As Lil­ly told me at the time:

The FDA has grant­ed us the op­por­tu­ni­ty to file our re­sub­mis­sion pack­age with­out a new clin­i­cal study.

Ther­a­peu­tic­sMD makes three, sig­nal­ing that the agency’s old stan­dards on safe­ty have clear­ly been down­grad­ed. While the agency has not been re­luc­tant to spurn new drug ap­pli­ca­tions, a new day has dawned on where the agency draws the line on safe­ty sig­nals. And that has ma­jor im­pli­ca­tions for drug de­vel­op­ers har­ried by ques­tions of safe­ty is­sues.

I asked Got­tlieb about the agency’s safe­ty stan­dards and a re­sponse to this sto­ry, but me­dia con­tacts at the FDA did not im­me­di­ate­ly re­spond.

While Am­i­cus and Eli Lil­ly both made cas­es for lead­ing ther­a­pies in their pipelines, Ther­a­peu­tic­sMD has been seek­ing an ap­proval for a me-too drug that will go up against oth­er well es­tab­lished ther­a­pies. Reg­u­la­tors had ob­ject­ed to the 12 weeks of safe­ty da­ta pro­vid­ed in the ap­pli­ca­tion, say­ing they want­ed 12 months of re­sults. But now they have been over­ruled.

An­oth­er con­sid­er­a­tion: If any of these drugs now be­ing helped to­ward the mar­ket back­fire and hurt pa­tients in un­ex­pect­ed ways, the FDA and Got­tlieb will have plen­ty of ex­plain­ing to do.

“We ap­pre­ci­ate the hard work and col­lab­o­ra­tive ef­fort by the FDA in mov­ing TX-004HR one step clos­er to ap­proval,” said Ther­a­peu­tic­sMD CEO Robert Finizio. “We are ex­treme­ly pleased with the FDA’s po­si­tion that an ad­di­tion­al pre-ap­proval safe­ty study is no longer nec­es­sary for the re­sub­mis­sion of the NDA for TX-004HR.”

Nick Leschly via Getty

UP­DAT­ED: Blue­bird shares sink as an­a­lysts puz­zle out $1.8M stick­er shock and an un­ex­pect­ed de­lay

Blue­bird bio $BLUE has un­veiled its price for the new­ly ap­proved gene ther­a­py Zyn­te­glo (Lenti­Glo­bin), which came as a big sur­prise. And it wasn’t the on­ly un­ex­pect­ed twist in to­day’s sto­ry.

With some an­a­lysts bet­ting on a $900,000 price for the β-tha­lassemia treat­ment in Eu­rope, where reg­u­la­tors pro­vid­ed a con­di­tion­al ear­ly OK, blue­bird CEO Nick Leschly said Fri­day morn­ing that the pa­tients who are suc­cess­ful­ly treat­ed with their drug over 5 years will be charged twice that — $1.8 mil­lion — on the con­ti­nent. That makes this drug the sec­ond most ex­pen­sive ther­a­py on the plan­et, just be­hind No­var­tis’ new­ly ap­proved Zol­gens­ma at $2.1 mil­lion, with an­a­lysts still wait­ing to see what kind of pre­mi­um can be had in the US.

Gene ther­a­pies seize the top of the list of the most ex­pen­sive drugs on the plan­et — and that trend has just be­gun

Anyone looking for a few simple reasons why the gene therapy field has caught fire with the pharma giants need only look at the new list of the 10 most expensive therapies from GoodRx.

Two recently approved gene therapies sit atop this list, with Novartis’ Zolgensma crowned the king of the priciest drugs at $2.1 million. Right below is Luxturna, the $850,000 pioneer from Spark, which Roche is pushing hard to acquire as it adds a gene therapy group to the global mix.

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Glob­al Blood Ther­a­peu­tics poised to sub­mit ap­pli­ca­tion for ac­cel­er­at­ed ap­proval, with new piv­otal da­ta on its sick­le cell dis­ease drug

Global Blood Therapeutics is set to submit an application for accelerated approval in the second-half of this year, after unveiling fresh data from a late-stage trial that showed just over half the patients given the highest dose of its experimental sickle cell disease drug experienced a statistically significant improvement in oxygen-wielding hemoglobin, meeting the study's main goal.

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J&J gains an en­thu­si­as­tic en­dorse­ment from Pres­i­dent Don­ald Trump for their big new drug Spra­va­to

Pres­i­dent Don­ald Trump has lit­tle love for Big Phar­ma, but there’s at least one new drug that just hit the mar­ket which he is en­am­ored with.

Trump, ev­i­dent­ly, has been read­ing up on J&J’s new an­ti-de­pres­sion drug, Spra­va­to. And the pres­i­dent — who of­ten likes to break out in­to a full-throat­ed at­tack on greedy drug­mak­ers — ap­par­ent­ly en­thused about the ther­a­py in a meet­ing with of­fi­cials of Vet­er­ans Af­fairs, which has long grap­pled with de­pres­sion among vet­er­ans.

In a boost to Rit­ux­an fran­chise, Roche nabs quick ap­proval for po­latuzum­ab ve­dotin

Roche’s lat­est an­ti­body-drug con­ju­gate has crossed the FDA fin­ish line, gain­ing an ac­cel­er­at­ed ap­proval a full two months ahead of sched­ule.

Po­livy, or po­latuzum­ab ve­dotin, is a first-in-class drug tar­get­ing CD79b — a pro­tein promi­nent in B-cell non-Hodgkin lym­phoma. It will now be mar­ket­ed for dif­fuse large B-cell lym­phoma as part of a reg­i­men that al­so in­cludes the chemother­a­py ben­damus­tine and a ver­sion of rit­ux­imab (Rit­ux­an).

An in­censed Cat­a­lyst Phar­ma sues the FDA, ac­cus­ing agency of bow­ing to po­lit­i­cal pres­sure and break­ing fed­er­al law

Af­ter hint­ing it was ex­plor­ing the le­gal­i­ty of the FDA’s ap­proval of a ri­val drug from fam­i­ly-run com­pa­ny Ja­cobus Phar­ma­ceu­ti­cals, Cat­a­lyst Phar­ma­ceu­ti­cals on Wednes­day filed a law­suit against the health reg­u­la­tor — ef­fec­tive­ly ac­cus­ing the agency of bow­ing to po­lit­i­cal pres­sure sur­round­ing sky­rock­et­ing drug prices.

Be­fore Cat­a­lyst’s Fir­dapse (which car­ries an av­er­age an­nu­al list price of $375,000) was sanc­tioned for use in Lam­bert-Eaton myas­thenic syn­drome (LEMS) by the FDA, hun­dreds of pa­tients had been able to ac­cess a sim­i­lar drug from com­pound­ing phar­ma­cies for a frac­tion of the cost, or Ja­cobus’ for free, as part of an FDA-rat­i­fied com­pas­sion­ate use pro­gram. But the ap­proval of the Cat­a­lyst drug — ac­com­pa­nied by mar­ket ex­clu­siv­i­ty span­ning sev­en years — ef­fec­tive­ly pre­clud­ed Ja­cobus and com­pound­ing phar­ma­cies from sell­ing their ver­sions.

Plagued by de­lays, As­traZeneca HQ costs soar to £750M as it edges to­ward 2020 com­ple­tion

In the lat­est up­date on As­traZeneca’s de­lay-prone HQ project, the phar­ma gi­ant re­vealed that the cost of con­struc­tion has swelled to £750 mil­lion ($956 mil­lion) — more than dou­ble the orig­i­nal es­ti­mate in 2013.

The move-in date is still in 2020, a spokesper­son con­firmed, af­ter As­traZeneca pushed pro­ject­ed com­ple­tion from 2016 to 2017, and then to the spring of 2019. While the ini­tial plan called for a £330 mil­lion (then $500 mil­lion) in­vest­ment, the cost bal­looned to £500 mil­lion ($650 mil­lion), and more in the most re­cent up­date.

Fresh analy­sis spot­lights car­dio ben­e­fit of J&J's In­vokana in di­a­betes pa­tients with­out his­to­ry of CV dis­ease

In­vokana sales may be mut­ed, but the di­a­betes drug is set to get some love af­ter its mak­er J&J un­veiled da­ta at the Amer­i­can Di­a­betes As­so­ci­a­tion meet­ing on Tues­day sug­gest­ing the med­i­cine can con­fer a car­dio­vas­cu­lar ben­e­fit in pa­tients who do not have pre­ex­ist­ing CV dis­ease.

Back in April, J&J had re­port­ed that in the late-stage CRE­DENCE study, the SGLT2 drug scored a 30% re­duc­tion in the risk of a com­pos­ite of ail­ments: a pro­gres­sion to the dou­bling of serum cre­a­ti­nine, end-stage kid­ney dis­ease and re­nal or car­dio­vas­cu­lar death. In terms of sec­ondary end­points, the drug was al­so found be heart-pro­tec­tive: low­er­ing the risk of CV death and hos­pi­tal­iza­tion for heart fail­ure by 31%, as well as ma­jor ad­verse CV events by 20%. In March, the com­pa­ny sub­mit­ted an ap­pli­ca­tion to ex­pand In­vokana’s la­bel to re­flect its im­pact on chron­ic kid­ney dis­ease.

Sil­i­con Val­ley's most an­tic­i­pat­ed slide deck just dropped. What does it mean for bio­phar­ma's dig­i­tal teams?

These aren’t the typ­i­cal slides you’d see at End­points — no mol­e­cules, clin­i­cal pro­grams, or p-val­ues. In­stead, we’ll talk dig­i­tal and in­ter­net trends, fac­tors that elite glob­al brands — re­gard­less of in­dus­try — must first mea­sure and un­der­stand be­fore de­ploy­ing prod­ucts in­to the world. That’s a con­cept that most of our Big Phar­ma au­di­ence is in tune with. Dig­i­tal aware­ness is key to suc­cess in the dis­cov­ery, de­vel­op­ment, and mar­ket­ing of new bio­phar­ma­ceu­ti­cals, and most of the ma­jors now have a chief dig­i­tal of­fi­cer: No­var­tis, Sanofi, and Pfiz­er, just to name a few.