In an­oth­er win for Trump, Mer­ck takes the drug pric­ing pledge. Its cuts are a joke, but is this an in­dus­try tip­ping point?

You can add Mer­ck to the list of phar­ma gi­ants tak­ing the pledge to ei­ther hold off on any price hikes or mov­ing to cut them. And there are grow­ing signs that oth­er ma­jors may soon join the par­ty as at least one top ex­ec re­port­ed­ly met with Pres­i­dent Don­ald Trump at the White House Thurs­day.

Fol­low­ing the lead of Pfiz­er and No­var­tis, Mer­ck put out a state­ment Thurs­day af­ter­noon that it has com­mit­ted to hold the line on any drug price hikes to the av­er­age in­fla­tion rate. In ad­di­tion, they have a spe­cial in mind. The com­pa­ny is slash­ing the price of their hep C com­bo Zepati­er by 60% while al­so promis­ing a 10% cut on oth­er ther­a­pies.

And they are not done.

The Mer­ck prod­ucts se­lect­ed were based on a range of fac­tors in­clud­ing the gap be­tween list price and ac­tu­al dis­count­ed (net) prices paid in the mar­ket, the con­trac­tu­al oblig­a­tions un­der ex­ist­ing arrange­ments with pay­ers, and the op­por­tu­ni­ty to broad­en ac­cess to treat­ment.

Go­ing for­ward, we will con­tin­ue to eval­u­ate our port­fo­lio of prod­ucts to look for op­por­tu­ni­ties to fur­ther re­duce costs for pa­tients and the health care sys­tem.

There’s been a con­sid­er­able amount of scoff­ing by in­dus­try ob­servers about these pric­ing promis­es, par­tic­u­lar­ly as it re­lat­ed to Pfiz­er CEO Ian Read’s promise to hold the line for just a few months. No­var­tis al­so was sub­ject­ed to con­sid­er­able scorn for of­fer­ing to rein it in, af­ter rais­ing prices on­ly re­cent­ly.

In this case, Mer­ck is cut­ting the price of a drug that con­tributes on­ly a tiny slice of its rev­enue — and which is fast fad­ing to noth­ing — in a dis­ease are­na dom­i­nat­ed by Gilead and Ab­b­Vie. Hep C was al­ready a los­er. And its oth­er 5 drugs in the cut­ting block are re­port­ed­ly off patent, mean­ing they are giv­ing up pre­cise­ly noth­ing in the way of mean­ing­ful cuts.

Mer­ck’s move, though, may in­di­cate that a fun­da­men­tal bio­phar­ma shift is un­der­way as the in­dus­try deals with the di­rect as­sault mount­ed by Pres­i­dent Trump. Trump may not ever get the free-falling prices he promised were on the way, but mar­ket lead­ers are falling in­to line in what may yet prove to be a durable truce on the drug price de­bate.

And love him or hate him, that’s a big win for Trump — even if this is just op­tics for now. HHS Sec­re­tary Alex Azar was quick to boast about it on Twit­ter:

The Pres­i­dent’s plan is work­ing—drug prices are com­ing down. Thanks Mer­ck for low­er­ing prices on 6 drugs, in­clud­ing a He­pati­tis C drug by 60% and com­mit­ting to keep fu­ture price in­creas­es be­low in­fla­tion. Look­ing for­ward to oth­ers do­ing the same to put Amer­i­can Pa­tients First!

Trump — who ear­li­er ex­co­ri­at­ed Pfiz­er af­ter news of price hikes hit — al­so ex­pressed his ap­pre­ci­a­tion in a new Tweet of his own:

Ac­cord­ing to Politi­co, Read met with Trump to­day in Wash­ing­ton DC as top CEOs in the in­dus­try hun­kered down in a PhRMA strat­e­gy ses­sion.

There’s no love lost be­tween Mer­ck CEO Ken Fra­zier and Trump. Fra­zier dis­tanced him­self from the White House af­ter the con­tro­ver­sy over the pres­i­dent’s re­marks about the ac­tiv­i­ties of ex­trem­ist groups dur­ing a dead­ly protest in Vir­ginia. That al­most cer­tain­ly rules out a di­rect call to Fra­zier from Trump.

I’ve asked Mer­ck, though, if any­one in the ad­min­is­tra­tion — per­haps Azar — had been in touch. No one has re­spond­ed.

ZS Per­spec­tive: 3 Pre­dic­tions on the Fu­ture of Cell & Gene Ther­a­pies

The field of cell and gene therapies (C&GTs) has seen a renaissance, with first generation commercial therapies such as Kymriah, Yescarta, and Luxturna laying the groundwork for an incoming wave of potentially transformative C&GTs that aim to address diverse disease areas. With this renaissance comes several potential opportunities, of which we discuss three predictions below.

Allogenic Natural Killer (NK) Cells have the potential to displace current Cell Therapies in oncology if proven durable.

Despite being early in development, Allogenic NKs are proving to be an attractive new treatment paradigm in oncology. The question of durability of response with allogenic therapies is still an unknown. Fate Therapeutics’ recent phase 1 data for FT516 showed relatively quicker relapses vs already approved autologous CAR-Ts. However, other manufacturers, like Allogene for their allogenic CAR-T therapy ALLO-501A, are exploring novel lymphodepletion approaches to improve persistence of allogenic cells. Nevertheless, allogenic NKs demonstrate a strong value proposition relative to their T cell counterparts due to comparable response rates (so far) combined with the added advantage of a significantly safer AE profile. Specifically, little to no risk of graft versus host disease (GvHD), cytotoxic release syndrome (CRS), and neurotoxicity (NT) have been seen so far with allogenic NK cells (Fig. 1). In addition, being able to harness an allogenic cell source gives way to operational advantages as “off-the-shelf” products provide improved turnaround time (TAT), scalability, and potentially reduced cost. NKs are currently in development for a variety of overlapping hematological indications with chimeric antigen receptor T cells (CAR-Ts) today, and the question remains to what extent they will disrupt the current cell therapy landscape. Click for more details.

Graphic: Kathy Wong for Endpoints News

What kind of biotech start­up wins a $3B syn­di­cate, woos a gallery of mar­quee sci­en­tists and re­cruits GSK's Hal Bar­ron as CEO in a stun­ner? Let Rick Klaus­ner ex­plain

It started with a question about a lifetime’s dream on a walk with tech investor Yuri Milner.

At the beginning of the great pandemic, former NCI chief and inveterate biotech entrepreneur Rick Klausner and the Facebook billionaire would traipse Los Altos Hills in Silicon Valley Saturday mornings and talk about ideas.

Milner’s question on one of those mornings on foot: “What do you want to do?”

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Sec­ondary patents prove to be key in biosim­i­lar block­ing strate­gies, re­searchers find

While the US biosimilars industry has generally been a disappointment since its inception, with FDA approving 33 biosimilars since 2015, just a fraction of those have immediately followed their approvals with launches. And more than a handful of biosimilars for two of the biggest blockbusters of all time — AbbVie’s Humira and Amgen’s Enbrel — remain approved by FDA but still have not launched because of legal settlements.

FDA+ roundup: FDA's neu­ro­science deputy de­parts amid on­go­ing Aduhelm in­ves­ti­ga­tions; Califf on the ropes?

Amid increased scrutiny into the close ties between FDA and Biogen prior to the controversial accelerated approval of Aduhelm, the deputy director of the FDA’s office of neuroscience has called it quits after more than two decades at the agency.

Eric Bastings will now take over as VP of development strategy at Ionis Pharmaceuticals, the company said Wednesday, where he will provide senior clinical and regulatory leadership in support of Ionis’ pipeline.

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Hal Barron (GSK via YouTube)

GSK R&D chief Hal Bar­ron jumps ship to run a $3B biotech start­up, Tony Wood tapped to re­place him

In a stunning switch, GlaxoSmithKline put out word early Wednesday that R&D chief Hal Barron is exiting the company after 4 years — a relatively brief run for the man chosen by CEO Emma Walmsley in late 2017 to turn around the slow-footed pharma giant.

Barron is being replaced by Tony Wood, a close associate of Barron’s who’s taking one of the top jobs in Big Pharma R&D. He’ll be closer to home, though, for GSK. Barron has been running a UK and Philadelphia-based research organization from his perch in San Francisco.

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Chamath Palihapitiya and Pablo Legorreta

Bil­lion­aires Chamath Pal­i­hapi­tiya and Pablo Legor­re­ta hatch an $825M SPAC for cell ther­a­py biotech

Three years after Royalty Pharma chief Pablo Legorreta led a group of investors to buy up a pair of biotechs and create a new startup called ProKidney, the biotech is jumping straight into an $825 million public shell created by SPAC king and tech billionaire Chamath Palihapitiya.

ProKidney was founded 6 years ago but really got going at the beginning of 2019 with the $62 million acquisition of inRegen, which was working on an autologous — from the patient — cell therapy for kidney disease. After extracting kidney cells from patients, researchers expand the cells in the lab and then inject them back into patients, aiming to restore the kidneys of patients suffering from CKD.

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CBO: Medicare ne­go­ti­a­tions will ham­per drug de­vel­op­ment more than pre­vi­ous­ly thought

As President Biden’s Build Back Better Act — and, with it, potentially the Democrats’ last shot at major drug pricing reforms in the foreseeable future — remains on life support, the Congressional Budget Office isn’t helping their case.

The CBO last week released a new slide deck, outlining an update to its model on how Medicare negotiations might take a bite out of new drugs making it to market. The new model estimates a 10% long-term reduction in the number of new drugs, whereas a previous CBO report from August estimated that 8% fewer new drugs will enter the market over 30 years.

Joshua Brumm, Dyne Therapeutics CEO

FDA or­ders DMD tri­al halt, rais­ing ques­tions about a whole class of promis­ing drugs

Dyne Therapeutics’ stock took a nasty hit this morning after the biotech put out word that the FDA had slapped a clinical hold on their top program for Duchenne muscular dystrophy. And now speculation is bouncing around Biotwitter that there could be a class effect at work here that would implicate other drug developers in the freeze.

Dyne execs didn’t have a whole lot to say about why the FDA sidelined their IND for DYNE-251 in DMD while “requesting additional clinical and non-clinical information for” the drug.

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Michel Vounatsos, Biogen CEO (Credit: World Economic Forum/Ciaran McCrickard)

An un­ortho­dox pro­pos­al for Bio­gen's Medicare-man­dat­ed Aduhelm tri­al

Biogen has gone full blitz since Medicare announced it would only cover its new Alzheimer’s drug when used in clinical trials, accusing the agency of discriminating against Alzheimer’s patients and trying to get physicians to change regulators’ minds.  Critics, meanwhile, cheered what they see as a necessary wall protecting payers and patients from an unproven and unsafe drug.

Far less attention, though, has gone to what a Medicare-funded clinical trial would actually look like. Biogen has operated as if it would be a standard late-stage Alzheimer’s trial, enrolling a couple thousand patients and giving half placebo.

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