Ron Cohen, Acorda Therapeutics president & CEO

Let­ters to the Ed­i­tor: Don't ex­pect a cor­re­la­tion be­tween an in­di­vid­ual drug's de­vel­op­ment cost and price

End­points News re­cent­ly re­port­ed on a new pa­per in JA­MA that pur­ports to show that there is no cor­re­la­tion be­tween the price of a drug and its R&D costs. If the JA­MA ed­i­tors were to ap­ply sim­i­lar stan­dards of ev­i­dence to a pa­per about a drug’s clin­i­cal tri­al, they would be jus­ti­fi­ably crit­i­cized.

The pa­per cher­ry picks 60 out of hun­dreds of drugs, with the ex­cuse that the rel­e­vant da­ta for oth­er drugs ap­proved over the se­lect­ed 10-year pe­ri­od were dif­fi­cult to source. Imag­ine if a bio­phar­ma com­pa­ny on­ly pub­lished da­ta on 60 out of sev­er­al hun­dred par­tic­i­pants in a tri­al, claim­ing that the da­ta from the oth­ers were “dif­fi­cult to ac­cess.” The au­thors them­selves note an­oth­er sig­nif­i­cant weak­ness: that they did not have ac­cess to the net prices of many of the drugs in their sam­ple. This re­flects our sys­tem of drug re­bates, in which phar­ma­cy ben­e­fit man­agers, or PBMs, can re­ceive 30%-50% or more of a drug’s list price, leav­ing the drug de­vel­op­er with a sub­stan­tial­ly low­er ac­tu­al, or “net,” price.

More con­cern­ing, the au­thors’ study de­sign sim­ply ig­nored the fact that for every FDA-ap­proved drug, there are on av­er­age about nine oth­ers that made it in­to clin­i­cal tri­als, but failed to reach the mar­ket. Yet drug com­pa­nies must in­vest huge sums de­vel­op­ing the 90% of drug can­di­dates that ul­ti­mate­ly fail. The re­turn on in­vest­ment for each suc­cess­ful drug must take in­to ac­count the ex­pen­di­tures on all of them, in­clud­ing the in­evitable fail­ures, or in­vestors will not con­tin­ue to sup­port the de­vel­op­ment of new med­i­cines. There­fore, one should not ex­pect there to be a cor­re­la­tion be­tween an in­di­vid­ual drug’s de­vel­op­ment costs and its price.

Ron Co­hen, M.D.
Pres­i­dent and CEO
Acor­da Ther­a­peu­tics

Has the mo­ment fi­nal­ly ar­rived for val­ue-based health­care?

RBC Capital Markets’ Healthcare Technology Analyst, Sean Dodge, spotlights a new breed of tech-enabled providers who are rapidly transforming the way clinicians deliver healthcare, and explores the key question: can this accelerating revolution overturn the US healthcare system?

Key points

Tech-enabled healthcare providers are poised to help the US transition to value, not volume, as the basis for reward.
The move to value-based care has policy momentum, but is risky and complex for clinicians.
Outsourced tech specialists are emerging to provide the required expertise, while healthcare and tech are also converging through M&A.
Value-based care remains in its early stages, but the transition is accelerating and represents a huge addressable market.

Clay Siegall, Morphimmune CEO

Up­dat­ed: Ex-Seagen chief Clay Sie­gall emerges as CEO of pri­vate biotech

Clay Siegall will be back in the CEO seat, taking the helm of a private startup working on targeted cancer therapies.

It’s been almost a year since Siegall resigned from Seagen, the biotech he co-founded and led for more than 20 years, in the wake of domestic violence allegations by his then-wife. His eventual successor, David Epstein, sold the company to Pfizer in a $43 billion deal unveiled last week.

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Zhi Hong, Brii Biosciences CEO

Brii Bio­sciences stops man­u­fac­tur­ing Covid-19 an­ti­body com­bo, plans to with­draw EUA re­quest

Brii Biosciences said it will stop manufacturing its Covid-19 antibody combination, sold in China, and is working to withdraw its emergency use authorization request in the US, which it started in October 2021.

The Beijing and North Carolina biotech commercially launched the treatment in China last July but is now axing the work and reverting resources to other “high-priority programs,” per a Friday update. The focus now is namely hepatitis B viral infection, postpartum depression and major depressive disorders.

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Sergio Traversa, Relmada Therapeutics CEO

Rel­ma­da makes 'crit­i­cal changes' to PhI­II tri­al to try and save de­pres­sion drug

Relmada Therapeutics is making changes to its Phase III study of its lead drug for major depressive disorder, in an attempt to avoid problems with a prior trial that showed little difference between the drug and a placebo.

That failure in October wiped 80% from Relmada’s stock price, and was followed by another negative readout a few months later. In both cases, the company said that there had been trial sites that were associated with what it called surprising placebo effects that skewed the results compared with the drug, REL-1017.

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Paul Song, NKGen Biotech CEO

NK cell ther­a­py-fo­cused biotech eyes SPAC deal

A small, Santa Ana-based biotech created in 2017 is looking to enter a SPAC deal as it lays out plans to begin trials in its lead cell therapy candidates and bring on new executives.

Graf Acquisition Corp. IV and NKGen Biotech announced Thursday, with few other details, that the two companies signed a non-binding letter of intent to “pursue a business combination.” Graf Acquisition II and III withdrew their IPOs last year.

In­cyte hit by CRL on ex­tend­ed-re­lease JAK tablets, mud­dy­ing plans for Jakafi fran­chise ex­pan­sion

The FDA has rejected Incyte’s extended-release formulation of ruxolitinib tablets, in a surprise setback for the company’s plans to build on its blockbuster Jakafi franchise.

The ruxolitinib XR tablets are designed to be taken once a day, whereas Jakafi is indicated for twice daily dosage (although some patients can take it once daily).

According to Incyte, the FDA acknowledged in its complete response letter that the study submitted in the NDA “met its objective of bioequivalence based on area under the curve (AUC) parameters but identified additional requirements for approval.”

Peter Hecht, Cyclerion Therapeutics CEO

Hard pressed for cash, Cy­cle­ri­on looks for help fund­ing rare dis­ease drug

Cyclerion Therapeutics may have the design of a Phase IIb study ready to go, but it’s scrambling for a way to fund it.

The company said in a press release that it’s “actively evaluating the best combination of capital, capabilities, and transactions available to it to advance the development of zagociguat,” its lead candidate for a rare, genetic mitochondrial disease known as MELAS.

In a separate SEC filing, Cyclerion once again flagged “substantial doubt about (its) ability to continue as a going concern.” As of the end of 2022, it had cash and cash equivalents of only $13.4 million.

FDA ad­vi­sors unan­i­mous­ly rec­om­mend ac­cel­er­at­ed ap­proval for Bio­gen's ALS drug

A panel of outside advisors to the FDA unanimously recommended that the agency grant accelerated approval to Biogen’s ALS drug tofersen despite the drug failing the primary goal of its Phase III study, an endorsement that could pave a path forward for the treatment.

By a 9-0 vote, members of the Peripheral and Central Nervous System Drugs Advisory Committee said there was sufficient evidence that tofersen’s effect on a certain protein associated with ALS is reasonably likely to predict a benefit for patients. But panelists stopped short of advocating for a full approval, voting 3-5 against (with one abstention) and largely citing the failed pivotal study.

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Alaa Halawa, executive director at Mubadala’s US venture group

The ven­ture crew at Mubadala are up­ping their biotech cre­ation game, tak­ing care­ful aim at a new fron­tier in drug de­vel­op­ment

It started with a cup of coffee and a slow burning desire to go early and long in the biotech creation business.

Wrapping up a 15-year discovery stint at Genentech back in the summer of 2021, Rami Hannoush was treated to a caffeine-fueled review of the latest work UCSF’s Jim Wells had been doing on protein degradation — one of the hottest fields in drug development.

“Jim and I have known each other for the past 15 years through Genentech collaborations. We met over coffee, and he was telling me about this concept of the company that he was thinking of,” says Hannoush. “And I got immediately intrigued by it because I knew that this could open up a big space in terms of adding a new modality in drug discovery that is desperately needed in pharma.”

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