The Shkre­li rule? FDA is ex­plor­ing whether se­lect­ed reim­por­ta­tion could crip­ple the drug prof­i­teers

Mar­tin Shkre­li was hauled in front of law­mak­ers, jailed on fraud con­vic­tions and sub­ject­ed to every known form of le­gal pres­sure af­ter hik­ing the price of Dara­prim by more than 5000%. But none of it worked to force him to back off a per­fect­ly le­gal strat­e­gy to gouge pay­ers on a nar­row­ly con­trolled gener­ic drug — where the sky is the lim­it on the price.

So now the FDA is ex­plor­ing a new op­tion, which in­volves a tac­tic that the drug in­dus­try — and many oth­ers in the gov­ern­ment — have long ab­horred.

In a state­ment out this morn­ing, the FDA says that it is as­sem­bling a work­ing group to con­sid­er whether reim­port­ing drugs from abroad may be the an­swer to the drug prof­i­teers. 

We want to ex­am­ine whether—un­der these nar­row con­di­tions—the ad­di­tion­al mar­ket com­pe­ti­tion from the short-term im­por­ta­tion of for­eign ver­sions of the drug may com­ple­ment the FDA’s cur­rent ef­forts, and help meet near-term pa­tient need in the U.S. un­til new com­pe­ti­tion is able to en­ter the do­mes­tic mar­ket.

Reim­por­ta­tion is noth­ing new. Many De­moc­rats have long sug­gest­ed that pa­tients in the US be al­lowed to buy drugs in for­eign mar­kets where sin­gle-pay­er sys­tems have forced down the price. The Trump ad­min­is­tra­tion and oth­ers, par­tic­u­lar­ly in the in­dus­try, have kicked back, say­ing it wouldn’t pro­vide a safe sup­ply of ther­a­pies. And drug man­u­fac­tur­ers, crit­ics add, wouldn’t al­low it any­way, cut­ting off any sup­pli­ers who might try.

FDA com­mis­sion­er Scott Got­tlieb, though, is pre­pared to con­sid­er us­ing reim­por­ta­tion for any oth­er Shkrelis that come along. 

Any pol­i­cy that in­volves the im­por­ta­tion of drugs would be tem­po­rary un­til ad­e­quate com­pe­ti­tion en­ters these cat­e­gories. Fur­ther­more, any re­sult­ing pol­i­cy would al­so be nar­row­ly tai­lored in or­der not to cre­ate the same risks of coun­ter­feits or oth­er un­safe drugs get­ting in­to the U.S. sup­ply chain as a broad­er im­por­ta­tion pol­i­cy would present. Our ul­ti­mate goal is to seek mul­ti­ple FDA-ap­proved and mar­ket­ed ver­sions of each med­ical­ly im­por­tant drug for which there are no block­ing patents or oth­er ex­clu­siv­i­ties.

That could prove in­ter­est­ing.

Shkre­li, the old Valeant, Mallinck­rodt and oth­ers have been known to spur dra­mat­i­cal­ly high­er prices. Where would the agency draw the line?

Would they go af­ter PTC Ther­a­peu­tics?

PTC bought an old, cheap steroid called de­flaza­cort from Marathon Phar­ma­ceu­ti­cals af­ter Marathon rolled it out for a stun­ning $89,000 an­nu­al price tag. PTC bagged it for $140 mil­lion up front, then set a vague net price of $35,000 based on the pa­tient’s weight — which could take some pa­tients past what Marathon want­ed to charge.

Marathon was ex­co­ri­at­ed for price goug­ing, but PTC has large­ly es­caped no­tice. Mean­while, there’s been grow­ing crit­i­cism of an­nu­al price hikes that are stan­dard in the in­dus­try — but that will al­most cer­tain­ly be off lim­its to reg­u­la­tors.

If the FDA does go for­ward against the prof­i­teers, though, it will be in­ter­est­ing to see where it draws the line.


Im­age: Scott Got­tlieb. AP IM­AGES

Aerial view of Genentech's campus in South San Francisco [Credit: Getty]

Genen­tech sub­mits a big plan to ex­pand its South San Fran­cis­co foot­print

The sign is still there, a quaint reminder of whitewashed concrete not 5 miles from Genentech’s sprawling, chrome-and-glass campus: South Francisco The Industrial City. 

The city keeps the old sign, first erected in 1923, as a tourist site and a kind of civic memento to the days it packed meat, milled lumber and burned enough steel to earn the moniker “Smokestack of the Peninsula.” But the real indication of where you are and how much has changed both in San Francisco and in the global economy since a couple researchers and investors rented out an empty warehouse 40 years ago comes in a far smaller blue sign, resembling a Rotary Club post, off the highway: South San Francisco, The Birthplace of Biotech.

Here comes the oral GLP-1 drug for di­a­betes — but No­vo Nordisk is­n't dis­clos­ing Ry­bel­sus price just yet

Novo Nordisk’s priority review voucher on oral semaglutide has paid off. The FDA approval for the GLP-1 drug hit late Friday morning, around six months after the NDA filing.

Rybelsus will be the first GLP-1 pill to enter the type 2 diabetes market — a compelling offering that analysts have pegged as a blockbuster drug with sales estimates ranging from $2 billion to $5 billion.

Ozempic, the once-weekly injectable formulation of semaglutide, brought in around $552 million (DKK 3.75 billion) in the first half of 2019.

As Nas­daq en­rolls the fi­nal batch of 2019 IPOs, how have the num­bers com­pared to past years?

IGM Biosciences’ upsized IPO haul, coming after SpringWorks’ sizable public debut, has revved up some momentum for the last rush of biotech IPOs in 2019.

With 39 new listings on the books and roughly two more months to go before winding down, Nasdaq’s head of healthcare listings Jordan Saxe sees the exchange marking 50 to 60 biopharma IPOs for the year.

“December 15 is usually the last possible day that companies will price,” he said, as companies get ready for business talks at the annual JP Morgan Healthcare Conference in January.

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Oxitec biologist releases genetically modified mosquitoes in Piracicaba, Brazil in 2016 [credit: Getty Images]

In­trex­on unit push­es back against claims its GM mos­qui­toes are mak­ing dis­ease-friend­ly mu­tants

When the hysteria of Zika transmission sprang into the American zeitgeist a few years ago, UK-based Oxitec was already field-testing its male Aedes aegypti mosquito, crafted to possess a gene engineered to obliterate its progeny long before maturation.

But when a group of independent scientists evaluated the impact of the release of these genetically-modified mosquitoes in a trial conducted by Oxitec in Brazil between 2013 and 2015, they found that some of the offspring had managed to survive — prompting them to speculate what impact the survivors could have on disease transmission and/or insecticide resistance.

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Pur­due threat­ens to walk away from set­tle­ment, asks to pay em­ploy­ees mil­lions in bonus­es

There are two updates on the lawsuit against Purdue Pharma over its role in fueling the opioid epidemic, as the Sackler family threatens to walk away from their pledge to pay out $3 billion if a bankruptcy judge does not stop outstanding state lawsuits against them. At the same time, the company has asked permission to pay millions in bonuses to select employees.

Purdue filed for chapter 11 bankruptcy this week as part of its signed resolution to over 2,000 lawsuits. The deal would see the Sackler family that owns Purdue give $3 billion from their personal wealth and the company turned into a trust committed to curbing and reversing overdoses.

While No­var­tis ban­ish­es Zol­gens­ma scan­dal scars — Bio­gen goes on a Spin­raza 'of­fen­sive'

While Novartis painstakingly works to mop up the stench of the data manipulation scandal associated with its expensive gene therapy for spinal muscular atrophy (SMA) Zolgensma— rival Biogen is attempting to expand the use of its SMA therapy, Spinraza. 

The US drugmaker $BIIB secured US approval for Spinraza for use in the often fatal genetic disease in 2016. The approval covered a broad range of patients with infantile-onset (most likely to develop Type 1) SMA. 

Jason Kelly. Mike Blake/Reuters via Adobe

Eye­ing big ther­a­peu­tic push, Gink­go bags $290M to build a cell pro­gram­ming em­pire

Ginkgo Bioworks is on a roll. Days after publicizing a plan to nurture new startups via partnerships with accelerators Y Combinator and Petri, the Boston biotech says it has raised another $290 million for its cell programming platform to reach further and wider.

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UP­DAT­ED: Speak­er Nan­cy Pelosi to un­veil bill for fed­er­al­ly ne­go­ti­at­ed drug prices

After months of buzz from both sides of the aisle, Speaker Nancy Pelosi will today introduce her plan to allow the federal government to negotiate prices for 250 prescription drugs, setting up a showdown with a pharmaceutical industry working overtime to prevent it.

The need to limit drug prices is a rare point of agreement between President Trump and Democrats, although the president has yet to comment on the proposal and will likely face pressure to back a more conservative option or no bill at all. Republican Senator Chuck Grassley is reportedly lobbying his fellow party members on a more modest proposal he negotiated with Democratic Senator Ron Wyden in July.

David Grainger [file photo]

'Dis­con­nect the bas­tard­s' — one biotech's plan to break can­cer cell­s' uni­fied de­fens­es

Chemotherapy and radiotherapy are the current gladiators of cancer treatment, but they come with well-known limitations and side-effects. The emergence of immunotherapy — a ferocious new titan in oncologist’s toolbox — takes the brakes off the immune system to kill cancer cells with remarkable success in some cases, but the approach is not always effective. What makes certain forms of cancer so resilient? Scientists may have finally pieced together a tantalizing piece of the puzzle, and a new biotech is banking on a new approach to fill the gap.

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