There’s one end­point that the boom­ing bio­phar­ma in­dus­try has failed at mis­er­ably: fi­nan­cial tox­i­c­i­ty

Bioreg­num Opin­ion Col­umn by John Car­roll

One of the big themes in R&D over the past few years has been the on­slaught of spend­ing on de­vel­op­ing new on­col­o­gy drugs. The FDA has en­cour­aged ear­ly ap­provals, open­ing the door to small­er tri­als as an on­slaught of in­vest­ment cash made it pos­si­ble for small play­ers to go the dis­tance.

Big Phar­ma, mean­while, has en­joyed the com­fort of bet­ter sci­en­tif­ic in­sights and the ar­rival of some huge new PD-1s on the scene. Next up: A tsuna­mi of com­bo ther­a­pies com­ing at you from the US, Eu­rope and Chi­na — the new fac­tor in drug hunt­ing.

For the in­dus­try, that means a ma­jor new source of rev­enue from com­ing ther­a­pies. For US pa­tients, that means a much bet­ter shot at longer sur­vival and pos­si­bly even a cure. As well as bank­rupt­cy.

Wait. What?

Re­searchers just pub­lished a new study in The Amer­i­can Jour­nal of Med­i­cine high­light­ing that 42% of can­cer pa­tients ex­haust their sav­ings with­in 2 years of di­ag­no­sis. And 62% of the 9.5 mil­lion can­cer pa­tients they re­viewed were in debt af­ter ther­a­py, with 40% to 85% quit­ting work due to can­cer. Af­ter 4 years of ther­a­py, 38.2% were in­sol­vent.

You hear a lot every time a new drug is ap­proved about what drug com­pa­nies are do­ing to make their ther­a­pies ac­ces­si­ble, but the sim­ple fact is that in the US large per­cent­ages of pa­tients are be­ing crushed by the price of brand­ed drugs. And while the new drugs be­ing in­tro­duced may be more im­por­tant than ever, the un­var­nished truth is that ba­sic pric­ing strate­gies are more about max­i­miz­ing rev­enue than ac­com­mo­dat­ing pa­tients.

The re­sult­ing fi­nan­cial tox­i­c­i­ty is enor­mous.

Let’s re­mem­ber that one of the rea­sons we’re see­ing all the in­vest­ment cash pour­ing in is that Wall Street has em­braced a big wave of biotech IPOs. And that’s where ex­ecs are fo­cused when they price new drugs.

That’s not a wild guess, ei­ther.

This is the bot­tom line re­searchers tot­ted up af­ter dis­cussing pric­ing strate­gies on new drugs for mul­ti­ple scle­ro­sis with 4 biotech ex­ecs, pub­lished in Neu­rol­o­gy this week.

Par­tic­i­pants con­sis­tent­ly stat­ed that ini­tial price de­ci­sions were dic­tat­ed by the price of ex­ist­ing com­peti­tors in the mar­ket. Rev­enue max­i­miza­tion and cor­po­rate growth were dri­vers of price es­ca­la­tions in the ab­sence of con­tin­ued mar­ket pen­e­tra­tion. Low­er rev­enue pre­dic­tions out­side the Unit­ed States al­so in­formed pric­ing strate­gies. The grow­ing com­plex­i­ty and clout of drug dis­tri­b­u­tion and sup­ply chan­nels were al­so cit­ed as con­tribut­ing fac­tors. Al­though de­ci­sions to raise prices were mo­ti­vat­ed by the need to at­tract in­vest­ment for fu­ture in­no­va­tion, re­coup­ing drug-spe­cif­ic re­search and de­vel­op­ment costs as a jus­ti­fi­ca­tion was not strong­ly en­dorsed as hav­ing a sig­nif­i­cant in­flu­ence on pric­ing de­ci­sions.

So while the in­dus­try likes to talk a lot about the pric­ing lev­els need­ed to back in­no­va­tion, it’s just not an ac­cu­rate re­flec­tion of re­al­i­ty.

In just a few weeks, we’re go­ing to wake up to a new year that will be dom­i­nat­ed by drug pric­ing dis­cus­sions. We’re go­ing to be do­ing some of this our­selves at JP Mor­gan.

The in­dus­try still has a shot at com­ing up with some kind of work­able re­form on drug prices. Bar­ring a mar­ket so­lu­tion, though, you can ex­pect plen­ty of un­work­able and de­struc­tive sug­ges­tions on drug im­por­ta­tion and com­pul­so­ry li­cens­ing and more. And some­day, law­mak­ers will do some­thing about it.

Late Fri­day ap­proval; Trio of biotechs wind down; Stem cell pi­o­neer finds new fron­tier; Biotech icon to re­tire; and more

Welcome back to Endpoints Weekly, your review of the week’s top biopharma headlines. Want this in your inbox every Saturday morning? Current Endpoints readers can visit their reader profile to add Endpoints Weekly. New to Endpoints? Sign up here.

I hope your weekend is off to a nice start, wherever you are reading this email. As for me, I’m trying to catch the tail of the Lunar New Year festivities.

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Pfiz­er lays off em­ploy­ees at Cal­i­for­nia and Con­necti­cut sites

Pfizer has laid off employees at its La Jolla, CA, and Groton, CT sites, according to multiple LinkedIn posts from former employees.

The Big Pharma confirmed to Endpoints News it has let go of some employees, but a spokesperson declined to specify how many workers were impacted and the exact locations affected. Earlier this month, the drug developer had confirmed to Endpoints it was sharpening its focus and doing away with some early research on areas such as rare disease, oncology and gene therapies.

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Jake Van Naarden, Loxo@Lilly CEO

Lil­ly en­ters ripe BTK field with quick FDA nod in man­tle cell lym­phoma

Eli Lilly has succeeded in its attempt to get the first non-covalent version of Bruton’s tyrosine kinase, or BTK, inhibitors to market, pushing it past rival Merck.

The FDA gave an accelerated nod to Lilly’s daily oral med, to be sold as Jaypirca, for patients with relapsed or refractory mantle cell lymphoma.

The agency’s green light, disclosed by the Indianapolis Big Pharma on Friday afternoon, catapults Lilly into a field dominated by covalent BTK inhibitors, which includes AbbVie and Johnson & Johnson’s Imbruvica, AstraZeneca’s Calquence and BeiGene’s Brukinsa.

No­var­tis' ap­proved sick­le cell dis­ease drug fails to beat place­bo in PhI­II

Novartis’ sickle cell drug, approved in 2019 and branded as Adakveo, has failed an ongoing Phase III, according to preliminary results.

The Swiss pharma giant unveiled early data from the ongoing STAND Phase III study on Friday, saying that crizanlizumab showed no statistically significant difference between the drug at two different dose levels compared to placebo in annualized rates of vaso-occlusive crises that lead to a healthcare visit over the first year since being randomized into the trial.

Filip Dubovsky, Novavax CMO

No­vavax gets ready to take an­oth­er shot at Covid vac­cine mar­ket with next sea­son plans

While mRNA took center stage at yesterday’s FDA vaccine advisory committee meeting, Novavax announced its plans to deliver an updated protein-based vaccine based on new guidance.

Vaccines and Related Biological Products Advisory Committee (VRBPAC) members voted unanimously in favor of “harmonizing” Covid vaccine compositions, meaning all future vaccine recipients would receive a bivalent vaccine, regardless of whether they’ve gotten their primary series.

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FDA ap­proves an­oth­er in­di­ca­tion for Keytru­da, this time in the ad­ju­vant NSCLC set­ting

Merck’s blockbuster cancer treatment Keytruda has been handed another indication by the FDA.

The US regulator announced on Thursday that it has approved Keytruda to serve as an adjuvant treatment for non-small cell lung cancer (NSCLC), which is its fifth indication in NSCLC and 34th indication overall.

According to a Merck release, the approval is based on data from a Phase III trial, dubbed Keynote-091, which measured disease-free survival in patients who received chemotherapy following surgery. The data from Merck displayed that Keytruda cut down on the risk of disease recurrence or death by 27% versus placebo.

Ying Huang, Legend CEO

J&J, Leg­end say Carvyk­ti beat stan­dard ther­a­py in ear­li­er-line blood can­cer

J&J and Legend Biotech’s next step in turning their CAR-T therapy Carvykti into a potential megablockbuster has succeeded, the companies said Friday.

Carvykti achieved the primary endpoint — progression-free survival — in an open-label Phase III study testing the treatment in second- to fourth-line multiple myeloma patients. The CARTITUDE-4 trial, for which there aren’t any hard data yet, represents the biggest development for Carvykti’s ability to compete with Bristol Myers Squibb’s Abecma since its approval last February.

Dutch biotech starts liq­ui­da­tion af­ter end­ing PhI­II in GVHD

A 13-year-old Dutch biotech is going through a liquidation process after an unexpected end to its Phase III trial testing whether its combination of two monoclonal antibodies was superior to Incyte’s Jakafi.

Xenikos had hoped to prove its investigational therapy, named T-Guard, was better than Jakafi at garnering a complete response in patients experiencing life-threatening complications in which new cells from a hematopoietic stem cell transplant begin to fight the body. Jakafi was approved for the indication, steroid-refractory acute graft-versus-host disease, in May 2019.

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Eliot Forster, F-star CEO (Rachel Kiki for Endpoints News)

F-star gets down to the wire with $161M sale to Chi­nese buy­er as na­tion­al se­cu­ri­ty con­cerns linger

With the clock ticking on F-star Therapeutics’ takeover by a Chinese buyer, the companies are still scrambling to remove a hold on the deal from the US government’s Committee on Foreign Investment in the United States.

F-star and invoX Pharma said they are “actively negotiating” with CFIUS “about the terms of a mitigation agreement to address CFIUS’s concerns regarding potential national security risks posed by the transaction.”

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