Battling the consequences of price controls at high altitude
As a pioneering PDAB takes its first baby steps in Colorado, we’re getting the impression that we’re watching the rules being made up as it goes along. Fortunately, we’re also witnessing the power of organized and impassioned patient advocacy to slow, reverse, and maybe someday reshape misinformed public policy.
Talking Trash 2: Getting Scrappy
Let’s dig into some of the most recycled materials in the world – metals – and how we might make metals recycling even better. We are obsessed with metals because they are critical materials to human civilization and well-being, which is why improved scrap metal recovery is good for the economy, good for the environment, and good for people – exactly the kind of win-win-wins we live for at Planetary Health.
US biosecurity starts at home, with insurance reform aimed at making innovation affordable
Congress has set its sights on China’s biotechnology industry and the US’s reliance on it. Legislators are worried about the Chinese Communist Party’s access to Americans’ genetic data and US taxpayer funds helping bolster CCP-affiliated companies and are proposing to sever ties between any federally funded work and Chinese “companies of concern,” which include BGI and Wuxi AppTech.
Talking Trash 1: Why Sortation Matters
Let’s talk about something everyone produces but nobody really likes – trash. People produce billions of tons of waste annually. While there are many ways to reduce the amount of waste we produce, it is not possible to stop it entirely. Waste is, quite literally, inevitable. The disorder (entropy) in the universe increases with time, which just means that things will always break and there will always be some amount of waste. Once our things become our trash, we have two options: we can dispose of them or we can try to reclaim them as a resource. From a planetary health perspective, there are a lot of reasons to want to reclaim wastes as resources. Unfortunately, it is not easy to do so economically.
Egypt and hepatitis C cures — the gift that keeps on giving
In covering how Egypt managed to eradicate hepatitis C, the New York Times rewrites a key bit of history that betrays its misunderstanding of global drug pricing. Egypt’s access to the life-saving Harvoni was a gift from Gilead, not a result of a bare knuckle negotiation. It’s important to understand and explain the increasingly vulnerable system that underpins that gift before bad policy dismantles it.
Can the European scorpion hold its sting?
European central planners should stop trying to talk the US out of incentivizing the development of better medicines that then also help Europeans and the rest of the world. It’s one thing to argue that any one country can’t afford to pay more for new drugs. It’s another thing entirely to put new drugs in jeopardy for everybody by exporting that thinking to the one country whose market-based system has underpinned the last several decades of pharmaceutical advances.
Want lower obesity drug costs? Medicare holds the key
Medicare coverage of anti-obesity medicines would boost competition due to an expanded market, more investors in search of better drugs, and more competitors. This would result in a true weight-loss revolution that can save lives and dramatically drive down the cost of these drugs.
Post-launch, pre-cliff: The R&D Congress ignores
Often, a drug’s initial approval only hints at its full therapeutic potential and the eventual number of patients who may benefit over time. Continued R&D investment can unlock much more utility before the drug ultimately goes generic, but those investments require adequate incentives.
Do we value curbing carbon emissions more than curing cancer?
It may surprise you to find out just how badly we’re failing to take a comprehensive approach to quantifying societal value from new innovations in medicine. The IRA’s investment in our climate future should be lauded; its treatment of medical innovation is unfortunately hobbled by its goal of lowering Medicare spending today at the expense of tomorrow’s patients – that is to say, all of us.
Toxic math: a British export that the US mustn’t import
It’s long been assumed that as long as NICE-like cost-effectiveness analyses stay on the other side of the ocean, our US biotech ecosystem will be fine. But in recent years, toxic math has begun to make its way to US soil. Peter Kolchinsky sat down with Jayson Dallas to get his take on NICE’s tactics, their increasingly global reach, and how biopharma can fight back.
Why fixing the IRA matters to all of us
The treatment of NDA-path drugs in the Inflation Reduction Act materially degrades the investment case for these treatments in age-related diseases and thus jeopardizes future biotechnology progress and the health of America’s seniors.
Act now to prevent SVB’s failure from becoming a national crisis
The federal government must address the failure of Silicon Valley Bank (SVB) with speed and clarity before it metastasizes into a national crisis, so the ecosystem of institutions in which SVB has operated, including other banks and investors, can help bridge companies so that they can continue to operate while they wait for their deposits.
What you were reading - RApport’s 2022 Top Ten
Our year-end wrap of the site’s most popular articles of 2022 reflects a challenging year for the biotech sector, featuring tumultuous markets and the shifting drug pricing policy landscape. But those pieces also reflect the ingenuity, hopefulness, and opportunity that is inherent in drug discovery and development.
Getting animated about GCEA
Traditional cost-effectiveness analyses done by organizations like ICER and NICE overlook much of the value of new drugs, including factors with crucial societal impact like genericization, risk reduction, and community spillover. Peer-reviewed research has made this clear again and again, but these organizations continue to insist on using outdated formulas to determine the value of drugs. With the passage of the IRA and imminent drug pricing “negotiations” (read: price controls), it’s more important than ever to get the math that values our medicines right.
Alnylam is doing what the IRA is telling it to do
The recent announcement by Alnylam Pharmaceuticals that it was holding off on a planned Phase 3 pivotal study for vutrisiran (marketed as Amvuttra in its sole approved indication so far, hATTR amyloidosis with polyneuropathy) in Stargardt disease illustrates how the Inflation Reduction Act is already having a negative impact on small molecule and orphan drug R&D prioritization. Alnylam’s announcement also brought out skeptics of the biotech industry, who argue the new law is being scapegoated by innovators who want to overturn its Medicare drug-negotiation provisions.
Saving money for Medicare by abandoning new drugs for Medicare patients
As the founder of two biotech companies in Arizona that are currently fundraising to support drug development, it’s clear to me that the Inflation Reduction Act will steer me away from developing cancer drugs for older Americans. This is a problem that can be fixed.
Navigating a storm that threatens American biotechnology
Over the past four decades, David Beier has observed and participated in the evolution of the US biotechnology industry for several key vantage points. The industry’s success and freedom to innovate, he says, has been underpinned by – and helped create – a marketplace that was open enough to fully reward risk-taking investors devoting capital to cutting edge science. Today, that success faces new threats.
The NIH, R&D, and the first mile of the marathon - a conversation with John LaMattina
A conversation with former Pfizer research head John LaMattina about the persistence of the misperception that NIH invents the drugs that biopharma companies sell, the chance encounters that can lead to breakthroughs years or even decades later, and the tough math facing investors and heads of research across the industry when deciding whether to invest in a project that’ll only enjoy nine years of market exclusivity.
When life-saving medication should be in aisle three
We talk a lot about access to care and the hurdles that might keep people from getting the medicine they need. Usually, we’re talking about the price of healthcare or the inanity of insurance requirements. But other hurdles hide in plain sight, as is the case with naloxone (Narcan), birth control, and other drugs that could (and should) be available over-the-counter (OTC).
Innovation and biopharma M&A: feature, not bug
If the FTC begins to look askance at M&A between commercial-stage biopharmaceutical companies and the innovative smaller biotechs that so often are the sources of new medicines, that would be bad news for future R&D and the patients who depend on our industry for life-saving medicines. That they might do so in the name of preserving or protecting innovation in the first place would add insult to injury.