LifeScienceTrends 2011
Transcription
LifeScienceTrends 2011
Life Science Trends 2011 Alexander, D., Pucci, A., Smith, M., Bloomfield, K. 1 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Table of Contents Introduction ……………………………………………………………………………………………….………..…Page 3 About the Authors ………………………………………………………………………………………………......Page 4 Research and Innovation ……………………………………………………………………………………….Pages 5-7 miRNA Page 5 Scientists Slay Superbugs…With Light Page 5 New Drug Produces Steep Drops in Bad Cholesterol Page 6 Top 5 Game-Changing Drug Delivery Technologies Page 6 Nanomedicine Page 6 Free DNA Testing for Everyone? Page 7 Liquid Biopsy Page 7 Advances in Regenerative Medicine Page 7 Fundamental Trends…………………………………………………………………………………………..…Pages 8–11 Outlook for Biopharma Industry Optimistic Page 8 Targeted Therapies for Genetic Disorders Page 8 Global Health Spotlight Turns to Chronic Disease Page 8 Genomic Era Medicine is back “In Vogue” Page 9 Increased Biologics Market Share Page 9 Massive Growth in Indian Markets Page 10 Alliance Management Page 10 Focus on Early-Phase Development to Decrease the Failure Rate Page 10 On Clean-Tech/Biotech Trends in 2011 Page 11 Return to Innovative Platform Technologies Page 11 Technology as a Game Changer Page 11 Investing and Deal-Making ……………………………………………………………………………………Pages 12–14 Venture Capital Outlook in 2011 Page 12 Venture Funding Page 12 Is Together Better? Page 13 Companies with the Biggest Cash Reserves Page 13 Possible Future Mergers and Acquisitions Page 14 Patent Expirations on the Horizon Page 14 Biotech Industry Cautiously Brings IPOs Back Page 14 Regulatory and Government ………………………………………………………………………………….Pages 15–18 Qualifying Drug-Development Tools: the FDA Weighs In Page 15 The FDA Encourages Companies to Combine Efforts and Drugs Page 15 Biosimilars in 2011: Pathway to the Future or Road to Nowhere? Page 15 What Impact Will the US Mid-Term Elections Have on Big Pharma Page 16 Impact of Health Care Reform Package Less Severe than Feared Page 16 New Drug Approvals Slipped in 2010 Page 17 Drugs Restricted & Pulled off the Market Page 17 Drug and Device Safety Page 17 The 510(k) Process Page 18 Innovation Pathway Page 18 Health Care …………………………………………………………………………………………………….…….Pages 19–20 Extreme Makeover for Health Care in 2011? Page 19 Health Care Trends for 2011: Outlook Brighter Despite Reform Hurdles Page 19 Comparative Effectiveness Page 20 E&Y: Moving Forward Companies Speak Out on Health Care Reform Page 20 Social Media Page 20 Pfizer Establishes CTI: An Interview with Dr. Anthony Coyle …………………….…………..…Pages 21-22 2 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Introduction About this Report Each year, Carlyle & Conlan provides an overview of trends and innovations in the life science industry, encompassing its drugs, biologics, devices and diagnostics sectors. Utilizing a number of in-depth, premium research reports available in the industry, Carlyle & Conlan’s Life Science Trends summarizes and presents a variety of the most up-to-date industry news under several macro headers: Research and Innovation, Fundamental Trends, Investing and Deal Making, Regulatory & Government, and Health Care. The result is a meaningful, “quick-read” newsletter into which our clients, partners and constituents can dig deeper based on their individual interests. Life Science Trends 2011 captures significant advances in the industry from the past year and makes observations about developments of interest through the year ahead. Of central importance is the understanding that trends do not necessarily change on a yearly basis. For instance, the field of personalized medicine is expected to continue as a trend well into the foreseeable future. Our report may differ from others in that an early version is sent to CEOs, venture capitalists, and other industry experts for review before its final release. This report was created using both primary and secondary data. Secondary data is highlighted with associated links to further information, as available in the public domain or credited to the appropriate source. We invite you to review the information contained in this report, which we trust you will find interesting and relevant to the sector. About Carlyle & Conlan Carlyle & Conlan, headquartered in the Research Triangle Park, is an executive and professional search firm focused on the technology and life science sectors. With a highly dedicated, experienced, and professional team of specialists, we work with small, mid-sized and large companies to secure their most important asset, human capital. Our placement focus is on highly experienced individual contributors through C-level search in a variety of functional position types throughout North America. More information about Carlyle & Conlan can be found at: http://www.ccesearch.com. 3 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved About the Authors Anastasia Pucci, Senior Partner Anastasia is a founding partner of Carlyle & Conlan and currently serves as Carlyle & Conlan’s Senior Partner. Anastasia has fourteen years of experience in Executive Search and Recruitment, with special emphasis on Clinical Development in the field of Life Sciences. Anastasia began her career in Canada, working with one of the country’s largest search and consulting firms. Early in her tenure she was recruited to open the company’s first U.S. office in Raleigh, NC. For four and a half years, Anastasia was instrumental in growing their local office into a multi-million dollar business. Her contributions included building a diverse network of clients from many major corporations, including Nortel Networks, IBM, and GlaxoSmithKline, to a group of “skills-on-demand” emerging growth companies. She consistently ranked as the # 1 U.S. Search Consultant within the firm and Top 5 globally. Since co-founding Carlyle & Conlan ten years ago, Anastasia has been personally involved in launching each specialty practice area, recruiting the best and brightest Search Consultants to join Carlyle & Conlan’s team and continuously developing and enhancing Carlyle & Conlan’s strategic approach to executive and professional search. Anastasia is also very active in the local community serving on the Board of the Council for Entrepreneurial Development, CED’s Executive Committee, and chairing CED’s Human Resources Committee. In 2008 she was named one of Business Leader’s Movers and Shakers and a Top 25 Human Resources Impact Player. Anastasia is a graduate of Queens University, Kingston, Ontario, Canada, having spent her formative years in England and South Africa. Her passions include her family and her business, and her hobbies include scuba diving and occasional rounds of golf. Don Alexander, Vice President of Life Sciences Development and Commercialization With over a decade of executive search industry experience, Don has spent the last several years focusing on executive search with a concentration on local and national search projects for mid to senior level professionals in the Life Sciences. His searches have involved senior level individual contributors through C-level executives, with particular emphasis on sales, business development, marketing, product development, project management and pre-clinical R&D. In addition, Don has prior experience recruiting in Technology and Engineering. An enabler of relationships that have resulted in quantifiable goodwill for his constituency, Don is recognized by his clients, candidates and peers as routinely creating value through a powerful network and deep industry knowledge. Throughout his recruiting career, Don has consistently finished in the top quartile of his peer group. Prior to the recruiting industry, Don spent several years in the financial services industry and managed several million dollars in assets. He holds the designations of CFP® and AAMS® and a BA in Business Management and Economics from North Carolina State University. 4 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Image: yaghi.chem.ucla.edu Research and Innovation miRNA “We are entering the era of RNA therapeutics. Just as small molecules led to the pharmaceutical industry in the late 1950s and 1960s, and recombinant DNA technology formed the biotech industry, followed by the monoclonal antibodies revolution, we are now embarking on the era of RNA therapeutics. This includes siRNAs, antisense, aptamers, and microRNA therapeutics. Isis will likely file an NDA in 2011 for Mipomersen, its RNA medicine for treatment of high cholesterol that will open the floodgates for several other innovative RNA drugs in clinical development.” The total market for RNAi component technologies is projected to be around $12 billion by 2015 with about $10.5 billion in therapeutic products. In 2010, Sanofi Aventis announced a partnership with Regulus Therapeutics that targets fibrosis with a $10M equity investment and a potential deal value of $750M. Although the future of miRNAi technology is appealing, drug development challenges confronting miRNA technology include clinical testing and delivery mechanisms. Sources: Regulus, Seeking Alpha, San Diego Magazine - Kleanthis Xanthopoulos, The Crystal Ball As a single miRNA can regulate entire networks of genes, these molecules are considered the master regulators of the genome. By affecting gene regulation, miRNAs have been shown to play an integral role in most biological processes including the immune response, cell-cycle control, metabolism, viral replication, stem cell differentiation and human development. Most miRNAs are conserved across multiple species indicating the evolutionary importance of these molecules as modulators of critical biological pathways. Aberrant expression of miRNAs has been implicated in many disease states, including cancer, heart failure and viral infections. Source: Regulus One of the more exciting scientific discoveries in the last decade is the discovery of microRNA in humans. MicroRNAs (miRNAs) are short ribonucleic acid (RNA) molecules, on average only 22 nucleotides long, that do not encode proteins but, instead, regulate gene expression. miRNAs are post-transcriptional regulators that bind to complementary sequences on target messenger RNA transcripts (mRNAs), usually resulting in translational repression and gene silencing. The human genome may encode over 1000 miRNAs of which around 700 miRNAs have been identified. More than one-third of all human genes are believed to be regulated by miRNAs. Scientists Slay Superbugs…With Light Scientists have shed light on a new way to kill hospital superbugs like MRSA: literally shed light on them. A set of wavelengths called HINS-light acts by stimulating molecules in the bacteria, causing them to create chemicals that kill the germs. In trials, the process appears far more effective than “cleaning and disinfection,” the Daily Mail reports. “The technology kills pathogens but is harmless to patients and staff, which means for the first time, hospitals can continuously disinfect wards and isolation rooms,” said an expert. The system uses violet-colored light, but researchers have also developed a white version appropriate for hospitals. Scientists call the idea, developed by Glasgow researchers, a “huge step forward.” Source: Newser 5 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved New Drug Produces Steep Drop in Bad Cholesterol Top 5 Game-Changing Drug Delivery Technologies An experimental drug boosted good cholesterol so high and dropped bad cholesterol so low in a study that doctors renewed hopes for an entirely new way of preventing heart attacks and strokes. Dr. Christopher Cannon of Brigham and Women's Hospital in Boston led the study of the novel drug for Merck & Co. It is not enough to invent a potential new miracle drug. If there is no efficient way to get the therapeutic to exactly where it is needed, without harming healthy cells, then the drug is no "miracle" at all. If the drug produces so many unpleasant side effects that patient compliance becomes an issue, development is far from over. This remains true not only with drugs that are in development, but even those that are already on the market. The drug, anacetrapib, will not be on the market anytime soon. It needs more testing to see if its dramatic effects on cholesterol will translate into fewer heart attacks, strokes and deaths. Merck announced a 30,000-patient study to answer that question. Anacetrapib would be the first drug of its kind. It helps keep fat particles attached to HDL, which carries them in the bloodstream to the liver to be disposed of. Merck says it is way too soon to estimate how much the drug would cost, but analysts say such a medication could mean billions for its maker. The Merck-sponsored study tested anacetrapib in 1,623 people already taking statins because they are at higher-than-usual risk of a heart attack. An LDL of 100 to 129 is considered good for healthy people, but patients like these should aim for under 100 or even under 70, guidelines say. For HDL, 40 to 59 is acceptable. After six months in the study, LDL scores fell from 81 to 45 in those on anacetrapib, and from 82 to 77 in those given dummy pills. HDL rose from 41 to a whopping 101 in the drug group, and from 40 to 46 in those on dummy pills. Such large changes have never been seen before, doctors say, and these improvements persisted for at least another year that the study went on. What new delivery methods bring to the table are not only unique ways to continue innovating even after the therapeutic goes off patent, but the ability to give relief to patients who may be suffering from drug side effects. Drug delivery is about finding new materials that can make the journey without interfering with the drug. One of the major problems facing the pharmaceutical industry today is the poor solubility of drugs. So, drugmakers tack on compounds to make it more soluble. Unfortunately, patients read about the side-effects of those soluble compounds in the "fine print" that drug companies are forced to include in their commercials. The challenge is to find materials that make those side effects disappear. The drug delivery industry is not only alive and well, but could be booming in the near future. The top five technologies catching drug makers' attention are. 1. Oral thin films 2. Microneedles 3. Extended release for addiction 4. Aerosol 5. Liposomes Source: Fierce Drug Delivery The Merck study was too small to tell whether anacetrapib lowered deaths, heart attacks or other heart problems. But the trend was in the right direction, with fewer of those cases among patients on the drug. The anacetrapib group also needed significantly fewer procedures to fix clogged arteries. Importantly, there were no signs of the blood pressure problems that led Pfizer Inc. to walk away from an $800 million investment in torcetrapib, a similar drug it was developing four years ago. Nanomedicine incorporates platform technologies for gene therapy, molecular imaging, drug delivery, and access to or mediation of groups of molecules or single molecules. In contrast to atoms and macroscopic materials, nano materials have a higher ratio of surface area to volume as well as tunable optical, electronic, magnetic, and biological properties. They can be engineered to have different sizes, shapes, structures and chemical compositions and surface characteristics. The advantages of nano materials are being incorporated into new technologies such as drug delivery vehicles, contrast agents, and diagnostic devices. Some of these new technologies are currently undergoing clinical trials or have been approved by the FDA human use. The cancer therapy applications of Nanomedicine are particularly enticing. They include increased ability to audit the presence of cancer cells in a patient's blood, as well as techniques for thermal ablation of solid tumors and delivery of chemotherapeutic agents with extreme precision. Source: Aol News Sources: NEJM and FAQ Archives 6 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Free DNA Testing for Everyone? Over the past 12 months, in scattered cases reported in top medical journals, doctors have done something amazing: They have entered a patient's genetic material into a machine and read out the genetic code embedded in that person's DNA and come up with medically useful information. Reading out a person's genetic code cost $3 billion a decade ago. Now it can be done for less than $10,000. With multiple companies racing to create a cheap solution, it could be a commodity in a decade. The impact, not only for medicine but also for engineering and chemistry, will be huge. Liquid Biopsy Johnson & Johnson and Mass General Hospital recently announced a microchip based blood test that can identify a single cancer cell within a given sample. While the research is still in its early stages, there is great excitement around the ability to isolate specific cancer cells, determine genetic composition and, then, leverage this knowledge to personalize patient monitoring and target specific therapies. The diagnostic might allow for both the early detection of cancer proliferation and greater precision in the development of new therapeutics. Source: CNN, USAToday The price war between Illumina and Life Technologies would alone drive costs down further, and a slew of new companies are emerging. Pacific Biosciences, which uses a powerful laser and optics to sequence in minutes instead of the days that are currently required, has filed for a $200 million public offering. Complete Genomics, which uses a technology that scales up to be cheap when large volumes of DNA are decoded at once, has set up a sequencing operation that drug companies such as Eli Lilly and Pfizer are using. Complete has filed for an $86 million IPO. Life Technologies recently spent $375 million to purchase Ion Torrent, which makes gene sequencers that have another advantage. Most human genomes are sequenced on machines that cost $700,000 or more apiece; the Ion Torrent machine, which uses a semiconductor process, is likely to cost less than $100,000 -- cheap enough for a doctor to have one in the office. These prices might still sound expensive, but one startup recently forecast that its technology might sequence a human genome for $30. Such estimates tend to rise once investors start sinking in money, but at that price the information is close to free. But if the cost of getting DNA code drops precipitously, what will be the business model of companies that create new DNA decoding or analyzing technology? Will patients pay for their sequence? Or will they own a copy of their code, but need to pay to access the algorithms that will make sense of it, or link it to new discoveries? That's the big question for scientists, entrepreneurs and everyone. Image Source: MSNBC Illumina, the market leader in selling DNA-sequencing machines, will sell consumers their own genetic code for $9,500, if they might benefit medically from the discovery. Life Technologies, Illumina's biggest competitor, has started a network of cancer research centers on a project to figure out how to use DNA sequencing in treating patients. This image shows the uniform blood flow through the device. The blood test is so sensitive that it can spot a single cancer cell lurking among a billion healthy ones. Source: MSNBC Advances in Regenerative Medicine Induced Pluripotent Stem Cells (iPSCs) have the ability to take ordinary human cells and transform them, like embryonic stem cells, into other cell types found within the body. A new method to reprogram ordinary human cells into stem cells, using RNAs, appears safer and more efficient than current methods involving viral vectors. This reprogramming can much more readily transform stem cells into specialized cells to treat disease. The current approach for making iPSCs is to use viruses to deliver genes that “reprogram” ordinary human cells into stem cells. This formula is both inefficient and it poses a risk for cancer. Moreover, turning IPs cells into different kinds of cells to combat disease has proven even more challenging. The lab of Dr. Derrick Rossi, at Children’s Hospital Boston, reports a new method that might overcome these obstacles. Instead of genes, it puts mRNAs in the cells that directly instruct them to make the reprogramming proteins. Unlike inserted genes, these RNAs have a shorter shelf life and don’t become part of the cell’s genome so the risk of cancer should be reduced. In addition, they are up to 100% more efficient in reprogramming cells. Sources: Harvard Medical School and YouTube Source: Forbes 7 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Image: Harrisonhayes.com Fundamental Trends Outlook for Biopharma Industry Optimistic Although 2010 was a better year for the biopharmaceutical industry than 2009, over the past two years the industry has lost nearly 100 public companies, and tens of thousands of employees. But reason for optimism exists: There was a year-over-year increase in IPOs, as well as a steady stream of venture capital funding. Biopharma supported passage of the health care reform law, which includes a provision for the creation of a regulatory pathway for biosimilars and the Therapeutic Discovery Project Program. The FDA concluded its hearings on AquaBounty Technologies’ biotech salmon meant for human consumption, which if approved would be the first food product from a genetically engineered animal. An FDA analysis of the product found that it was as safe for humans and the environment as its natural counterpart. Industrial and environmental biotech companies are closely watching the legislative debate surrounding investment for alternative fuels. Aside from ethanol subsidies, these firms are hoping for an extension of the infrastructure credit for alternative fuels and want Congress to broaden the scope of the producer’s credit for cellulosic-ethanol to include algae and other emerging feedstocks. Source: Biotechnology Industry Organization “Targeted Therapies for Genetic Disorders. For years, illnesses such as cystic fibrosis were treated primarily by symptomatic therapies. Symptomatic treatments have been responsible for dramatic increases in survival of affected patients, but are not disease modifying. Now we appear to be moving in the direction of therapies that attack such diseases at their root cause(s). It has been a long time coming, but it’s apparent that the distance between the bench and bedside is shrinking.” Source: Ken Kramer, The Crystal Ball Global Health Spotlight Turns to Chronic Disease With donor fund levels sinking, multilateral institutions are finally facing an issue they have avoided for years: prioritizing time, people and resources to tackle a few health challenges rather than many. The UN Millennium Development Goals are widely viewed as a failure in terms of creating the necessary framework to define roles and channel program implementation around agreed outcomes. The solution is supposedly to be found in building a new global, multi-party initiative to treat and cure non-communicable diseases, which are the leading cause of mortality and morbidity in most countries. The UN is hosting a conference on noncommunicable diseases to be attended by heads of state, finance and health ministers from 190 countries. The extent of industry involvement is still unclear, but the conference is likely to represent a lost opportunity for cooperation with Big Pharma since the developing country bloc is insisting that the focus of discussion be on access, technology transfer and IP issues rather than on science and the development of new treatments. The impasse is reflective of a much larger problem affecting the global health community: poor governance. Recent reports have documented extensive overlap in activities, the disruptive impact of a spike in AIDS program funding on other health care interventions, corruption in the distribution of resources, and the negative impact of foreign assistance on development and economic growth in poor countries. Look for a slow but growing movement by outsiders to reform these large institutional stakeholders – or defund them. NGOs like the Gates Foundation are already filling the space with resources that far exceed the pinched coffers of governments. Source: Pharmexec.com 8 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Image Source: NY Times Genomic Era Medicine is back “In Vogue” After a decade, the initial excitement generated by the human genome project and subsequent unsatisfactory results, the promise of actual products attributed to genomic era research is starting to pay off. It is expected that Benlysta, the first new therapy for Lupus in 50 years, will be approved in 2011. If approved, the therapy may represent both a big win for patients suffering from this lethal disease and the makers of the therapy, Human Genome Sciences and GlaxoSmithKline, with sales estimates of between $1.5B and $2B, annually. According to a recent Quintiles white paper, “As genetic predispositions for disease and drug response are increasingly identified and validated, and as biomarker development matures, leveraging these technologies becomes essential. This will enable a more informed approach to compound development and a shift in clinical development strategy to more aggressive, but ultimately less costly, proof-of-concept evaluation of NME’s and NBE’s. When applied during earlier phase studies, this paradigm will begin to yield even greater efficiencies and lower costs throughout the industry.” Simply put, drug development costs should begin to fall with the coupling of genomic era research and advanced informatics platforms. Sources: NY Times and Quintiles Increased Biologics Market Share. “With the decline we are seeing in R&D productivity, and a disproportionally higher success rate for biological vs. small molecules, many companies are growing their biologics capability, either organically or through acquisition. The increased success rate for biologics is due in part to their high target specificity and ability to successfully modulate targets in areas of high unmet medical need. Although small molecules continue to be the majority of new products launched, by 2015 eight of the top 10 selling drugs will be biologics and the landscape will become even more interesting with the launch of biosimilars. Many of the top biologics are reaching the end of their patent exclusivity in the next few years, so we anticipate the future will see many of the large pharmaceutical companies entering into the generic biologics market. Mega pharma players, such as Merck, Pfizer, and Lilly with recombinant facilities will learn from their generic sector mistakes and be early participants in the biosimilar space. Targeting disease categories that require patient support, physician understanding, and clinical validation and reimbursement management, they will focus on therapeutic sectors that play to their structural strengths. Even minimal competition will reduce cost for these high-ticket medications by 20% to 25%. Down the line they will enter the high-risk clinical effort around biobetters.” Source: Gil Bashe & -John Arrowsmith, The Crystal Ball 9 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Alliance Management Between 2011 and 2016, pharmaceutical global patents will expire on 18 of the world's 20 biggest medicines, and generics will take over the past bonanza. Higher R & D costs coupled with a relatively dry pipeline for new drugs and the ever-increasing pressure from payers and providers for reduced health care costs are putting pressure on the pharmaceutical companies, big and small, to look beyond established markets in the US, Europe and Japan. This means that the center of gravity in the pharmaceutical industry is shifting to Asia, particularly to India: All sizes of biopharm organizations are looking to trim costs, expand pipelines, execute co-commercialization alliances and fund ongoing research via transformational partnerships. According to David Luvison, a professor at the Keller Graduate School of Management at DeVry University, companies in the biopharm and other sectors are “changing the buyer / seller / customer mind set to one of shared risk and reward”. Image: koausa.org Massive Growth in Indian Markets North American drug sales will grow only at 1.4 % while Indian drug sales are projected to rise from $19 billion in 2009 to $50 billion by 2020 – an increase of 163% in 11 years. India’s large domestic market coupled with its mature manufacturing prowess in generics with the most approved GMP compliant sites outside the US gives it a big advantage – although outsourcing Western quality is not an easy feat. A new Indian patent regime provides better protection of intellectual property rights, although some issues remain. It also means companies need to be more innovative, rather than relying solely on reverse engineering existing formulations. Source: FDA Smart In a strategic report, “Alliance Culture : It’s in the DNA”, Luvison and his colleagues research the importance of alliance cultures and why some companies have more successful outcomes with alliance management than others. “For the larger part of the twentieth century… external organizations were seen as customers, suppliers, or competitors, but not as partners. With that also came a set of norms, values and behaviors that directed managers to optimize their businesses internally, keep knowledge and information in-house and see other organizations as external entities to sell to, buy from, or compete against. With the change towards the network economy, alliances have become increasingly important for revenue generation, innovation and cost management. The network has become the firm, and this has required a change in attitudes as well.” The changing nature of the network means an alliance culture becomes more of a “required skill” for management, moving forward. Does an alliance culture lead to success? Statistically comparisons of companies grouped by success rates < 40% and success rates > 60% were examined. The results showed that Norms (e.g. Empathy, Solidarity and Long Term Commitment) and Partner Focus (e.g. Importance, Integration and Respect) were much better developed in the high success group than in the low success group. In fact, 25% of the difference in success rate between the high and low performers can be explained by the fact that these companies have strong alliance norms and a healthy partner focus. Source: Interview with David Luvison Focus on Early-Phase Development to Decrease the Failure Rate For years pharma companies have treated clinical development much as a venture capitalist would treat investments in start-ups, betting that one in ten Phase I starts would results in a launch. In order to increase the number of launches, pharma companies simply invested in more Phase I trials. However, this approach has proven to be a failure in many ways. As a result, pharma companies are focusing more attention on improving study designs in early-phase development to increase the chances of success in the latter stages of development. Additionally, more companies are devoting resources on quality over quantity when it comes to development in the hopes of significantly improving the odds of delivering drugs that are not only first, but best-in-class. Improved study designs, including more creative, cutting-edge approaches and adaptive methods for combining protocols over multiple phases, biomarkers and surrogate endpoints, will become more the norm than the exception. Moreover, patient stratification strategies and improved translational science should provide pharma companies with earlier results regarding drug efficacy. These strategies will lead to cost and time improvements, enhanced trial designs and will allow for the collection of more safety and efficacy data earlier in the development process. 10 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved On Clean-Tech/Biotech Trends in 2011 – An Interview with Codexis CEO Alan Shaw The effect of the midterm election results: Potential legislative gridlock for the next two years will produce a negative atmosphere for new technology development. Specifically, new clean technology as an enabler for green Pharma manufacturing and advanced biofuels, as well as job creation and energy security, will be affected, resulting in a major competitive disadvantage with countries like Brazil and China. Best prospects for clean-tech/biotech funding: Strategic partnerships and the public markets (Codexis was first clean tech US IPO in 2010). R&D challenges, opportunities and trends in 2011: Clean-tech sector will likely be characterized by a global focus on moving to scale. In transportation, advances in biofuels are likely to come from Brazil. Funding for carbon-capture programs will increase. Source: Bio SmartBrief Technology as a Game Changer “The convergence of technological development along with a shortage of physicians, coupled with increasing demand for the services of those physicians – both from a growing and aging population, and from those added to the insurance rolls based on new laws – will force more electronic communication or visits between patient and physician. It will ultimately be the only way to meet the demand, and in some ways may be a more efficient use of the physicians’ and patients’ time. As an example, a morning video chat with your doctor, where you discuss the symptoms that your child has, followed by your doctor emailing you and the pharmacy the relevant prescription, will save you and the doctor critical time and money. Adapting to how patients and physicians utilize technology will be critical for pharmaceutical companies to continue to educate customers about the benefits and risks of their products.” “Increased use of mobile devices will also speed up the dissemination of information. “From basic taking your medication alerts and refill reminds, to more complex compliance programs that have triggers based on vital signs read and interpreted by your mobile device, mobile will change medicine from the physician and patient perspective.” “Hosted systems, Software-as-a-Service (Saas) models, and cloud computing will slowly make their way into the life-sciences, despite data sensitivity concerns. “Software vendors can simply provide a better level of service and more innovative systems using this model, since much of the laborious time spent implementing, testing, and validating these systems can be handled directly by vendors, and once per upgrade cycle versus once per install. This is amplified in regulated environments, where validation and upgrade cycles are far more costly than in other industries.” “The Pew Internet and American Life Project sees the same move to an e-focused pharma environment. Analysts report that 61% of Internet users in the United States are looking online for health care guidance. Of these, 66% are seeking information on a specific disease or condition.” Source: Dr. David Hahn, R.J. Lewis, James Errico, & Chris DeAngelis, The Crystal Ball Return to Innovative Platform Technologies “Platform-based technologies are clearly having a renewed impact, and platform companies will continue to demonstrate significantly higher value in comparison to pharmaceutical companies that are based on a single candidate molecule.” Source: Kleanthis Xanthopoulos, The Crystal Ball 11 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Investing & Deal-Making: Image: ivcapitalpartners.com Venture Capital Outlook in 2011 Venture Funding At a recent American Chemical Society conference, investors were asked their thoughts regarding 2011. While 2010 marked the end of the worst decade for VC investing, when valuations are low, expected returns are high so 2010-2012 may wind up being vintage years for limited partners. Opinions on life science investing in 2011 are split closely in the medical device and biotechnology sectors. 330 VCs are almost equally divided as to whether investment in biotechnology and medical devices will increase, decrease, or stay the same. In early stage biotech, capital is scarce with poor aftermarket returns in comparison to price differentials with existing public companies so future returns are likely to be higher. For the near term, however, the biotech market may continue to struggle. Corporations have record cash balances with a big push to pay dividends. Aside from the public markets, 2011 will continue to see M&A domination as the principal exit pathway. Challenges to the VC industry in 2011 included ensuring bigger returns. The US venture industry may also have too many "me too" funds that will be paired down and, collectively, there is the notion of adding value around the world and too many funds are just too small to do this. What may be needed are fantastic global networks along with small boutiques. Source: ACS Webinars Reflecting increased optimism, 75% percent of all respondents expect venture investment dollar levels to remain the same or increase from 2010 versus 63% in 2009. Of note, 44% of VC’s say the number of investments they will make into new (vs. follow-on) companies will increase. Optimism is also more prevalent across stage of development with 51% of the VCs predicting increases in later-stage investment, 49% in expansion and seed investment, and 46% in earlystage investment. More exits are on the horizon with two-thirds of VCs anticipating more venture-backed companies going public while 81% of VCs expect more acquisitions in 2011. More than half expect IPO and acquisition quality to improve or remain steady in the coming year. Source: Dow Jones Venture Source and National Venture Capital Association Total Venture Capital Investment Dollars (Through Q3 2010) 8 7 6 5 4 2 1 0 Q3 2008 Q4 2008 Q1 2009 Q2 2009 Q3 2009 Q4 2009 Q1 2010 Q2 2010 Q3 2010 Amount Invested ($B) 12 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Source: ACS Webinars 3 Is Together Better? Consolidation: Prudent Business Strategy or Corporate Cannibalism? Due to a slowdown in the drug pipeline and the impact of the federal government’s health care reform package, the PharmBio sector may experience an acceleration of consolidation and M&A activity in 2011. Pfizer’s $68 billion dollar bid for Wyeth gives it access to its rival’s vaccines, consumer health and animal products. The merger creates a massive player in the industry, with more than 15 products with $1 billion each in annual revenue, allowing the company to move away from its dependence on a single blockbuster. According to Steven Silver, biotechnology equity analyst at S&P, the situation of Amgen Inc. (NASDAQ: AMGN) – with a market cap now in excess of $50billion – illustrations the near-term outlook for the industry. He says that Amgen, like many of the big pharmaceutical names, is facing a wave of patent expiration issues in the next few years; also, the health care reform package will require generic versions of existing biotech drugs. When these generic drugs hit the market, large biotech companies will clearly suffer some revenue losses. Companies such as Amgen are keen to make deals in order to reinvigorate their growth profile. With about $14-billion in cash on its balance sheet, Amgen is wellpositioned to make numerous acquisitions, both big and small. Silver indicated that the large-cap biotech space was one of the few sectors that managed to flourish during the dark days of the global financial crisis and recession of 2008 and early 2009. “The large biotech firms like Amgen, Biogen (NASDAQ: BIIB) and some others had enough cash on their books that did not need to access credit markets,” he said. “Contrarily, smaller biotech companies found credit frozen and they found themselves in crisis mode, running out of money. Many cut costs by drastically reducing their workforces. But even for them, the financing environment improved markedly by the middle of 2009, when they found a receptive market for secondary offerings and other financial endeavors.” In addition to increased M&A activity, the PharmBio sector will have to bridge the R&D gap. According to the latest report from PricewaterhouseCoopers, Pharma 2020: Virtual R&D, Which path will you take?, this “innovation deficit” has enormous strategic implications for the industry as a whole: “Pharmaceutical companies need to decide what they want to concentrate on doing and identify the core competencies they will require, a process which may involve exiting form some parts of research and development. “But even those that regard research and development as a core element of their business will have to make fundamental alterations in the way they work. They may, for example, have to focus more heavily on specialty therapies, as well as reducing the time and costs involved in researching and developing such medicines to ensure that society can afford them.” The world needs the pharmaceutical industry. Without the innovative research and development it funds and carries out, many serious diseases would remain untreated. So what’s the answer? It could be what some observers were expecting Jeffrey Kindler to do when he took over the top job at Pfizer in 2006: instead of gorging yourself on your rivals, then going on a ruthless job-cutting purge, try slimming down from within, focusing on your core areas, finding yourself a niche. Build a portfolio of mid-performers – then if you close one drug to a generic competition, it won’t smash a meteor-sized hold in your profits. This will require the supports of regulators and vendors in making the strategic changes necessary to carry the industry forward. As the PWC reports puts it, “If pharma is to remain at the forefront of medical research and continue helping patients to live longer, healthier lives, it must become much more innovative.” “Incremental improvements are no longer enough; the industry will need to make a seismic shift to facilitate further progress in the treatment of disease. It will have to learn much more about how the human body functions at the molecular level and the pathophysiological changes disease causes. This is a huge undertaking – and one that pharma cannot complete alone. It will require the support of academia, governments, technology vendors, health care providers and the regulators.” Easier said than done, perhaps. But in these ruthless times, there may be no other choice. Sources: International Business Times and Next Generation Pharmaceutical Companies With the Biggest Cash Reserves: Novartis Roche Johnson & Johnson Merck & Co. GlaxoSmithKline $15 billion $13.5 billion $13 billion $10 billion $9.5 billion Source: Next Generation Pharmaceutical 13 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Potential Mergers and Acquisitions Johnson & Johnson/Crucell: Crucell would give J&J a vaccine platform. Sanofi-Aventis/Bristol Myers Squibb: If Sanofi and BMS merged, the new company would be number two behind Pfizer/Wyeth. Eli Lilly/Takeda: The two companies have an existing collaboration in the diabetes arena. Johnson & Johnson/Vertex: J&J has a history of deals with Vertex and may want to acquire its pipeline of candidates for cystic fibrosis and rheumatoid arthritis. Bristol Myers Squibb/Amgen: Amgen’s biotech pipeline would boost BMS’s position in the industry. Source: Next Businessweek Generation Pharmaceutical and Bloomberg Patent Expirations on the Horizon S&P Equity Research estimate that by 2013, big pharma drug makers will face patent expiration issues on drugs that currently generate more than $100 billion in sales. Among the high-profile names: Eli Lilly & Co. (NYSE: LLY) will lose its antipsychotic drug Zyprexa next year. Bristol-Myers Squibb Co. (NYSE: BMY) lost its heart attack/stroke treatment drug Plavix in 2010. Pfizer Inc. (NYSE: PFE) lost its huge anticholesterol drug, Lipitor in 2010. Wyeth’s two biggest selling drugs, Effexor for depression and Protonix for heartburn, will lose patent protection in 2010 and 2011. Other companies with patents set to run out on major drugs by 2010 include Ratiopharm, Sandoz, Merck KgaA, Actavis, Apotex, Barr, GSK and Watson. Source: International Business Times Biotech Industry Cautiously Brings IPOs Back After a near absence of initial public offerings for two years, 17 biotech companies launched IPOs in 2010. By comparison, only three IPOs were filed by biotech companies in 2009, and just one in 2008. Some experts say the trend suggests the industry is gradually recovering from the recession. But others note that the main reason some of these businesses are entering the stock market is that venture financing remains elusive. Steven Burrill, CEO of Burrill & Co., a San Franciscobased merchant bank that invests in biotechnology, predicted the number of biotech companies going public in 2011 could hit 25. That would be the most since 2007, when 28 biotech IPOs were filed, but a far cry from 2000, when there were 66. “Although the IPO window was open, investors were more skittish this year about buying into biotech’s newly minted public companies,” noted Burrill. “The 17 new biotech issues that debuted on the U.S. market were plagued by lackluster receptions (selling fewer shares well below the pricing range). Thanks to an improvement in the capital markets in the final quarter of the year, which saw the Dow increase over 7 percent and the Nasdaq Composite index jump 13 percent, the average market performance for the group of new biotech IPOs strengthened and closed the year down marginally. The companies, however, only managed to generate the same amount of cash as three companies did in 2009.” California-based Complete Genomics, which began operations in 2006 and now has 160 employees, found that its debut in the market has been less lucrative than it had hoped. Lackluster interest from potential investors reportedly prompted two other biotech companies -- Ikaria of Clinton, N.J., and Rules-Based Medicine of Austin, Texas – to cancel their planned IPOs. Not everyone is bullish about biotech businesses, said Scott Sweet, senior managing partner of IPO Boutique of Lutz, Fla., which tracks new public ventures. Although "there have been great biotech stories," he said, many people in this economy are reluctant to put money into that industry, given how long it typically takes to develop a commercially-viable product. "It's still very challenging for many biotech companies to go public," acknowledged Paul Bard, Vice President of Research for Renaissance Capital in Greenwich, Conn. But he sees a change occurring. As this year has demonstrated, he said, "The window has been opening a bit." Source: Mercury News and Burrill & Company 14 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Regulatory and Government: Qualifying Drug-Development Tools: The FDA Weighs In In late October of 2010, the FDA issued a draft guidance on the “Qualification Process for Drug Development Tools.” According to the guidance, these drug–development tools (DDTs) include biomarkers, patient-reported outcome instruments, etc. The guidance outlines a framework for FDA interaction regarding submissions involving DDTs and required supporting data to qualify a DDT. To date, DDTs have been reviewed by the FDA on a case-bycase basis. The FDA stated in the draft guidance recognition that “the process of drug development and the availability of new therapies have not been as strongly affected by recent advances in biomedical science as might be possible.” In CDER’s opinion, a new process may provide “some degree of generalizability for use of the tool … (and) may aid in advancing therapy development and evaluation in multiple cases, and can more widely benefit patients.” Source: PharmTech.com The FDA Encourages Companies to Combine Efforts and Drugs to Produce Novel Treatments In December the FDA issued draft guidelines encouraging companies to work together to develop drugs to be used in combination to treat a variety of illnesses including cancer and infectious diseases. FDA Commissioner Margaret Hamburg spoke at the Partnering for Cures meeting, confirming that the new guidelines were an acknowledgement that combining experimental therapies may yield more effective results or possibly prevent drug resistance. The guidelines clearly state that when companies develop two or more drugs together, there is less data on safety and efficacy available for each drug. As a result, there must be a compelling reason for FDA approval, such as unmet needs within serious illnesses. The guidelines also urge companies to provide comparative effectiveness data from lab studies or animal models. Michael Caligiuri, director of Ohio State University’s Cancer Center weighed in on the draft guidelines calling them a “positive first step” in co-development efforts of combination therapies; he expressed concern, however, about legal issues around compound ownership and testing rights, intellectual property rights and responsibility should anything go wrong. Biosimilars in 2011: Pathway to the Future or Road to Nowhere? The recently enacted Biologics Price Competition and Innovation Act (“BPCIA”) created a pathway for the approval of “biosimilar” copies of licensed biologics. The enactment of the law, however, was just the first step in a long process. Both innovator and generic companies should watch the trends in 2011 and develop strategies for conducting business under the BPCIA. Manufacturers seeking to market a “biosimilar” must decide whether to use the new BPCIA “biosimilar” application. Although it requires more data, filing a “full” biologics license application (“BLA”) may be more prudent for some manufacturers. The BPCIA requires a biosimilar applicant to disclose its application to the innovator company. This will give innovators a “road map” for employing tactics to delay the biosimilar’s approval. Uncertain approval requirements and patent litigation processes also weigh against using the BPCIA application for a biosimilar. Innovators should begin developing asset protection strategies before a biosimilar application is filed for their product. The BPCIA contains a complex patent dispute procedure with short timelines. Innovators should review their patent portfolios and develop patent defense strategies tailored to the BPCIA procedures. Similarly, manufacturers may want to determine the type of data that FDA should require to support biosimilar versions of their products. This information, along with legal arguments, can be submitted to FDA in a Citizen Petition to ensure that the agency requires the proper quantity and quality of data. Manufacturers will face numerous challenges in 2011 as FDA implements the BPCIA. As FDA announces new policies, companies may want to consider submitting formal comments to the agency. Throughout the year manufacturers will need to stay apprised of new developments and work with their regulatory counsel and scientific experts to adjust their biosimilar strategies accordingly. Source: Mike Hinckle, Partner at K&L Gates Source: Wall Street Journal Health Blog 15 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved What Impact Will the US Mid-Term Elections Have on Big Pharma? Impact of Health Care Reform Package Less Severe Than Feared In all likelihood, the mid-term election results will barely change the stakes for pharma in its pursuit of the US legislative and regulatory agenda. If anything, the industry is at an impasse on key issues such as health reform rollback and deficit, with a modicum of optimism on ideological issues involving trade agreements, patent reform, taxation of foreign-held assets and approval of follow-on biologics. 2009 was a relatively tough year for biotech as parts of the new Democratic administration's health care reform package cast a pall over the entire medical industry. It was widely believed that the reform act would not be favorable to the pharmaceutical and biotech businesses, but by late 2009, drug and biotech companies realized that the legislation would not have quite as severe impact on them as previously feared. Looking forward, what will matter most for pharma will be a possible business confidence boost, restoration of productivity growth and improved US global competitiveness. Industry exports depend heavily on the dollar fluctuation, that of itself is a measure of confidence in US economic leadership. The federal reform package, however, will likely weigh on biotech revenues in the near term. The bill will require higher Medicaid rebates that will hurt revenues of biotech companies. By 2011, biotech and the big drug makers will be assessed certain fees to fund the reform. As a result the market is focusing on the costs that the biotech industry will have to bear, rather than on any longer-term benefits. One of those benefits could be the hordes of newly-insured patients that will arrive by 2014. For now, the industry continues to sort out the near-term impact of health care reform on their bottom lines. On the “FIO” (friends in office) front, the GOP sweep brought in Dan Coats (former PhRMA lobbyist) and Rob Portman (former USTR). Sen.Harry Reid’s win in Nevada is a net plus, as it resulted in the prevention of industry antagonists – Senators Chuck Schumer and Dick Durbin – moving to the post of majority leader. Of most importance might be the lost subpoena power of critics like Rep. Henry Waxman resulting in far fewer embarrassing investigations into regulatory compliance etc. The new GOP majority in the house and the election of ten new Republican governors will put significant pressure on the Obama administration on all things related to the health reform law. In the opinion of William Looney, PharmExec blogger, prospects for roll-back, let alone appeal, are remote. This is due to the remaining Democratic majority in the Senate, the President’s power of veto and the GOP’s focus on job creation. The government posed another obstacle for biotech – namely problems that have plagued the FDA. The agency had been very under-funded and didn’t have enough resources to meet its mandate of making timely reviews of new drug applications. This had been going on for at least five years until, under President Obama, funding for the FDA was increased and the review process expanded. Resulting improvements to the regulatory system are of benefit to the biotech drugs seeking approval. Source: International Business Times One area of low-hanging fruit might be pharma’s long-sought-after ratification of pending free trade agreements with Latin America and South Korea. If the House pushes this through, there may be a significant opportunity for a positive repositioning of the pharma industry as a job creator and a driver of income growth versus the blow it has taken in recent years due to a wave of promotional and product safety scandals. On the regulatory front, there is likely to be renewed interest in FDA efforts to strike a better balance for risk and the importance of innovation in drug discovery. Source: PharmExec Blog 16 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved New Drug Approvals Slipped in 2010 The Food and Drug Administration approved about 21 drugs in 2010, a relatively modest figure. A few potential blockbusters won approval during the year, but some of the most highly anticipated new products got delayed into next year or beyond. That partly reflects a tougher environment at the FDA, with regulators stepping up their scrutiny of safety issues in drugs for obesity, diabetes and other conditions. According to monthly drugapproval reports on the FDA’s website, 21 new drugs were approved in 2010, down from 25 in 2009 and 24 in 2008, but higher from a recent low of 18 in 2007. The figures include approvals for several major biologic drugs: Amgen Inc. for Prolia, a drug that is injected twice yearly to treat osteoporosis in postmenopausal women. Roche Holding AG’s biotechnology unit, Genentech, for Actemra, a drug that’s administered intravenously to treat rheumatoid arthritis. Boehringer Ingelheim GmbH received approval for Pradaxa, a new type of blood-thinning drug to prevent strokes in patients with irregular heart rhythms. Novartis AG for x Gilenya, an oral product for the treatment of multiple sclerosis, which has traditionally been treated by injections or infusions. The FDA also approved Acorda Therapeutics Inc.’s drug Ampyra to improve walking in MS patients. HRA pharma, a closely held company in Paris, for ella, a longer-lasting emergency contraceptive; it was introduced in the U.S. by Watson Pharmaceuticals Inc. Dendreon Corp. for its prostate cancer therapy Provenge, which had previously been rejected by the agency. Provenge is designed to use a patient’s own cells to stimulate the body’s immune system to fight the cancer and may be the first in a new class of cancer-fighting drugs. Source: Wall Street Journal Drugs Restricted & Pulled off the Market 2010 may be more notable for drugs that weren’t approved, as well as for drugs the agency restricted or pulled off the market: AstraZeneca PLC suffered a setback when the FDA asked for more information about a study backing its application for the blood-thinning drug Brilinta. The delay drove down AstraZeneca shares more than 5 %. A long-acting version of diabetes drug Byetta, sold by Amylin Pharmaceuticals Inc. and Eli Lilly & Co., was rejected as needing more clinical data to address cardiovascular safety concerns. Two proposed weight-loss drugs from Arena Pharmaceuticals Inc. and Vivus Inc. were denied approval. The FDA also curtailed the use of or removed other drugs from the market: GlaxoSmithKline PLC’s diabetes drug Avandia was sharply curtailed after it was linked to increased risks of heart attacks. Abbott Laboratories’ weight-loss drug Meridia was removed from the market; the FDA says the drug didn’t work well enough to justify potential heart problems. Painkillers Darvon and Darvocet were taken off the market after many years of concerns about an increased risk of serious abnormal heart rhythms. The FDA says it will also move to revoke the approval of Roche’s cancer drug Avastin for use in breast cancer, saying the product didn’t appear to help patients live longer. Roche is appealing the move, which won’t affect the use of Avastin in other types of cancer. The agency said it needed more time to review Mannkind Corp.’s inhaled-insulin product to treat diabetes. It also said it needed until March 2011 to review Benlysta, a highly anticipated lupus drug from Human Genome Sciences Inc. and GlaxoSmithKline. Source: Wall Street Journal “Over the next five years, there will be more significant changes in the way drug and device safety is monitored. Larger clinical and administrative databases (e.g., Sentinel), will be increasingly mined for information on potential signal. Our ability to understand that signal and to design studies to strengthen or refute signal will have a big impact on how pharmaceutical companies manage and communicate safety information for their products.” Source: Dr. Richard Gliklich, The Crystal Ball 17 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved FDA Unveils Improvements in the 510(k) Process Innovation Pathway for New Breakthrough Devices In January 2011 the FDA unveiled a plan containing 25 actions, including new guidance and enhanced staff training, it intends to implement during 2011 to improve the most common path to market for medical devices. Responding to criticism that it is hindering innovation, in February 2011 the FDA proposed the Innovation Pathway, a priority review program for new, breakthrough medical devices and announced the first submission. The FDA also announced plans to seek further public comment before the Pathway can be used more broadly. Key Actions Include: Streamlining the “de novo” review process for certain innovative, lower-risk medical devices Clarifying when clinical data should be submitted in a premarket submission, guidance that will increase the efficiency and transparency of the review process Establishing a new Center Science Council of senior FDA experts to assure timely and consistent sciencebased decision making The proposed Innovation Pathway program for pioneering medical devices is part of a broader effort underway in the FDA’s Center for Devices and Radiological Health designed to encourage cutting-edge technologies among medical device manufacturers. Medical devices in this program would be reviewed within about 5 months, roughly half the time it now takes to review the most innovative medical devices. In September 2009, CDRH set up two internal working groups to address concerns relating to the premarket notification portion of the 510(k) process – industry argued that the 510(k) process was unpredictable, inconsistent and opaque, while consumers and health care professionals argued that the review process wasn’t robust enough. At the same time, CDRH also asked the independent, nonprofit Institute of Medicine to study the program. That review is still underway. In addition to the 25 planned actions, CDRH also is giving the Institute of Medicine an opportunity to provide feedback on seven recommendations before making a final decision and is planning for a public meeting in April to seek additional feedback on two other recommendations. Source: FDA The initiative will also seek to strengthen the nation’s research infrastructure for developing breakthrough technologies and advancing quality regulatory science. Proposed actions include: Establishing a voluntary, third-party certification program for U.S. medical device test centers designed to promote rapid improvements to new technologies during a product’s development and clinical testing stages Creating a publicly-available core curriculum for medical device development and testing to train the next generation of innovators Using more device experience and data collected outside the United States In addition, CDRH intends to engage in formal horizon scanning – monitoring medical literature and scientific funding in a systematic way to predict where technology is heading. CDRH will include public input in this process to prepare for and respond to transformative innovative technologies and scientific breakthroughs. The proposed Innovation Pathway program includes the following features: Products would have to be truly pioneering technologies with the potential of revolutionizing patient care or health care delivery Selected products would receive an Innovation pathway memorandum from CDRH containing a proposed roadmap and timeline for device development, clinical assessment and regulatory review Products would be assigned a case manager, their important scientific issues would be identified and addressed earlier in the development process, and they might be able to qualify for flexible clinical trial protocols The FDA could conduct premarket review of products in the Innovation Pathway within 150 days, nearly half the time it currently takes the FDA to review most premarket approval applications. CDRH has set up a public docket to solicit public comment on the Innovation Initiative and will host a public meeting on the topic on March 15, 2011 at the Center’s White Oak campus. Source: FDA Image Source: FDA 18 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Health Care Extreme Makeover for Health Care in 2011? Health Care Trends for 2011: Outlook Brighter Despite Reform Hurdles Health organizations will undergo a strategy makeover in 2011 as they react to new rules and payment models, continuing cost pressures and new customer demands, according to a report from PricewaterhouseCoopers’s (PwC) Health Research Institute. The Healthcare Intelligence Network’s sixth annual Healthcare Trends for the Year Ahead e-survey conducted in October 2010 revealed how 73 health care organizations perceived the business environment in 2010 and how they are preparing for 2011. Record spending on health IT in 2011 is likely to increase demand for skilled health IT professionals, promote an expanded role for CIOs and fuel increased merger and acquisition activity. Significant changes in benefit plan design, plan pricing and the health plan landscape can be expected as insurers adapt to new medical loss ratios. Nearly half of consumers surveyed (49 percent) still call their doctor's offices to request paper medical records. While the policy goal of EHRs is to allow consumers to participate in shared medical decision making, only 13 percent of consumers have ever been asked for input into what they would like to see in their EMRs. New risks and opportunities may emerge as payment models shift from fee-for-service to new models that focus on performance, health outcomes and shared cost savings, such as accountable care organizations (ACOs). An uptick in merger and acquisition activity is one way health organizations may share administrative burdens and IT investments, gain market share and fill strategic gaps. Increased consolidation is expected among payors, physicians are aligning with hospitals, hospitals are merging with other hospitals and health systems, and recent deals reflect blurring of the lines between the payors and providers sectors. Pharmaceutical companies see an opportunity to increase their visibility with consumers, influence health outcomes and reduce health care costs while increasing revenue using digital strategies and technology. The use of mobile health and wireless technologies by all health organizations is expected to continue to surge. Source: CMIO Survey Highlights Sixty percent of respondents said 2010 was a better year than 2009. Areas having the greatest overall impact on respondents in 2010 were: the economy (63%); budget constraints (62%); PPACA (3%4); wellness promotion (34%); and hiring and recruitment (31%). Organizational areas most affected by the financial climate of 2010 were business growth (79%); service expansion (53%); and services and sales (46%). Staffing concerns were frequently reported. Respondents’ Most Successful Programs & Services Practice transformation. Creating products to support critical thinking, executive, leadership and team development. Clinical practice registry, medical home program. Training staff in preparation for Certified Professional in Healthcare Quality (CPAC) certification; focus on URAC and NCQA training; development of regional quality groups to implement work plans. Concierge services for staff, patients and physicians. Physical and mental health integration. Respondents’ Best Business Decisions Increased triage productivity. Increased dedication to up-front collections. Focus on care transitions and drug expenses. Hiring the right staff. Respondents’ Biggest Mistakes Understaffing. Not realizing that the impact of the physician shortage would be here so soon. Expansion of service sites without expansion of infrastructure. Not raising salaries of hospitalists to retain them. Waiting too long to reduce staffing. Being too optimistic about finding a nurse practitioner. Source: Healthcare Intelligence Network 19 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Comparative effectiveness research will become as big an issue for pharmaceutical companies as drug safety has become over the last decade, due primarily to costcontainment programs and pricing pressures in mature markets. As pharma moves products through to commercialization, this research will drive market access, reimbursement and prescribing behaviors. Patient-reported outcomes are also an important piece of this research, to measure how patients experience changes in their quality of life, daily functioning, satisfaction, and other health categories as a result of the care they receive. Source: Dr. Richard Gliklich, Mark Gianforcano, and Carolyn Buck Luce, The Crystal Ball E&Y: Moving Forward, Companies Speak out on Health Care Reform Highlights of a survey of senior executives Companies in every industry will be affected by the health care law. Responding to the law is a critical business issue on the C-suite agenda. 87% of respondents said their company’s CFO will be involved in efforts to respond to the new law; 79% said their CEO will be involved. The law is complex and will continue to undergo changes in definition and interpretation. This will pose a significant challenge to organizations as they attempt to prepare for enforcement deadlines while being mindful of changes. Cost and compliance are key concerns for respondents. 43% of respondents anticipate cost increases to comply, and 44% of respondents had not yet calculated the financial impact. At the time of the survey, 92% of respondents said their companies were not considering terminating health care benefits. 76% were anticipating that their employees would likely experience an increase in what they pay for health care coverage. Companies are uncertain how they will communicate benefit plan changes to their employees. Source: Ernst & Young Image Source: IBM Center Social Media “The emergence and adoption of social media is not a fad – it’s here to stay. How the industry will adapt to this shift in communication is still unclear. It’s vital to patients and health care communities that pharma companies do engage, because we want to serve the best interests of physicians and their patients, while remaining compliant with the laws and regulations that govern such communication.” Image Source: Net Strategies Source: Dr. Greg Barrett, The Crystal Ball 20 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved Pfizer Establishes CTI: An Interview with Dr. Anthony Coyle Pfizer Inc. (NYSE: PFE) recently announced the establishment of the Global Centers for Therapeutic Innovation (CTI), an entrepreneurial network of partnerships with leading academic medical centers to transform research and development by accessing leading translational researchers. The University of California, San Francisco (UCSF) is the first collaborator in the network. Don Alexander of Carlyle & Conlan interviewed Dr. Anthony Coyle, head of Pfizer’s global CTI efforts, for perspective on these collaborations. Don: Dr. Coyle, thanks for your time this morning. Could you provide an overview of Pfizer’s CTI efforts to date? Dr. Coyle: The original construct of the CTI efforts is built on a true 50/50 partnership. There is a decision-making body that oversees the selection and progress of programs. For this collaboration to be effective, physical co-location was important. There is lab space on the Mission Bay campus, where there are about 40 total people (half Pfizer employees and half UCSF scientists) who come and go in a complete open exchange. The goals of the program are to jointly identify targets and develop them through end of Phase I. The culture is very entrepreneurial and Pfizer wants to work with institutions that focus on bringing basic science through early stage clinical development so the idea of developing novel therapeutics together with academics is essential. The work involves developing biologic therapeutics and understanding the concept of patient heterogeneity. The collaborations focus on mechanism of action, targeted therapeutics and which patient populations are relevant. The goal is to work with the best, most innovative scientists in translating drug discovery into data rich, Phase I studies. Don: How does this novel model complement existing investments in the biotech sector such as Venture Capital? Dr. Coyle: I’ve had the opportunity to speak to a number of venture firms. Although the discussions are still early stage, the model is flexible to allow VCs to fund part of CTI and thus, make investments in the process. Additionally, the opportunity exists that Pfizer’s CTI can replace or provide a different option for those investors who would like to see an increase in the value of assets. Pfizer is interested in finding ways to share risk and build upon the scope of organizations they know, with eight centers across the globe. Don: How does CTI governance work? Dr. Coyle: At UCSF, there is a joint Board of Review consisting of eight people, four from UCSF and four from Pfizer. This governance mechanism allows CTI to be semi-autonomous and not dependent on central Pfizer for decisions around programs. These decisions remain with the Board. Don: How do the agreements work from an Intellectual (IP) and investment perspective? Dr. Coyle: At UCSF once a target is part of the agreement, the program is driven by a steering board that decides which programs continue to be funded. The programs are really almost “biotech VC-like” with funding being made in tranches as programs progress. Typically one-to-three post-docs are assigned to programs with various inflection points that provide flexible fund access. These flexible funds allow the joint Pfizer-UCSF teams to develop preclinical concepts to the end of Phase I for Proof of Mechanism (POM) trials. Once POM has been achieved, Pfizer has the ability to exercise an exclusive option. 21 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved IP is jointly owned on assets developed at the end of certain milestones with prior work recognized by whoever discovered it. If Pfizer exercises its option, Pfizer develops the asset in-house. If not, the institution has the right to develop in-house or look for another partner. Different disease indications could be sub-licensed. All work is subject to the end of Phase I milestones and the institution is compensated with pre-negotiated payments and milestones. The value of the IP is determined upfront on a program basis with discussions between attorneys at UCSF and Pfizer, as part of the steering board. There is joint decision-making on the value of IP where both parties understand what is in the CTI’s best interest. The IND filed is owned by the academic institution, not Pfizer, which allows for appropriate award structures for investigators. Don: What additional assets does Pfizer bring to these partnerships? Dr. Coyle: The entire focus of the CTI network is on biologics where Pfizer can offer unparalleled access to protein technologies. For instance, collaborators can access phage and peptide libraries. Pharma providing completely free access to academic institutions has not been done before. The groups are small and have the opportunity to leverage Pfizer’s assets in areas such as pharmaceutical science, toxicology and regulatory support. Don: Regarding the press release discussing global expansion, what types and locations of institutions are of interest to Pfizer? Dr. Coyle: The present emphasis is getting UCSF up and running and finalizing two other major centers in the US in Boston and New York. The UCSF contract would be identical to other institutions. Pfizer is interested in similar types of academic institutions and teaching hospitals that allow for pre-negotiated milestones that will allow Pfizer teams to move to the next step. London would be a natural fit in this context. The excitement of this program is the ability to be a catalyst for bringing multiple institutions together to establish a broad network of collaborators. Pfizer could be the catalyst that helps pull these things together. 430 Davis Drive, Suite 230 Morrisville, NC 27560 T: +1 (919) 474-0771 F: +1 (919) 474-0682 www.ccesearch.com 22 Life Science Trends 2011 Carlyle & Conlan © Copyright (1-22) All Rights Reserved