Euro-Sante :: Euro-Health

Kuhn used the duck-rabbit optical illusion to ...
European pharma: which is it?

Recent research suggests that the European pharmaceutical industry is more productive than the US one. Euractive reports on this here: article-184974.

A few things to consider. Light’s work is a reanalysis of existing data. His conclusions are based on using the head-office of the company discovering the drug as determining the country of origin. He is trying to distinguish between drugs that are important, and add clinical value, and those that are ‘me to’ drugs. He notes that the reimbursement system in the US favours me-to drug development. This drives a logic that drugs that are top-selling are also important — this is the so-called blockbuster model of drug development and sales. The European Commission still thinks this is a sensible way to measure innovation.

This model is tiresome and bankrupt. We are in paradigm shift in the medicines industry which few in policy circles seem to have noticed. And of course the major pharmas will be the last ones to admit it. One major pharma CEO is reported to have said that they are going to ride this baby (blockbusters) until the wheels fall off. Well, someone should tell this person, the wheels are falling off.

Light’s point is a simple one really. The value-add of research spending on pharmaceutical research should produce better medicines, with improved clinical value, not me-to’s. Europe appears to be better at doing this. The Commission’s plans to work with the pharmaceutical industry should pay attention to this. Indeed, there are lots of medicines around, just not as many of the ones we really need. And of course, big pharma isn’t the same as little pharma or biotech pharma, and the latter are the disruptive players. Medicines are moving away from blockbuster drugs administered to millions and sold in vast quantities toward personalised medicines, focused on specific categories of patients. [Keep in mind, that in clinical trials, many of these subgroups of patients could be discarded from the trials as they were too small and skewed the studies. Now of course, by data-mining past clinical trials we can identify subgroups of patients with specific response characteristics that a tailored medicine will do. But that doesn’t produce sales in the billions.]

Of course, Light’s work lumps all the countries of Europe together. There are free-riders on that innovation claim, EU member states with small and probably ineffective pharmaceutical research and development capabilities, while there are a few world-class countries. Certainly, the big players are those countries with the big companies, but also the ones with policies which make it productive for pharma research to be done in the first place, e.g. Germany, Sweden, UK. I might add France, but it isn’t particularly good at commercialisation of its research. One could add a couple of others. I would like to have seen the disaggregated country-by-country data, in the same way as disaggregated US data would have shown which US states are the real drivers and which are the free-riders.

In the end, comments will fall on either sides of the issue. Industry will point to claims of innovation based on sales, while others will point to importance. Methinks the Commission and Europe generally should align its policies around importance. That way the goals are over quality not quantity.

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