Photo: (Jan Chlebik for the ICR)
Universities should work with new forms of commercial partner to take their own cancer drugs to market and drive down the ‘spiralling’ cost of new medicines, leading experts propose.
A high-profile commentary warns that the price of cancer drugs is now rising so fast it threatens the whole financial viability of cancer treatment – particularly as the increased use of drug combinations multiplies costs.
The authors propose that expert drug discovery teams in academia could develop cancer drugs more cheaply by working with new forms of private enterprise as an alternative to the traditional pharmaceutical industry model.
'$100,000 cancer drugs'
The commentary – How much longer will we put up with $100,000 cancer drugs? – puts forward a series of radical solutions to disrupt the drug discovery and development system and provide real competition for the conventional pharmaceutical industry approach.
Its aim is to find ways of providing drugs at prices that health systems like the NHS can afford – so more patients can access the latest cancer treatments.
One of the authors of the paper is Professor Paul Workman, Chief Executive of The Institute of Cancer Research, London – the world’s most successful academic organisation at discovering new cancer drugs.
Under the new proposals, academic teams would partner with new forms of private company to fund clinical trials and marketing.
These new companies might specialise in partnerships with the non-profit sector, and would agree to cap the price of new medicines.
The authors do not suggest that the new model would replace the traditional pharmaceutical industry, but they argue that academics should take much greater control of the development of the drugs they discover. In this way they can reduce costs, and also have more say in how new drugs are evaluated and used.
They acknowledge that there is currently only limited capacity within academia for drug development – but argue that creating drugs more cheaply could provide competition for traditional pharmaceutical companies and help drive down prices.
The commentary – published on Thursday 9 February 2017 in the prestigious journal Cell (ScienceDirect link) – argues that pharmaceutical companies have become used to big profit margins, and often set high prices even where a drug’s development was underpinned by research in universities.
Many cancer drugs have been successfully taken to patients through partnerships between academic research organisations like the ICR and the pharmaceutical and biotechnology industry.
The ICR has discovered 20 drug candidates since 2005, alone or with academic and commercial partners, and its prostate cancer drug abiraterone is benefiting hundreds of thousands of men worldwide.
Academic organisations lack the resources or marketing expertise to take drugs to patients, so they typically work with pharma companies to run clinical trials and navigate the regulatory system.
But Professor Workman and colleagues in the Netherlands and the US argued that pharmaceutical companies often fail to pass on savings in research costs and usually price new cancer treatments at whatever they feel the market can bear.
Costs 'should be falling'
The authors said the costs of drug development should actually be coming down, since advances in science now allow drugs to be assessed in smaller clinical trials by targeting treatment more precisely at those patients who will benefit.
But there is little evidence that savings in drug development costs are being passed on to healthcare systems.
And when an established drug gains a licence to be used in an additional type of cancer, or at an earlier stage of disease or in combination, the price very rarely comes down – even though it is becoming available to a wider market, and most of its discovery costs will already have been covered.
The pharmaceutical industry has also become extremely inefficient, with multiple companies developing very similar products.
The answer, according to the authors, is for expert multidisciplinary teams of researchers within universities to drive the discovery of new drugs, and to become more active at taking new treatments onto the market.
New uses needed
The authors also recommended that prices could be reduced by finding new uses for drugs that have come off patent, with academic researchers helping to identify which patients could benefit.
Professor Workman is joined on the commentary by co-authors from The Netherlands Cancer Institute and The University of Texas MD Anderson Cancer Center in the US – both also leading centres for translational cancer research and drug development.
Commentary co-author Professor Workman, Chief Executive and President of the ICR, said: “It’s essential that we find ways of making sure that patients can benefit from the very latest, highly innovative cancer treatments. It just won’t be possible for healthcare systems like the NHS to afford the newest and best cancer drugs if prices continue to rise as rapidly as they are now – let alone to be able to cover the cost of new combination treatments made up of several different drugs.
“If we’re to end this era of $100,000 cancer drugs, we’re going to have to make some radical changes to the whole way drugs are discovered and developed. I believe the solution is for an increasing proportion of drug discovery to be driven forward by academic scientists, as is done at the ICR. And in addition we need academic organisations to become braver at moving new treatments into clinical trials and onto the market – increasingly by working in partnership with companies in creative new approaches rather than limiting their partnerships to the traditional pharmaceutical industry model.
“It’s important that in the new models we create we have sufficient expertise, experience and resources to ensure that drugs are progressed both intelligently and rapidly so that cancer patients can receive drugs as quickly as possible, as well as at affordable prices.”
Fellow commentary co-author Professor Rene Bernards of the Netherlands Cancer Institute added: “There are quite a few near-term opportunities to bring drugs to patients at sustainable prices through academic consortia. For instance, through academic research new uses can be found for drugs whose patents have expired, a process known as drug repurposing. Such drugs have been used in patients before, which expedites their testing in new indications."