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MADD > Challenges #2 > Flashcards

Challenges #2 Flashcards

1
Q

What is pharma?

A

A very large and complex growing part of the economy

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2
Q

What was its market size in 2018 and what is it expected to reach?

A

$1.2 trillion, expected to grow to $1.5 trillion by 2023

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3
Q

What becomes clear when looking at the current environment?

A

That there is a rising demand for effective medicines

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4
Q

What brings opportunity?

A

The ageing population, with previously terminal illnesses now being viewed as chronic conditions

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5
Q

What does the fact that previously terminal illnesses are now viewed as chronic conditions give rise to?

A

New, unmet medical needs

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6
Q

What is happening to the developing world?

A

It is increasingly resembling the developed world, with the GDP of the E7 having tripled in the last 3 years

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7
Q

What does the fact that this is all happening very quickly indicate?

A

A need to adapt and change in order to survive

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8
Q

First major shift in the pharma landscape?

A

Globalisation

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9
Q

Where was pharma’s main focus until recently?

A

Global market leaders, namely the US, China, Japan and Europe

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10
Q

What are we experiencing with globalisation making people richer, and ultimately healthier?

A

The emergence of a truly global market with a rapidly expanding patient base

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11
Q

As people become wealthier, what will this enable?

A

Society to pay for drugs and fuel demand for new therapies

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12
Q

What exemplifies globalisation?

A

20 years ago, 20% of the Asian population were middle class; now, 1.5 billion fall in this category, representing a 15% increase that is associated with an increased demand for higher standards of living in terms of food, energy, transport, tourism and healthcare

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13
Q

What do these fast growing economies with high GDP growth and fast-growing populations represent?

A

An increasingly attractive environment for pharmaceutical companies

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14
Q

What have urbanisation and increasing international mobility enabled?

A

The rapid and widespread transmission of disease in a global scale

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15
Q

What is now of great concern to the developed world?

A

Viruses that were previously isolated to small, impoverished countries or villages

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16
Q

2 examples of urbanisation and spread of disease?

A
  1. SARS virus moved from Asia to the Middle East within 3 days
  2. H3N1 virus spread from China to SE Asia to Middle East rapidly
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17
Q

What would be the impact of a pandemic flu in the West?

A

Huge - but will also present an exciting and lucrative opportunity for innovative players in the industry

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18
Q

What has happened to healthcare spending in the US in the last 90 yrs?

A

It has gone up faster than GDP

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19
Q

What does is the increased demand for healthcare spending fuelled by?

A

Changes in lifestyle, such as unhealthy eating, less sleeping, lack of exercise

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20
Q

What do these changes in lifestyle result in?

A

Increasingly high obesity rates and other physical problems, such as diabetes

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21
Q

How many people are living with diabetes, and what is this expected to grow to?

A

In 2019, 415 million people were living with diabetes, with 46% remaining undiagnosed. This is expected to grow to 650 million by 2040, highlighting a large, growing unmet medical need

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22
Q

What are rising obesity rates correlating with?

A

Increased diagnoses of metabolic syndrome, which has been linked with some cancers

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23
Q

What are the lifestyle trends consistent with?

A

An analysis predicting that the key therapy area driving healthcare spending and industry growth in the next 5 years will be oncology, with diabetes treatments continuing to rapidly evolve

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24
Q

What is the 65+ population projected to be this year?

A

10% of the global population by 2020

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25
Q

What factors contribute to the increased life expectancy?

A

Better living conditions
Improved sanitation
Better prevention of disease
Growing access to medicine

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26
Q

What is the proliferation of chronic disease having?

A

Serious repercussions in both developed and emerging countries

27
Q

What is true about obesity, cardiovascular diseases and diabetes?

A

These are now persistent, widespread health problems that will challenge public health systems to meet the increasing demand for drugs and treatment

28
Q

What do chronic conditions require?

A

Continuous support, treatment and other associated healthcare spending

29
Q

How many prescription drugs to older people take?

A

80% over the age of 75 take at least one prescription drug; 36% take 4 or more

30
Q

What does the 0.2oC increase in temperature per decade mean?

A

Diseases such as malaria, cholera, diphtheria and dengue are spreading to more developed, previously endemic areas

31
Q

What has global warming allowed?

A

The reestablishment of malaria in previously endemic areas such as Europe and the US, having already done so in Azerbaijan, Corsica and Georgia

32
Q

What else are increases in temperature associated with?

A

Increased risk of infection by microorganisms

33
Q

How is the replication rate of E. coli affected by increasing temperatures?

A

It has been found that for every degree above -10oC, the replication rate of E. coli increases by 6%

34
Q

What has been subject o extensive scrutiny by society?

A

The high cost of medicines, with governments and payers becoming increasingly aware of cost

35
Q

What has the high cost of medicines created?

A

A negative image for the pharma industry

36
Q

What has a recent Harris poll indicated?

A

11% thought the pharma industry was honest and trustworthy, compared to 20% of people who had faith in banks

37
Q

What does the high cost of drugs represent?

A

A financial provision by pharma companies to avoid litigation

38
Q

What is the drug discovery and development process?

A

Time consuming, complex and highly risky

39
Q

When can concerns over a compounds safety, efficacy or commercial viability become visible?

A

At any point from early stages of R&D, to clinical development, regulatory approval and later pricing stages

40
Q

What has the increased risk of litigation led to?

A

Reduced probability of bringing a drug to market, increased safety tests, and ultimately augmented the cost of drug discovery and development

41
Q

How many molecules make it to market?

A

1/10,000

42
Q

What is the price per patient in phase III?

A

$25,000

43
Q

What is the total cost of bringing a drug to market?

A

Approx. $2 billion

44
Q

What has changed about incremental science?

A

It is no longer rewarded due to increased risk and ambiguous returns, so pharma is failing to look for constant improvement out of fear of not being reimbursed

45
Q

What is the role of patents?

A

Incentivise innovation and enable pharma companies to achieve a return on their investment and also to fund further R&D

46
Q

What happens after the expiration of a typical 14 year patent?

A

Generics manufacturers can market ‘bioequivelant’ drugs that are the same as the branded drug, at greatly reduced cost

47
Q

What proportion of prescription drugs did generics account for in 2019?

A

88%

48
Q

What will occur as more and more generics enter the market?

A

Price erosion will intensify, posing a major threat to pharma’s bottom line

49
Q

What is more important than ever in the face of increasing pressure due to patent expiries?

A

Innovation is more important than ever for growth

50
Q

Where must effort be made within the pharma industry?

A

In the space of research and innovation, with a strong focus on unmet medical needs

51
Q

What happens as research increases the knowledge of various diseases and biological pathways?

A

This will increase the number of therapeutic targets and therefore increase the ability to treat and prevent disease

52
Q

What is an imperative for the pharma industry?

A

To increase productivity within R&D investment by delivering clearly differentiated medicines

53
Q

What will be key in increasing productivity within R&D investment?

A

Externalisation and creative deal-making

54
Q

What major shift are we observing?

A

From in-house research to speculative buying and development

55
Q

Why is speculative buying beneficial?

A

It eliminates some of the risk and fixed costs associated with drug discovery and development for pharma companies

56
Q

What has the nature of competition shifted from and to? What does pharma need to do?

A

From “scale and stability” to “innovation and change”, meaning that pharma needs to segment into small, lean and fully segmented business units that can innovate and rapidly respond to change

57
Q

Why is innovative science crucial?

A

Because it is now first, and not best, in class

58
Q

What is innovation in healthcare being driven by?

A

More than ever by advances in technology, such as NGS enabling advances in personalised medicine and targeted therapies, which have the potential to drastically cut R&D costs while bringing great value to the end user

59
Q

What is happening with these breakthrough techniques?

A

Techniques developed in the lab are reaching the clinic at an accelerated rate, with the potential of having a major impact on healthcare

60
Q

What will the increasing application of IT and mobile tech foster?

A

Evidence-based medicine, while driving healthcare from an acute setting to the community, which is likely to reduce costs

61
Q

What is ultimately needed?

A

A balance between performance and organisational health

62
Q

What is meant by organisational health?

A

The ability of an organisation to align, execute and renew itself better than the competition

63
Q

What are the characteristics comprising organisational health?

A

Direction, accountability, coordination, motivation and EXTERNAL ORIENTATION, LEADERSHIP, INNOVATION & LEARNING

MADD (5 decks)

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