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MADD > Challenges facing the pharma industry > Flashcards

Challenges facing the pharma industry Flashcards

1
Q

What does the current environment look like?

Hint: DAN Drives Everywhere Stoned

A
  1. The demand for effective medicines is rising
  2. Ageing population brings opportunity
  3. Developing world is increasingly resembling the developed world
  4. The E7 (Brazil, China, India, Indonesia, Mexico, Turkey and Russia) GDP has tripled in the last 3 years
  5. In 2020, E7 will be 1/5th of global sales
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2
Q

What is globalisation doing?

A

Making people richer and ultimately healthier

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3
Q

What has happened to the world population in the last 50 years?

A

It has more than doubled, predicted to reach 9 billion by 2050

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4
Q

What does the growing population raise the question of?

A

Where will the resources come from?

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5
Q

What follows the increase in Asian middle class?

A

Increasing demands for higher standards in their lives for food, energy, tourism and healthcare, amongst others

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6
Q

How many people are living with diabetes and how many remain undiagnosed (2019)?

A

415 million; 46%

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7
Q

What is meant by the Grey Factor?

A

By 2020, 10% of the population will be 65+

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8
Q

What is important about older people’s drug-taking habits?

A

Older people consume more medicine; 80% over the age of 75 take at least 1 prescription medication, 36% take 4 or more

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9
Q

What is true about many previously terminal illnesses?

A

They are now chronic conditions

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10
Q

Statistic on heart attacks?

A

Since 1960, heart attacks have declined by almost 50% in most industrialised countries

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11
Q

What has happened to 5 year survival rates for US cancer patients?

A

They have risen from 50% in the 1980s to 66% today

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12
Q

What proportion of hospital infections are resistant to at least 1 antibiotic?

A

More than 70%

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13
Q

What is metabolic syndrome?

A

The consequence of increasing obesity and abnormal secretions from adipose tissue

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14
Q

What can metabolic syndrome lead to?

A

Cancer

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15
Q

What has changed about chronic fatigue syndrome?

A

Now perceived as a change in expression in white blood cells

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16
Q

What have urbanisation and increased mobility led to?

A

Viruses can spread globally very quickly, e.g. SARS moved from Asia to the Middle East in 3 days

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17
Q

What is the temperature increase each decade?

A

+ 0.2 degrees celcius

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18
Q

What does the rise in temperatures mean?

A

Malaria, cholera, diphtheria and dengue will move towards developed areas

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19
Q

Where can malaria be found now?

A

Azerbaijan, Corsica, Georgia and even East Anglia

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20
Q

What has led to an increase in asthma and other respiratory diseases?

A

Pollen production from ragweed (result of climate change)

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21
Q

Example of bacteria where increased infection occurs due to higher replication rates?

A

E. coli increases by 6% for every degree above -10 degrees celcius

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22
Q

What was pharma looking for a decade ago?

A

Improvements in a drug class, i.e. “best-in-class”

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23
Q

What is pharma looking for now that money is limited?

A

First in class, as otherwise they will not be reimbursed by payers

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24
Q

Why is incremental science not rewarded?

A

Risk

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25
Q

What has the increasing pressure from payers to find the first-in-class led to?

A

Increasing outsourcing of R&D to small companies, i.e. model moving from in-house research to more speculative buying and development

26
Q

What is the benefit of speculative buying?

A

If it goes wrong there is no fixed cost

27
Q

What evidence is there that the image of the industry is not good?

A

A Harris poll found that 11% think the pharmaceutical industry is honest and trustworthy, compared to 20% who have faith in banks

28
Q

Why do only 1 in 10,000 molecules become drugs?

A

Litigation - need many more tests, trials etc to establish safety

29
Q

How many drugs make it to clinical trials?

A

1/1,000

30
Q

What is the price per patient in clinical trials?

A

$25,000 (total of $1.8 billion)

31
Q

What else contributes to the high cost of medicines?

A

Pharma companies have a 14yr period in which they can make money from their patents, but clinical trials take almost just as long

32
Q

Why is there no nationalised pharmaceutical company?

A

Need shares and private investors

33
Q

How long does it take, on average, from the time a compound is synthesised until FDA approval?

A

12 years

34
Q

What do companies need to be?

A

Increasingly customer-focused, need to take patient and customer insight seriously

35
Q

What did a recent piece of US research indicate about old replacing medicines?

A

Replacing an older medicine with one 15 years newer increases cost by $18/day but reduces hospital and other costs by $129/day

36
Q

What could the shift from acute to community to home care lead to?

A

Major reductions in costs

37
Q

What is the biggest problem the industry faces?

A

Litigation

38
Q

Which medicines would not exist if in today’s regulatory environment?

A

Aspirin, paracetamol, digoxin and warfarin

39
Q

What can be explained by litigation?

A

The high number of clinical trials and associated high cost of drugs

40
Q

What will be a fundamental driver of positive change in the industry?

A

Research & Innovation

41
Q

What should be the target of research & innovation?

A

Unmet medical needs

42
Q

Why do we need innovative science?

A

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

43
Q

What do pharma companies need to realise, and what kind of science does this required

A

That the payer is paramount - need evidence-based/translational science

44
Q

How can companies innovate? (x6)

A
  1. Personalised medicine
  2. Predictive science
  3. Adaptive clinical trials
  4. Commercial insight
  5. Application of IT
  6. Mobile technology
45
Q

What will happen to conventional R&D?

A

It will continue to play a role

46
Q

What will change about R&D?

A

Externalisation will play an increasingly important role, and creative deal-making will be required

47
Q

What needs to change about IP?

A

Radical approaches to IP protection are needed

48
Q

Why will companies prefer to go into cancer compared to brain disorders?

A

Drugs for brain disorders take typically 13 years from concept to launch, cancer treatments only 5 years - however, they both have the same patent life of ~14 yrs

49
Q

What is an imperative for the pharma industry?

A

To increase productivity within R&D investment

50
Q

How can productivity within R&D investment increase?

A

Must deliver differentiated medicines that are proven to be safe and effective

51
Q

Why are shareholder returns plummeting?

A

Due to the increased number of clinical studies

52
Q

What is true about the genomic revolution?

A

Provided less advancement than anticipated

53
Q

What is there a huge need for?

A

Mindset changes

54
Q

What do companies need to find if they are to survive?

A

The right operating model for their business

55
Q

What has the nature of competition shifted from?

A

“Scale and Stability” to “Innovation and Change”

56
Q

What does big pharma need to segment into?

A

Small, lean and fully segmented business units that can innovate

57
Q

What has the “narrow pursuit of shareholder value” been described as?

A

The dumbest idea in the world (Jack Walsh)

58
Q

What should companies seek, rather than shareholder value?

A

Meaningful and impactful science which will generate return

59
Q

What will lead companies to disaster?

A

Commercial functions advising on research, rather than selling the product of research

60
Q

What is the single biggest reason companies fail?

A

They over-invest in what is, as opposed to what might be

61
Q

What does strong health correlate with?

A

Strong performance

62
Q

What are the three most important characteristics comprising organisational health?

A

External Orientation
Leadership
Innovation & Learning

MADD (5 decks)

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