̽��ֱ�� of Cambridge - hepatitis C

Graduate, get a job … make a difference #4

ta385 — Tue, 31 Jan 2017 09:00:00 +0000

Isobel Firth (Newnham College) BA Natural Sciences (2016)

I graduated last summer and I’m currently working with the Drugs for Neglected Diseases initiative (DNDi), a non-profit organisation based in Geneva that develops treatments for neglected diseases and patients with a public health focus.

I’m working in the paediatric HIV and Hepatitis C programmes with a very experienced and interdisciplinary team. ̽��ֱ��projects are a fantastic mixture of medicine, chemistry, law and public health rolled into one and I’m learning lots about the world of drug development.

In the HIV project we are working to provide a treatment for children with HIV which is practical to dose, easy to administer, in a taste-masked formulation, and which is available to infants as soon as they are diagnosed with HIV. This is vital because early treatment makes the difference between life and death for these children. ̽��ֱ��Hepatitis C project is focussed on developing an affordable treatment for Hepatitis C as the current treatment options are too expensive for the majority of people living with the disease which can eventually lead to liver cancer.

̽��ֱ��work I do on these projects is varied, including literature reviews, presenting and analysing scientific data on potential drug candidates and editing scientific papers for peer review. These all require skills I developed during my time at Cambridge. Working here has confirmed my interest in a career in public health, and the experience of working in this organisation will help in making that a reality.

What Cambridge did for me

On the Natural Sciences course, I had to write scientific essays for supervisions which left nowhere to hide – if you have misunderstood a topic it becomes very obvious. I had never written a scientific essay before coming to Cambridge and the first few took me days to write but I slowly improved through practice. In my final year I did a laboratory research project where, along with other practical lab skills, I learnt the ropes of academic science writing which I use all the time in my current job.

On top of my studies, I was part of the Cambridge ̽��ֱ�� Swimming and Water Polo Club (CUSWPC) throughout my three years and was president of the club in my final year. This involved organising events such as alumni meals and our historic varsity match against Oxford, and lobbying for greater provision for sports clubs within the university. Many of the skills I now have in the workplace were developed as a result of being involved with CUSWPC and it was definitely the best thing I did while at Cambridge.

When I was applying to do a Masters in public health I met with a Cambridge careers advisor who helped me to re-engineer my CV and, as a bonus, told me about the Cambridge Global Health Scheme. I applied with little hope but was accepted onto the scheme which led me to an internship at the World Health Organisation in Geneva. It was a fantastic experience for someone with aspirations in public health and I was lucky to have the experience so early in my career. Through that, I began an internship with DNDi in Geneva – this wouldn’t have been possible without the ̽��ֱ��’s Global Health Scheme.

My motivation

I was always impressed, if not intimidated, by the calibre of research going on at Cambridge. I understood that it was, in some abstract way, impactful down the line, however my real interest was how incredible scientific innovation translates into positive change. For that reason, I wanted to use my scientific background to work in public health, where science meets the harsh reality of economics and politics.

Bridging the gap between innovation and health intervention for the most needy is what motivates me now, which is why the work of DNDi appealed to me so much. Their motto is ‘the best science for the most neglected’ which means that the organisation is the vital link between a eureka moment at the laboratory bench and helping people with diseases for which they would not otherwise get treatment.

Applying to Cambridge

I went to a local comprehensive school in Chesterfield, Derbyshire. I had great teachers who inspired me to learn science and helped me with the things I found difficult (thanks Mrs Nicholl for all the help). My school would generally have a couple of Oxbridge applicants every year but I had almost no preparation for my Cambridge interview. Following one good interview and one terrible interview at the College I applied to, I was offered a place in the Winter Pool by a different College, Newnham, where I happily completed my three year Natural Sciences degree.

Starting at Cambridge was intense, the first year Natural Sciences course is extremely full on and I don’t think any of us, whatever schools we had been to, were prepared for it. We helped each other through it and when I received my good results at the end of first year, I realised that I wasn’t as out of my depth at Cambridge as I sometimes felt.

Cambridge graduates enter a wide range of careers but making a difference tops their career wish lists. In this series, inspiring graduates from the last three years describe Cambridge, their current work and their determination to give back.

Bridging the gap between innovation and health intervention for the most needy is what motivates me

Isobel Firth (alumna)

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

Yes

Financial cycles of acquisitions and ‘buybacks’ threaten public access to breakthrough drugs

fpjl2 — Thu, 28 Jul 2016 10:10:12 +0000

New research on the financial practices surrounding a ‘wonder drug’ with a more than 90% cure rate for hepatitis C – a blood-borne infection that damages the liver over many years – shows how this medical breakthrough, developed with the help of public funding, was acquired by a major pharmaceutical company following a late-stage bidding war.

̽��ֱ��research shows how that company more than doubled the drug’s price over original pricing estimates, calculating “how much health systems could bear” according to researchers, and channelled billions of dollars in profits into buying its own shares rather than funding further research.

In this way, the company, Gilead Sciences, passed significant rewards on to shareholders while charging public health services in the US up to $86k per patient, and NHS England almost £35k per patient, for a three month course of the drug.

̽��ֱ��high prices have contributed to a rationing effect: many public systems across the US and Europe treat only the sickest patients with the new drug, despite its extraordinary cure rate, and the fact that earlier treatment of an infectious disease gives it less opportunity to spread.

Gilead’s strategy of acquisitions and buybacks is an example of an industry-wide pattern, say the researchers. Many big pharmaceutical companies now rely on innovation emerging from public institutes, universities, and venture-capital supported start-ups – acquiring the most promising drug compounds once there is a level of “certainty”, rather than investing in their own internal research and development.

̽��ֱ��researchers, from Cambridge ̽��ֱ��’s Department of Sociology, say this effectively leaves the public “paying twice”: firstly for the initial research, and then for patent-protected high priced medications. A summary of their research has been commissioned by the British Medical Journal (BMJ) and is published today.

“Large pharmaceutical companies rarely take a drug from early stage research all the way to patients. They often operate as regulatory and acquisition specialists, returning most of the subsequent profits to shareholders and keeping some to make further acquisitions,” said lead researcher Victor Roy, a Cambridge Gates Scholar.

̽��ֱ��study’s senior author, Prof Lawrence King, said: “Drug research involves trial and error, and can take years to bear fruit – too long for companies that need to show the promise of annual growth to investors, so acquisitions are often the best way to generate this growth.”

There are an estimated 150 million people worldwide chronically infected with hepatitis C. It disproportionately affects vulnerable groups such as drug users and HIV sufferers, and can ultimately lead to liver failure through cirrhosis if left untreated.

Roy and King’s article tells the story of the curative drug Sofosbuvir. ̽��ֱ��compound was developed by a start-up that emerged from an Emory-based laboratory that received funding from the US National Institutes of Health and the US Veterans Administration.

̽��ֱ��start-up, Pharmasset, eventually raised private funding to develop sofosbuvir. When Phase II trials proved more promising than Gilead’s in-house hepatitis C prospects, it acquired Pharmasset for $11bn following a bidding war – the final weeks of which saw Pharmasset’s valuation rocket by nearly 40%.

“ ̽��ֱ��cost of this late stage arms race for revenues has become part of the industry justification for high drug prices,” write Roy and King.

Once Sofosbuvir was market-ready in 2013, Gilead set a price of $84k. A US Senate investigation later revealed that Pharmasset had initially considered a price of $36k.

By the first quarter of 2016, Gilead had accumulated over $35bn in revenue from hepatitis C medicines in a little over two years – nearly 40 times Gilead and Pharmasset’s combined reported costs for developing the medicines.

Last year, Gilead announced that a lion’s share of those profits – some $27bn – will go towards ‘share buybacks’: purchasing its own shares to increase the value of the remaining ones for shareholders. By contrast, between 2013 and 2015 Gilead increased research investment by $0.9bn to $3bn total.

“Share buybacks are a financial manoeuvre that emerged during the early 1980s due to a change in rules for corporations by the Reagan administration. ̽��ֱ��financial community now expects companies to reward shareholders with buybacks, but directing profit into buybacks can mean cannibalising innovation,” said Roy.

A further example they cite is that of Merck, who spent $8.4bn in 2014 to acquire a drug developer specialising in staph infections. ̽��ֱ��next year they closed the developer’s early stage research unit, laying off 120 staff. Three weeks after that, Merck announced an extra $10bn in share buybacks.

In the BMJ article, the researchers set out a number of suggestions to counter the consequences of the current financial model. These include giving health systems greater bargaining power to negotiate deals for breakthrough treatments, and limiting share buybacks.

Roy and King also highlight a possible future model that uses a mix of grants and major milestone prizes to “push” and “pull” promising therapies into wider application, and, crucially, uncouples drug prices from supposed development costs, including those added by shareholder expectations. They write that this approach may be attempted for areas of major public health concern.

“ ̽��ֱ��treatments for Hepatitis C may portend a future of expensive therapies for Alzheimer’s to many cancers to HIV/AIDS. Health systems and patients could face growing financial challenges,” said King.

“We need to recognise what current business models around drug development might mean for this future.”

An analysis of a new drug’s journey to market, published today in the BMJ, shines a light on financial practices that see some major pharmaceutical companies relying on a cycle of acquisitions, profits from high prices, and shareholder-driven manoeuvres that threatens access to medicines for current and future patients.

̽��ֱ��treatments for Hepatitis C may portend a future of expensive therapies for Alzheimer’s to many cancers to HIV/AIDS. Health systems and patients could face growing financial challenges

Lawrence King

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

Yes