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PHARMA: Where are the orphan cancer drugs? by The Industry Veteran

Greg Pawelski’s recent posting here about whether cancer care could improve has drawn several responses, many of which I’m trying to redirect back into the comments section.  One, however,  that deserves its own posting is from our old friend The Industry Veteran who wonders whether the current model of big pharma itself can sustain itself in the kind kind of designer-drug world Greg is proposing:

Greg Pawelski makes a good point in his post, specifically, that the economic
model under which Pharma companies develop oncology products may be inimical to
the individualized treatment approaches required for the disease(s).  I suspect
that the figurative lumber rooms of the Big Pharma companies are stacked with
discontinued oncology compounds that proved wonderfully effective and tolerable
for 5%-10% of the target candidates but, sadly, they were terribly toxic or no
better than placebo for the others.  In fact, I know that’s the case.  Not long
ago I completed a study for a client to find why the companies are so reluctant
to out-license these moribund compounds.  The overwhelming answer, the one that
dwarfs all the others, is ego of the fiduciary executives.  The executives feel
they would invite serious job trouble by out-licensing an abandoned compound to
a small startup that proceeds to make it a successful brand.
While
Pawelski deplores the one-size-fits-all requirement, that constitutes the
standard among Big Pharma for launching a product. 

Today the Big Pharmas will
curtail development of a product with projected, peak year, global sales of less
than $850 million.  Anything less will not sustain their high fixed costs or
permit the economies of scale on variable expenses that represents their
comparative advantage.  When BusinessWeek asked Pfizer’s CEO Hank
McKinnell if the era of the blockbuster (and the giant Pharmas created to
support such megaliths) has passed, he replied, “Anybody who says that doesn’t
understand our business.”  A small company, however, can derive a large return
on equity/sales/assets from a product that successfully treats 5%-10% of a
comparatively small, target population.  The CEO of such a company probably
won’t receive $50 million annual compensation the way Mr. McKinnell does, but
its stockholders and a reasonable number of patients can benefit when a Celgene
takes an abandoned and despised compound (thalidomide, developed as a
tranquilizer for pregnant women) and brings it to market as a major therapy for
multiple myeloma.

I suspect this dilemma will resolve itself as the
pharmaceutical industry evolves into what Oracle’s CEO, Larry Ellison, once
called the Hollywood approach to drug development.  I’ve written about this
before and don’t wish to repeat myself, but basically this involves the Big
Pharmas limiting themselves to acting as sources for development funding and
distribution, while independent producers (biotechs? specialty companies?) buy
the properties and develop them.  Movies today can successfully reach smaller,
more segmented audiences than the big Hollywood studios ever could during the
Mickey Rooney, Judy Garland days.  Unfortunately a lot of people will needlessly
die of cancer before Andy Hardy grows up and tells Louis B. Mayer to go screw
himself.  But hey, in a country that twice elects a wannabe redneck as
president, the market is sacrosanct and its pace of Darwinian change is all we
can expect.

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~KatherineCancer SearcherGregory PawelskiRF Case Recent comment authors
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~Katherine
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~Katherine

Not the same Neal Deoul, Cancer Searcher. Here’s that obit on someone else entirely: http://goliath.ecnext.com/coms2/gi_0199-1218263/Neal-Deoul-72-physicist-lawyer.html

Gregory Pawelski
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Gregory Pawelski

Two years later, Angelo De Palma, PhD, writes in Pharmaceutical Commerce what The Industry Veteran talks about in this posting.
Personalized medicine represents a radical departure in the pharma business model with technologies for personalizing drug treatments – for identifying responders and individuals likely to experience serious side effects.
http://www.pharmaceuticalcommerce.com/frontEnd/main.php?idSeccion=560

Cancer Searcher
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Cancer Searcher

I don’t think Neal Deoul can say too much about his therapy now. He died in 2003, from a long term illness (probably cancer) I found his obiturary on a web site.

Gregory Pawelski
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Gregory Pawelski

There are at least a half dozen empiric regimens that no honest clinical oncologist would say are not equally likely to work as the others in an average patient. Let us say that we have a test which has been shown to be as accurate in predicting response and survival to chemotherapy as is the case with bacterial culture and sensitivity tests (which everyone uses without controversy). And the test shows that three treatments look poor, one looks fair, and the last two look good. So now the oncologist narrows his choices to the final two and then factors in… Read more »

RF Case
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RF Case

Something’s wrong here. Either the following URL: http://www.cancercoverup.com/fighters/cesium-science.htm is a hoax and the Neal Deoul story is a fraud, or everybody is covering for Big Pharma and/or the FDA/AMA. Does cesium/concentrated aloe vera work as a cancer treatment or not? My own doctor says it does. Why is it such a secret?