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Bernard Munos
Senior Fellow, FasterCures
Founder, InnoThink Center for Research in Biomedical Innovation
Bangalore, August 11, 2018
Rethinking The Pharmaceutical Business Model
InnoThink
Part 1
The Pharma Challenge
The pharma model does not scale well
InnoThink
R² = 0.9937
0
5
10
15
20
25
30
35
40
1/1/1980 6/23/1985 12/14/1990 6/5/1996 11/26/2001 5/19/2007 11/8/2012
Pfizer's cumulative number of NMEs
More Evidence That Innovation Does Not Scale With Size
Source: drugs@FDA
• Pfizer has produced new drugs at the same rate since at least 1980
• Similar charts can be drawn for every other company
Warner-Lambert ($90 bn)
Pharmacia ($60 bn)
Wyeth ($68 bn)
37 drugs over 38 years
InnoThink
0
10
20
30
40
50
60
70
80
90
Large Pharmaceutical Companies*
NME approved R&D spending
NMEs or $ billion
More R&D Is Not Yielding More Drugs
*includes AbbVie, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, GSK, J&J, Lilly, MSD, Novartis, Pfizer, Roche,
Sanofi, and their predecessors
$78 billion
17 new drugs
$4.6 billion/NME
+8.4%
InnoThink
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
18.0%
20.0%
2010 2011 2012 2013 2014 2015 2016 2017
Return on R&D
large cap mid-large cap
Source: Measuring the return from pharmaceutical innovation 2017, Deloitte Center
for Health Solutions
Source: Pharma’s broken business model, Kelvin Stott
cost-of-capital
0%
20%
40%
60%
80%
100%
VRTX
REGN
BMY
GILD
BIIB
JNJ
BAY
BI
ASTE
BMRN
TAKE
NVO
NVS
OTSU
AMGN
CELG
LLY
EISA
AZN
MRK
ROC
GSK
PFE
SHP
SNY
ABBV
10-year Freshness Index
(Percent of sales from drugs approved in last 10 years)
large companies
biotech & mid-sized
0.0
2.0
4.0
6.0
8.0
10.0
ASTE
SNY
PFE
TAKE
AZN
OTSU
LLY
GSK
BI
NVS
ROC
MRK
AMGN
REGN
EISA
CELG
BAY
VRTX
JNJ
NVO
ABBV
BMY
BIIB
SHP
GILD
BMRN
R&D spending/NME ($ billion)
calculated over 1990-2017
Source: EvaluatePharma ; drugs@FDASource: EvaluatePharma ; drugs@FDA
large companies
biotech & mid-sized
“Every $1 invested in R&D returns $0.70“
Chris Viehbacher, former CEO, Sanofi
• Old blockbusters (e.g., Lipitor) used to treat millions
• New targeted drugs treat thousands
• In the US…
 90% of prescriptions are filled by generics for $30 billion
 10% of prescriptions are filled by proprietary drugs for $250 billion
 In 2000, only ~50% of prescriptions were filled by generics
Generics Are Crowding Out Proprietary Drugs
InnoThink
Yet, as the metrics deteriorate…
We cure cancer We restore vision
(Luxturna)
We change cystic
fibrosis patients’ lives
We cure hepatitis C We prevent Ebola
• All this would have been unthinkable 10 years ago
• Science is opening incredible new horizons
• How can we bring that promise to patients in an affordable way?
InnoThink
Part 2
Changing The Economics of Drug R&D
InnoThink
Data drives innovation
“If you think about the scientific revolutions that
have occurred in history, they’ve been driven by
one thing — the availability of data”
“From Copernicus to quantum mechanics,
it’s data that drives innovation”John Quackenbush
Harvard University
It Must Start With Data
InnoThink
Breakthrough Science Does Not Cost Much
R² = 0.9882
0
5
10
15
20
25
30
35
40
45
50
1944 1951 1958 1965 1972 1979 1986 1993 2000 2007 2014
Nobel prize Lasker prize
Source: Rockefeller University
Fostering a culture of innovation
on a shoestring
82 professors
200 students
325 postdocs
Research budget: $228 million
Rockefeller has predictably produced Nobel and Lasker prizes for 74 years. What’s the secret?
 Not the size: only 82 professors
 Not the money: only $228 million of annual research spending
 It’s the talent and the culture
Rockefeller: 25 Nobel + 22 Lasker over 74 years
InnoThink
 It is collected in clinical trials… the highest possible cost setting
 Over $110 billion per year for human clinical trials!
 It has limitations
 Rare diseases, or rare mutations of common diseases
 Diseases that progress slowly over many years (Alzheimer’s, cancers)
 It is sparse — collected intermittently. Tells little about what’s
really happening. A snapshot, not a movie.
 It does measure long-run outcomes. How is patient evolving
after treatment?
But Patient Data Is Expensive
InnoThink
Pulse oximeter
Blood pressure monitor
EKG monitor
Pill dispenser
Blood glucose monitor
Activity tracker
Smart car seat
Smart clothes
Smart toilet
Smart mattress
& sheets
Personal digital cloud
(Terabytes of data)
Smart phone
Smart
thermostat
genome
Xrays, lab results
eRx
and a lot more…
Digital Technologies Are Helping Overcome The Data Challenge
Digital Technologies Are Also Changing Science And Medicine
 They enable open science and big science initiatives such as the “All of
Us” million-patient cohort
 They allow data to be easily shared, aggregated, stored, and analyzed
in new ways
 Increasingly, these open databases serve as starting points for many
research investigations. Exploratory research is less dependent upon
funding.
 Collaborations are no longer hampered by geographic distance
InnoThink
These Collaborations Are Changing Innovation Dynamics
And Giving Rise To New Research Models
• They tap the global brain, facilitate access to top talent, and
foster cross-pollination
• They bring together competences that are seldom found
under one roof (e.g., AI, tissue engineering, biochips, etc)
• They broaden the locus of innovation by helping it flourish in
areas that have not traditionally participated in it (e.g., Africa)
• Examples:
• Public-Private Partnerships (e.g., MMV, GAVI, ADNI, SGC, AMP)
• Open-source collaboration platforms (e.g., OSDD)
• Crowdsourcing (e.g., Innocentive, drug repurposing)
• Partnerships (with academia, VCs, other pharma, e.g., Biden Cancer Initiative)
• Consortia (e.g., Critical Path Institute)
InnoThink
Part 3
Discussion: Audience’s Experience With Open Science
InnoThink
Thank You!

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Access to Research Open Source Pharma Dr Bernard Munos

  • 1. Bernard Munos Senior Fellow, FasterCures Founder, InnoThink Center for Research in Biomedical Innovation Bangalore, August 11, 2018 Rethinking The Pharmaceutical Business Model InnoThink
  • 2. Part 1 The Pharma Challenge
  • 3. The pharma model does not scale well InnoThink
  • 4. R² = 0.9937 0 5 10 15 20 25 30 35 40 1/1/1980 6/23/1985 12/14/1990 6/5/1996 11/26/2001 5/19/2007 11/8/2012 Pfizer's cumulative number of NMEs More Evidence That Innovation Does Not Scale With Size Source: drugs@FDA • Pfizer has produced new drugs at the same rate since at least 1980 • Similar charts can be drawn for every other company Warner-Lambert ($90 bn) Pharmacia ($60 bn) Wyeth ($68 bn) 37 drugs over 38 years InnoThink
  • 5. 0 10 20 30 40 50 60 70 80 90 Large Pharmaceutical Companies* NME approved R&D spending NMEs or $ billion More R&D Is Not Yielding More Drugs *includes AbbVie, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, GSK, J&J, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi, and their predecessors $78 billion 17 new drugs $4.6 billion/NME +8.4% InnoThink
  • 6. 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0% 20.0% 2010 2011 2012 2013 2014 2015 2016 2017 Return on R&D large cap mid-large cap Source: Measuring the return from pharmaceutical innovation 2017, Deloitte Center for Health Solutions Source: Pharma’s broken business model, Kelvin Stott cost-of-capital 0% 20% 40% 60% 80% 100% VRTX REGN BMY GILD BIIB JNJ BAY BI ASTE BMRN TAKE NVO NVS OTSU AMGN CELG LLY EISA AZN MRK ROC GSK PFE SHP SNY ABBV 10-year Freshness Index (Percent of sales from drugs approved in last 10 years) large companies biotech & mid-sized 0.0 2.0 4.0 6.0 8.0 10.0 ASTE SNY PFE TAKE AZN OTSU LLY GSK BI NVS ROC MRK AMGN REGN EISA CELG BAY VRTX JNJ NVO ABBV BMY BIIB SHP GILD BMRN R&D spending/NME ($ billion) calculated over 1990-2017 Source: EvaluatePharma ; drugs@FDASource: EvaluatePharma ; drugs@FDA large companies biotech & mid-sized “Every $1 invested in R&D returns $0.70“ Chris Viehbacher, former CEO, Sanofi
  • 7. • Old blockbusters (e.g., Lipitor) used to treat millions • New targeted drugs treat thousands • In the US…  90% of prescriptions are filled by generics for $30 billion  10% of prescriptions are filled by proprietary drugs for $250 billion  In 2000, only ~50% of prescriptions were filled by generics Generics Are Crowding Out Proprietary Drugs InnoThink
  • 8. Yet, as the metrics deteriorate… We cure cancer We restore vision (Luxturna) We change cystic fibrosis patients’ lives We cure hepatitis C We prevent Ebola • All this would have been unthinkable 10 years ago • Science is opening incredible new horizons • How can we bring that promise to patients in an affordable way? InnoThink
  • 9. Part 2 Changing The Economics of Drug R&D InnoThink
  • 10. Data drives innovation “If you think about the scientific revolutions that have occurred in history, they’ve been driven by one thing — the availability of data” “From Copernicus to quantum mechanics, it’s data that drives innovation”John Quackenbush Harvard University It Must Start With Data InnoThink
  • 11. Breakthrough Science Does Not Cost Much R² = 0.9882 0 5 10 15 20 25 30 35 40 45 50 1944 1951 1958 1965 1972 1979 1986 1993 2000 2007 2014 Nobel prize Lasker prize Source: Rockefeller University Fostering a culture of innovation on a shoestring 82 professors 200 students 325 postdocs Research budget: $228 million Rockefeller has predictably produced Nobel and Lasker prizes for 74 years. What’s the secret?  Not the size: only 82 professors  Not the money: only $228 million of annual research spending  It’s the talent and the culture Rockefeller: 25 Nobel + 22 Lasker over 74 years InnoThink
  • 12.  It is collected in clinical trials… the highest possible cost setting  Over $110 billion per year for human clinical trials!  It has limitations  Rare diseases, or rare mutations of common diseases  Diseases that progress slowly over many years (Alzheimer’s, cancers)  It is sparse — collected intermittently. Tells little about what’s really happening. A snapshot, not a movie.  It does measure long-run outcomes. How is patient evolving after treatment? But Patient Data Is Expensive InnoThink
  • 13. Pulse oximeter Blood pressure monitor EKG monitor Pill dispenser Blood glucose monitor Activity tracker Smart car seat Smart clothes Smart toilet Smart mattress & sheets Personal digital cloud (Terabytes of data) Smart phone Smart thermostat genome Xrays, lab results eRx and a lot more… Digital Technologies Are Helping Overcome The Data Challenge
  • 14. Digital Technologies Are Also Changing Science And Medicine  They enable open science and big science initiatives such as the “All of Us” million-patient cohort  They allow data to be easily shared, aggregated, stored, and analyzed in new ways  Increasingly, these open databases serve as starting points for many research investigations. Exploratory research is less dependent upon funding.  Collaborations are no longer hampered by geographic distance InnoThink
  • 15. These Collaborations Are Changing Innovation Dynamics And Giving Rise To New Research Models • They tap the global brain, facilitate access to top talent, and foster cross-pollination • They bring together competences that are seldom found under one roof (e.g., AI, tissue engineering, biochips, etc) • They broaden the locus of innovation by helping it flourish in areas that have not traditionally participated in it (e.g., Africa) • Examples: • Public-Private Partnerships (e.g., MMV, GAVI, ADNI, SGC, AMP) • Open-source collaboration platforms (e.g., OSDD) • Crowdsourcing (e.g., Innocentive, drug repurposing) • Partnerships (with academia, VCs, other pharma, e.g., Biden Cancer Initiative) • Consortia (e.g., Critical Path Institute) InnoThink
  • 16. Part 3 Discussion: Audience’s Experience With Open Science InnoThink

Editor's Notes

  1. 4