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Monday, March 26, 2018

The Readout by Damian Garde & Meghana Keshavan

Welcome to The Readout, where we keep you on top of the latest in biotech. For more in-depth coverage of biopharma, subscribe to STAT Plus. On Twitter: @damiangarde@megkesh, and @statnews.

These billionaires are taking on high drug prices. Why?

photo credit: Brent Humphreys

John and Laura Arnold: Who are these billionaire crusaders taking aim at high drug costs? 

STAT’s Rebecca Robbins takes a look at the couple with a philanthropic bent that does not please drug makers. The Arnold Foundation is investing heavily in projects meant to increase transparency in health care, doling out millions of dollars in grants to wonkish academics, advocacy groups, and journalists while seemingly asking nothing in return. 

Still, their funding often backs contradictory research — with one Arnold-funded group decrying the high price of CAR-T drugs, for example, while another pronounces them cost-effective.

“If they have some master plan, that master plan is running in a lot of different directions,” one employee of the foundation told STAT.

Read more. 

That big Incyte trial is a coin flip, readers say

The next big binary thing in biotech belongs to Incyte, which is running a Phase 3 trial that will determine whether its cancer drug is a perfect partner to blockbusters like Keytruda or an ill-advised science project worth zero dollars.

So, last week, we asked readers to make a call: Will Incyte succeed? About 57 percent said yes, betting a combination of Incyte’s drug and Keytruda will perform better than Keytruda alone. And the rest, 43 percent, voted no, predicting the kind of massive clinical failure that has a habit of dragging down whole indices in biotech.

We’ll find out who’s right soon enough.

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A mousetrap bootcamp for immune cells

Novartis just licensed out a Harvard-developed implant meant to train immune cells to become cancer-hunting mercenaries.

The device pulls immune cells in, teaches them how to recognize a patient’s tumor by exposing them to tumor proteins and immune modulators, then releases them for attack. 

The hope is that this embedded cancer vaccine might cause fewer side effects, because unlike checkpoint inhibitors and CAR-T therapy, it’s installed locally — not given systemically. 

Of course, the approach faces the same hurdle other cancer vaccines might: The patient’s immune system has already seen the cancer, and has failed to attack it. 

Read more. 

In defense of the me-too

Why bother with the me-too drug? Peter Kolchinsky of RA Capital Management outlines a defense for the incrementally improved therapeutic in a Medium post. Companies used to retain in-class monopolies for the novel drugs they’d develop — with patients paying a premium until they went generic. 

Enter the me-too: Competitors would launch drugs that ate into the profit of the first-in-class drug. Now, however, the me-too’s are following so quickly, Kolchinsky writes, that they’re encouraging competition and forcing companies to keep prices reasonable well before any generic competitors come into play. This was seen, for instance, in the two PCSK9 drugs approved in tandem to treat high cholesterol: Repatha and Praulent played off each other in terms of pricing, he says.

And some drug classes, particularly biologic drugs like CAR-T therapy, simply cannot be made generic — meaning “me-toos remain the only foreseeable strategy to commoditize certain drugs,” he writes. 

More reads from STAT

  • After a torrent of criticism, PLOS One retracts study pushing “Gut Makeover” diet. (BuzzFeed News)
  • Reward and risk: the two faces of Hong Kong’s new listing rules for biotech firms (South China Morning Post)

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