Puente: The industry needs a better return from its investment in cancer. Pfizer has ceded more than $20 billion in revenues from
patent expirations over the past five years; the industry itself will lose another $40 billion in the next three. That's a
lot of money flowing back into the healthcare system, a saving that should be recognized. Meanwhile, Pfizer is spending about
35 percent of its R&D budget on oncology, even though oncology products currently amount to only three percent of our global
sales. So the last thing our management is predisposed to do is give us more money for this market. I actually make a point
to seek out investors, and there is a big challenge in getting them to see we have a strong value proposition. Society must
understand the consequences: when the value proposition goes away, money for research will stop. In turn, government must
know that decline can affect its own legitimacy. Information is boundary less. There is someone in a small village in central
China right now who has been diagnosed with lung cancer; he will soon find through the Internet that treatments we have in
the West are not going to be available to him, and he will die. This is a latent source of social unrest.
Rutstein: What is needed in oncology is more active cooperation in the development of treatments that are tailored to the clinical
profile of each patient. There is great emphasis on the financial and regulatory hurdles to commercialization of new treatments,
but it's also important to consider how we can increase collaboration across industry and with regulators on the science.
The competitive aspects of drug development can make scientific collaboration difficult, but industry should continue efforts
to build consortiums to share biomarker data and learn from each other.
Geipel: Global demographic trends suggest that this is not the time to disinvest in medicines for the diseases of old age, which includes
cancer. In an era of scarcity, it is equally true the only viable way to make progress is through collaboration. Lilly's PACE
Project is a good example of how to create networks that promote awareness and patient access to care. Building communities
able to tackle practical issues—such as the ways in which health technology assessment and cost-effectiveness research shape
investment and access to new cancer treatments—is also important.
Denduluri: All the complex strands that bind our work in oncology—from discovery to clinical trials to patient access—have to be brought
together. Pathways and guidelines are an ideal instrument to facilitate interaction, but vigilance is required to keep them
current and relevant to the practitioner. Redundancies and the inconsistencies that flow from this are a threat as government
supervision of the healthcare system increases.
Paterson: Payers hold a great deal of power, so industry has to think more about how they can be compelled to cooperate. We must separate
out the negatives like perceptions about pricing and inappropriate marketing and focus on some of the creative approaches
to drug benefit design now underway between insurers and companies.
Coker: I second the comments about more cooperation. It surprises me, but there is still resistance in some quarters of industry
to working together around a commitment to transparency. Another issue is to ensure that our regulatory and legal framework
keeps pace with science and the preferences of clinicians and patients. Regulation should never be a drag on innovation.
William Looney is Pharm Exec's Editor-in-Chief. He can be reached at firstname.lastname@example.org