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BMI: Global - Drug Design - An Important Aspect Of The R&D Process
BMI View: The design of drugs - both visual and in terms of their administration - will become an increasingly important facet of the drug development process, as the value of a medicine has to be communicated to both patients and healthcare professionals. Patient expectations will rise as the shift towards taking greater responsibility for personal healthcare plays out, driven by the increasing individuality of modern drugs.
BMI welcomes the focus on humanising medication as we believe that more consumer-friendly drug designs will work towards improving patients' adherence to medication and the management of disease. According to the New England Healthcare Institute (NEHI), approximately 30-50% of patients in the US do not take medicines as prescribed. Reasons for not following the proper medication regimen include: unpleasant side effects; confusion; forgetfulness; language barriers; and feeling 'too good' to need medicine. Additionally, non-adherence to medicine regimens results in US$100bn in excess hospitalisations and alongside sub-optimal prescribing, drug administration and diagnosis can result in up to US$290bn in increased medical costs.
Why Consumer Focused Drug Design Is Important: The Case Of Pfizer And Exubera
In 2007, multinational drugmaker Pfizer withdrew diabetes therapy Exubera from the market, despite having only having acquired worldwide rights to the drug from Sanofi-Aventis in 2006. The withdrawal forced Pfizer to write-off nearly US$3bn from its books.
When federal regulators approved Exubera in January 2006, analysts and Pfizer predicted it would become a blockbuster and would top US$1bn in sales annually. However, Exubera's sales amounted to a poor US$12mn during the first three quarters of 2007 and despite heavy promotion, the drug achieved a less than 0.3% share of the of the insulin market.
The problems faced by the drug included the reluctance of insurance companies to pay for it - Exubera cost about US$5 a day, compared with US$2-3 a day for injectable insulin. Doctors were also worried that patients would receive more - or less - insulin than they expected because of the natural day-to-day variability of lung functions. Highlighting the importance of consumer-friendly drug design, patients - who were already benefiting from almost painless needles - were unconvinced by Exubera because its spraying device was bulky, describing it as looking similar to a tennis ball can, or more controversially, a bong for smoking cannabis.
Patient Friendly Medication
• The Medicines for Malaria Venture, a Swiss-based non-profit group, has reformulated Novartis's bitter-tasting Coartem pill into a cherry-flavoured powder, making it more suitable for consumption by children.
• In September 2009, it was announced that Novartis had partnered with intelligent medicine start-up company Proteus Biomedical to track patients' compliance with a blood pressure drug treatment regimen via Proteus's Raisin 'chip in the pill' technology. The Raisin System works using an ingestible event marker (IEM) - a tiny, digestible sensor made from food ingredients, activated by fluids in the stomach. Upon activation, the IEM sends a low-power, private, digital signal through the body to a microelectronic receiver in the form of a small bandage-style skin patch or a tiny device inserted under the skin. The receiver date- and time-stamps and records information such as the type of medicine, its dose and its place of manufacture, as well as measuring and reporting physiologic measures such as heart rate and respiratory rate. The information is then sent to the patient's mobile phone and the internet for healthcare workers to review and analyse.
• Bayer has hooked its Didget glucometer to Nintendo's video-gaming devices to encourage children with diabetes to monitor their blood sugar regularly, rewarding users with electronic points.
• Novo Nordisk has replaced insulin syringes with devices that look more like pens. According to Jesper Kløve, senior vice-president and head of device research and development at the company, 'We are seeing people seeking to be more discrete, so if you are out dining you can use it publicly in a restaurant without looking like a junkie'. The company has also introduced plastic "skins", that are wrapped around insulin pens in bright colours and with lively images that appeal to children.
• GlaxoSmithKline worked with Ideo, a design consultancy, to create a portable 'Shuttle', essentially a pill box that is designed to be discreet yet stylish, to facilitate daily mealtime dosing of its Alli (orlistat) over-the-counter dieting treatment.
BMI's Pharmaceuticals & Healthcare reports provide unparalleled analysis and forecasts of market expenditure covering all therapeutic areas, disease prevalence, regulatory and reimbursement policies, and company-by-company activity globally. They cover key developments within the following areas: generic drugs, over-the-counter (OTC) medicines, patented drugs, research and development, regulations, biotechnology, medical devices, pricing and reimbursement, imports and exports, supply chain, and epidemiology. BMI’s analysts constantly revise and update almost 80 reports and maintain industry forecasts for virtually the entire global pharmaceuticals market.
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