Monday, April 29, 2019

Very Brief Blog: Bach/Trusheim on Biosimilars Folly; New Book on Precision Medicine Economics

Two brief items from the horizon scan - Peter Bach and Mark Trusheim and colleagues blog on Health Affairs on why biosimilars aren't working well; and separately, a new academic textbook on precision medicine and economics.

Why Biosimilar's Aren't Effective (...Competition)

In a 2017 article in Forbes, Bach and Trusheim pointed out it would be cheaper for the feds to buy Gilead (even above market price) than pay for all the anticipated sales of Sovaldi.

With colleagues Preston Atteberry and Jennifer Ohn, they're back with a pair of long blogs in Health Affairs (Part 1 here, Part 2 here) on why biosimilars aren't and won't be an effective deterrent (or, a drug on the market) to the high prices of biologicals.

The articles have their own little firestorm on Twitter, and have been picked up in STAT and in ENDPOINTS.  Here and here.

For a recent 2019 piece in Forbes by Dan Mendelson on the same topic, here. For a 2018 view on "the biosimilars problem," also in Forbes, here.   

For a July 2019 response, as a blog in Health Affairs by Brill & Ippolito, here. 

  • Former FDA commissioner Scott Gottlieb was about as forthright as he could be, as Commissioner, in December 2018 in describing biosimilars problems, here.   And he was more outspoken after leaving office, here.

More Links:  Bach x 2

For Bach's testimony to the Senate Finance Committee in January 2019, here.  This is a quite interesting 11-page essay in its own right. 

For Bach's Sloan Kettering, "Center for Health Policy & Outcomes," here; for its Drug Pricing Lab (website) here.

New Book on Economics of Precision Medicine

Just released by the University of Chicago, and available as Ebook and textbook on Amazon (circa $100): Economic Dimensions of Personalized and Precision Medicine, about 270pp.

I've clipped the table of contents below the break.  It includes a chapter on precision medicine and game theory by Berndt & Trusheim.  (Be prepared to google Bertrand Competition).

Economic Dimensions of Personalized and Precision Medicine
University of Chicago
From a conference of the National Bureau of Economic Research.
Publication Date: April 2019

Ernst R. Berndt, Dana Goldman, and John Rowe

1. The Economic Value and Pricing of Personalized Medicine
Tomas J. Philipson

2. Therapeutic Translation of Genomic Science: Opportunities and Limitations of GWAS
Manuel Hermosilla and Jorge Lemus

3. The Value of Pharmacogenomic Information
John A. Graves, Zilu Zhou, Shawn Garbett, and Josh F. Peterson

4. The Information Pharms Race and Competitive Dynamics of Precision Medicine: Insights from Game Theory
Ernst R. Berndt and Mark R. Trusheim

5. Characterizing the Drug Development Pipeline for Precision Medicines
Amitabh Chandra, Craig Garthwaite, and Ariel Dora Stern

6. Cost Sharing in Insurance Coverage for Precision Medicine
Mark V. Pauly

7. Measuring the Potential Health Impact of Personalized Medicine: Evidence from Multiple Sclerosis Treatments
Kristopher J. Hult

8. Physicians’ Financial Incentives to Personalize Medicine
David H. Howard, Jason Hockenberry, and Guy David

9. Economic Dimensions of Personalized and Precision Medicine in Asia: Evidence from Breast Cancer Treatment in Taiwan
Jui-fen Rachel Lu, Karen Eggleston, and Joseph Tung-Chieh Chang

10. The Value of Cytochrome P450 2C19 Pharmacogenomic Information for Patients Receiving Clopidogrel Therapy Following a Major Cardiovascular Event: Evidence from Geisinger
Rebecca A. Pulk, Jove Graham, Frank R. Lichtenberg, Daniel Maeng, Marc S. Williams, and Eric Wright

11. Orphan Drug Designations as Valuable Intangible Assets for IPO Investors in Pharma-Biotech Companies
Philippe Gorry and Diego Useche