By
Donald Zuhn —
Last
spring, Patent Docs discussed pending
follow-on biologics legislation with California Healthcare Institute (CHI)
president and CEO Dr. David Gollaher (see
"CHI CEO on Patent Reform and Follow-on Biologics Legislation"). During the discussion, Dr. Gollaher
mentioned that Deloitte Consulting LLP (a subsidiary of CHI member Deloitte LLP)
had released its own white paper on follow-on biologics entitled "Avoiding
No Man's Land: Potential Unintended Consequences of Follow-on
Biologics."
The
Deloitte paper is a recent addition to a growing collection of publications
that address the potential impact of implementing a follow-on biologics
regulatory pathway in the United States.
To date, Patent Docs has reported
on papers by AEI Resident Scholar Dr. John Calfee (see "AEI Presents Follow-on Biologic 'Reality'"
and "AEI Believes Advantages of Longer Data Exclusivity Period Outweigh
Disadvantages"),
economist Dr. Robert Shapiro (see
"Dr. Robert Shapiro Discusses Follow-on Biologics Report"), Duke Professor Dr.
Henry Grabowski (see "Professor
Grabowski's Economic Analysis of Data Exclusivity for Follow-on Biologic
Drugs"),
the Congressional Budget Office (CBO) (see
"CBO Releases Report on Senate Follow-on Biologics Bill; BIO Calls for
Congress to Pass Biologics Bill in 2008"), Boston University
Professor Dr. Laurence Kotlikoff (see
"BU Economics Professor Releases Report on the Impact of Marketing
Exclusivity on Biologics Innovation"),
Matrix Global Advisors principal (and AEI Research Fellow) Alex Brill (see "Former House Ways and Means
Economist Claims 7-Year Data Exclusivity Period Is Sufficient"),
and the Federal Trade Commission (FTC) (see
"No One Seems Happy with Follow-on Biologics According to the FTC").
In
discussing the potential impact of a follow-on biologics (FOB) regulatory
pathway on the biotech industry, the Deloitte paper carefully outlines the
impact of the Hatch-Waxman Act on the small molecule pharmaceutical industry,
and then analyzes the differences between the small molecule pharma and
biotech industries in order to predict how an FOB regulatory pathway might
affect the biotech industry. The
paper, authored by Jim Hollingshead and Rob Jacoby, notes that the Hatch-Waxman
Act "fundamentally altered the 1983 pharmaceutical business system by
changing . . . clinical trial requirements and market economics." The Act changed clinical trial
requirements by creating an abbreviated regulatory path for generic drugs,
allowing a generic drug company to "borrow" an innovator's clinical
data in order to secure FDA approval for a generic drug without having to perform
lengthy and costly clinical trials.
In this way, the Act could meet its goal of speeding market entry of
generic drugs to foster price competition. In exchange for "loaning" their clinical data,
the Act provided innovators with mechanisms to extend patent life (i.e., patent term extension) and data
exclusivity (up to 5 years under Hatch-Waxman). Stating that "[t]he results of Hatch-Waxman have been
striking," the Deloitte paper notes that "[c]onsistent with its
intent, it did succeed in creating price competition in the market" — with the
Congressional Budget Office (CBO) estimating that the Act was generating annual
cost savings of $8-10 billion ten years after its passage.
The Deloitte paper, however, also notes that the Hatch-Waxman Act produced unintended
consequences. One consequence was
a sharp increase in R&D investment among innovator companies, and another consequence was that prices for
new branded drugs have substantially outpaced baseline GDP growth. Contending that "it is important
to understand these unintended consequences, because they may shed light on
what we might expect if an abbreviated approval pathway is created for
FOBs," the paper explains that these consequences are the result of three
effects: the "make hay
effect," the "blockbuster effect," and the threat of "no
man's land."
With
respect to the "make hay effect," the paper explains that when a
generic company enters the market, it quickly takes market share from the
innovator, which in turn reduces the innovator's revenues. Faced with the prospect of lower
revenues and a lower return on investment, the innovator will try to maximize
its revenues prior to generic competition, which the innovator can do by raising prices
and by investing more in the marketing of a new drug at launch in order to
drive earlier adoption. The paper
states that in response to Hatch-Waxman, innovators utilized both of these
options.
Innovators
also responded to Hatch-Waxman by increasing their R&D investment. However, the Deloitte paper observes
that "[g]iven an ever-increasing cost for drug development, but a capped
period of patent protection during which to achieve most return on investment,
innovators will concentrate on the development of drugs with the highest
revenue potential, i.e., blockbusters." Noting that the development of a single drug takes about 12 years and costs about $1
billion, the paper concludes that "to break even the average
drug must achieve average annual revenue of roughly $150 million," which
"cannot reliably be achieved unless a drug targets a large population of
patients, or comes at a high cost per treatment."
The
final effect, the threat of "no man's land," arises because "for
each compound waiting to be developed, there is a point at which it will never
earn sufficient return to fund its development, because if too much time
elapses, there won't be enough time remaining on market for it to generate
sufficient sales." When a
drug has reached that point, the Deloitte paper says it has crossed into
"no man's land."
Interestingly (and unfortunately), the paper "estimate[s] that no
man's land appears very quickly for a new compound — within as little as one
year of receiving a patent" (see
note 7 in the paper, where the authors assume 25 years of total patent life, and then subtract
10-12 years for drug development and 10-12 years of time on market to earn
required ROI, leaving the innovator with 1-4 years of commercial viability).
In
view of differences between the small molecule pharma and biotech industries, the
paper next addresses whether a follow-on biologics regulatory pathway would likely
generate unintended consequences and effects similar to those arising after
passage of Hatch-Waxman.
The paper notes that because biologics are more complex than small
molecule therapeutics, it takes longer (on average, 97.7 months for new
biological entities versus 90.3 months for new chemical entities) and costs
more to bring biologics to market.
In addition, the pharma and biotech industries are quite different, with
the former comprising larger, self-funding companies and the latter comprising a
smaller number of large companies and hundreds of smaller companies that are
dependent on venture investment.
The
paper speculates that "the introduction of a follow-on path could spur
investment in the technologies required to make it work," including, for
example, "increased investment and therefore advances in genetic and molecular
assay technology, required to assess biosimilarity" — which would be a positive consequence. However, the paper also states
that "[t]he very size of these molecules opens the possibility that a very
small change to the molecule that preserves the core design . . . could
circumvent the IP of the innovator company without technically infringing on
its patent." Thus, the paper
asserts that while "patents protected innovators' IP, and the data
exclusivity period rarely came into effect" for small molecule therapeutics,
"[f]or biotech innovators, if patent provisions are not sufficient to
protect their IP, it may need to be the other way around."
The
authors also contend that several of the effects seen in the pharma industry's
response to Hatch-Waxman are already impacting the biotech industry (even
without an FOB regulatory pathway). Thus, innovators are forced to focus on drugs
with the largest possible market potential — a result that "runs exactly counter
to the direction and promise of the science of biotech, which has the potential
to create more highly targeted and therefore more efficacious therapies." The paper adds that "[i]t would be
unfortunate if new regulations unintentionally circumvented the advances that
now appear to be possible in medical science by putting in place economic
incentives that rule out everything but blockbuster investments."
After
assessing the differences between the small molecule pharma industry, which was
a stable and mature in 1984 when Hatch-Waxman was implemented, and the biotech
industry, which is nascent and complex (both scientifically and financially), the
Deloitte paper concludes that "[i]n establishing a path to market for
follow-on biologics, Congress may need to employ a different set of levers to
achieve the same results." Therefore, an FOB regulatory pathway patterned too closely on the Hatch-Waxman regime would likely have unintended, and potentially adverse, consequences for the biotech industry.
Patent Docs
readers are encouraged to alert us to any papers that we may have missed —
regardless of the positions that the authors of such papers may take on the
issue.

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