Logistics
Cash in on
linical trials are designed to test the safety and efficacy of medical interventions. They were not developed to determine the economic value of those interventions, much less to optimise pharmaceutical productivity. As clinical supply chain and operations staff know better than anyone, a randomised control trial, whether it ends in success or failure, costs what it costs to get it there. Beyond that, grubby monetary considerations are supposed to be kept well away from a study’s objective pursuit of health and understanding. If only that were still an option.
C
‘Cost disease’ is a term well-suited to a system that spends an estimated $2.56bn to develop a new drug therapy, according to an article in the Journal of Health Economics. First used by economist William Baumol in the 1960s, the term links the increasing cost
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opportunity
Adaptive trial designs have enabled clinical research to keep up with Covid-19, but their operational costs and complexities might be harder to justify once the pandemic has passed – unless we’ve been thinking about them the wrong way. New research suggests greater use of adaptive trials can lower the overall cost of drug development and create new opportunities for generating value in healthcare. Isabel Ellis fi nds out more from Stephen Chick, the Novartis chaired professor of healthcare management at INSEAD, and Jörg Mahlich, market access and government affairs lead at Miltenyi Biomedicine.
of healthcare in advanced economies to its stagnant productivity relative to manufacturing and commodity- producing industries. Productivity increases in the latter enable wage hikes that sectors such as healthcare have to match in order to retain staff and attract talent. As these sectors aren’t saving money elsewhere, however, costs climb.
Although the importance of manufacturing to the pharmaceutical industry partially shields it from this effect, one 2012 study in Nature Reviews Drug Discovery found that, despite all its technological and operational advancements, the number of new drugs approved per billion US dollars spent on R&D has halved roughly every nine years since 1950 – a drop by a factor of 80 in inflation-adjusted terms. In contrast to Moore’s Law – which describes the exponential increase in the number of transistors that can be fitted
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