What drives innovation? Lessons from COVID-19 R&D

The response of the benchmark healthcare index of India to COVID-19 pandemic: a return volatility approach

PURPOSE

From poor healthcare infrastructure to vaccine donors, India has traveled a long way. In this study, the author tried to find the investment certainty and persistence of volatility in the Indian healthcare system due to COVID-19.

DESIGN/METHODOLOGY/APPROACH

Using the Generalized Autoregressive Conditional Heteroskedasticity (GARCH 1,1) model, this study quantifies the change in the conditional variance after the first case report of COVID-19. The author has used the S&P BSE HEALTHCARE index time series to analyze India's healthcare infrastructure and practices.

FINDINGS

The author found evidence of a decrease in investment certainty in investments related to India's healthcare infrastructure and practices after the first case report of COVID-19. Furthermore, the estimation of the econometric model suggests the presence of a large degree of volatility persistence in the S&P BSE HEALTHCARE index.

ORIGINALITY/VALUE

This research would be the first of its kind where the return volatility of the Indian healthcare sector has been discussed. Also, this research quantifies the return volatility of the healthcare sector during the pre- and post-COVID-19 period.

Determining the drivers of global innovation under COVID-19: An FSQCA approach

During the COVID-19 epidemic, national innovation faced the challenges of high-risk research and development and intensified trade competition. How to allocate resources reasonably to promote national innovation has become a problem that must be solved. Based on the global innovation index (GII) framework, this study analyzes the influence of national innovation input elements (such as human capital resources, infrastructure, business maturity, etc.) on innovation output from the perspective of configuration, combining with the necessary condition analysis (NCA) and fuzzy set/qualitative comparative analysis (FSQCA). The research results show that:(1) A single innovation input constitutes the necessary condition and serves as a bottleneck for high innovation output;(2) ITT, HCR, IFT, MS and BS are all "multiple concurrent" and form different configurations, namely, two high-innovation and four nonhigh innovation configurations, that drive national innovation governance is characterized by "different roads leading to the same goals." (3) As innovation is limited by the income levels of various countries, there are obvious differences in innovation drive paths between high- and low-income countries. Moreover, the configuration of asymmetric relationships with low-innovation output that occurs in high-income countries has unique characteristics. In this study, the influence of the coupling of national innovation input elements on innovation output is explored.

Synergistic fight against future pandemics: Lessons from previous pandemics

The history of pandemics spans centuries and has had a profound impact on human health, societies, and economies. Pandemics have caused fear, panic, and significant morbidity and mortality rates throughout history. From the Athenian Plague in 430 BC to the ongoing COVID-19 pandemic, infectious diseases have posed a continuous threat to global health systems. The transition from hunter-gatherer societies to agrarian communities, increased trade and interaction between humans and animals, urbanization, travel rates, and the impact of a growing human population have all contributed to the emergence and spread of infectious diseases. Climate change and changes in land use further affect the transmission of pathogens and the distribution of disease-carrying vectors. Lessons from previous pandemics include the importance of early diagnosis and response, global cooperation and collaboration, strengthened healthcare systems, preparedness planning, public health education and communication, research and development, and adaptability and flexibility in response strategies. These lessons emphasize the significance of timely identification, swift action, sharing information and resources, investing in healthcare infrastructure, preparedness planning, effective communication, research advancements, and the ability to adapt measures as pandemics evolve. In addition, the COVID-19 pandemic has reinforced the need for a collaborative and coordinated global response to future pandemics. Governments, international bodies, healthcare organizations, and individuals could learn from the lessons of the past and apply them effectively to combat and mitigate the impact of future outbreaks. By prioritizing all the recommendations stated, the world can synergistically protect public health and minimize the devastating consequences of pandemics.

The role of patient organisations in research and development: Evidence from rare diseases

Patient organisations play an increasingly crucial role in the pharmaceutical sector, yet their impact on innovation remains unexplored. We estimate the impact of patient organisations on R&D activity in the context of rare diseases in Europe using a proprietary dataset that maps clinical trials from discovery to phase III across 29 countries, 1893 indications, and 30 years (1990-2019). By applying difference-in-differences and event study methodologies to a panel of 1,646,910 unique R&D observations, we find that country-indication pairs with at least one operating patient organisation have a higher rate of R&D activity compared to those without, with stronger effect in more prevalent rare diseases compared to ultra-rare conditions. We observe a lag in effects from patient organisation introduction, suggesting it takes approximately five years for these organisations to affect R&D activity. Overall, our work suggests that patient organisations play an important role in steering R&D efforts in rare diseases. Further research is needed to better understand mechanisms driving this effect and the potential impact of patient organisations on existing health inequities.

Factors influencing the time to ethics and governance approvals for clinical trials: a retrospective cross-sectional survey

BACKGROUND

The findings from multi-centre trials are central to the practice of evidence-based medicine, enabling the development and implementation of new treatments. The time it takes to commence clinical trials at sites can be long, and ethics and governance approvals are key steps on the pathway to site activation. The goal of this study was to explore factors influencing the times to ethics approval, governance approval and site activation for multi-centre clinical trials.

METHODS

This paper assessed the associations of trial characteristics (disease area and trial phase), site characteristics (government or private ownership, country) and characteristics of the ethics and governance processes (scope guidelines, mutual acceptance requirements and triage of projects by risk) with times to approvals and activation. Median times were compared between site initiations that were and were not exposed to each characteristic using non-parametric tests in univariable and multivariable regressions.

RESULTS

There were data from 150 site activations done across 91 sites, 16 trials and 5 countries from November 2013 to November 2021. The overall median time to activation was 234 days (range 74 to 657), with ethics approval taking a median of 48 days (0 to 369) and governance approval a median of 34 days (0 to 489). Both the univariable and multivariable analyses identified associations of disease area, particularly oncology (p univariable = 0.012, p multivariable = 0.044), use of scope guidelines (p < 0.001, p = 0.020) and use of a triage process (p < 0.001, 0.043) with shorter median times for governance approval. These characteristics (all p < 0.001) plus early trial phase (p = 0.028) were also predictive of shorter median times for ethics approval in univariable analyses, but none remained predictive in multivariable models (all p > 0.054). The only factors associated with reduced overall time to site activation in both univariable and multivariable analyses were the early trial phase (p < 0.001, p = 0.013) and mutual acceptance of ethics approvals (p = 0.031, p = 0.030).

INTERPRETATION

Times to ethics and governance approvals were only one third of total trial start-up time. Factors influencing times to approval and activation were somewhat inconsistent across analyses, but it seems likely that the introduction of selected governance and ethics processes can reduce approval times.

Biopharma innovation trends during COVID-19 and beyond: an evidence from global partnerships and fundraising activities, 2011-2022

BACKGROUND

Co-development alliances and capital-raising activities are essential supports for biopharmaceutical innovation. During the initial outbreak of the COVID-19, the level of these business activities has increased greatly. Yet the magnitude, direction, and duration of the trend remain ambiguous. Real-time real-world data are needed to inform strategic redirections and industrial policies.

METHODS

This observational study aims to characterize trends in global biopharma innovation activities throughout the global pandemic outbreak. Our extensive deal dataset is retrieved from the commercial database GlobalData (12,866 partnership deals and 32,250 fundraising deals announced between 2011 and 2022). We perform Chi-squared tests to examine the changes in qualitative deal attributes during and beyond the outbreak. Our deal-level sample is further aggregated into category-level panel data according to deal characteristics such as therapy area, molecule type, and development phase. We run a series of regressions to examine how the monthly investment amount raised in each category changed with the onset of the pandemic, controlling for the US Federal funds rate.

RESULTS

The temporary surge of partnership and capital-raising activities was associated with the increase in infectious disease-related deals. Academic and government institutions played an increased role in supporting COVID-related co-development partnerships in 2020, and biopharma ventures had been securing more investments in the capital market throughout 2020 and 2021. The partnership and investment boom did not last till the later pandemic in 2022. The most significant and enduring trend was the shifting focus toward discovery-phase investments. Our regression model reveals that the discovery-phase fundraising deals did not suffer from a bounce back in the late pandemic, consistent with a persistent focus on early innovation.

CONCLUSIONS

Despite the reduced level of partnership and fundraising activities during 2022, we observe a lasting change in focus toward biopharmaceutical innovation after the pandemic outbreak. Our evidence suggests how entrepreneurs and investors should allocate resources in response to the post-pandemic tight monetary environment. We also suggest the need for policy interventions in financing private/public co-development partnerships and non-COVID-related technologies, to maintain their research capacity and generate breakthroughs when faced with unforeseen diseases.

Comparative analysis of level of evidence and class of recommendation for 50 clinical practice guidelines released by the European Society of Cardiology from 2011 to 2022

BACKGROUND

The European Society of Cardiology (ESC) clinical practice guidelines are essential tools for decision-making.

AIM

To analyze the level of evidence (LOE) and the class of recommendations in the ESC guidelines released in the last 12 years.

METHODS

We evaluated 50 ESC guidelines released from 2011 to 2022, related to 27 topics and categorized them into seven macro-groups. We analyzed every recommendation in terms of LOE and class of recommendation, calculating their relative proportions and changes over time in consecutive editions of the same guideline.

RESULTS

A total of 6972 recommendations were found, with an increase in number per year over time. Among the 50 ESC guidelines, the proportional distribution of classes of recommendations was 49% for Class I, 29% for Class IIa, 15% for Class IIb, and 8% for Class III. Overall, 16% of the recommendations were classified as LOE A, 31% LOE B and 53% LOE C. The field of preventive cardiology had the largest proportion of LOE A, while the lowest was in the field of valvular, myocardial, pericardial and pulmonary diseases. The overall proportion of LOE A recommendations in the most recent guidelines compared to their prior versions increased from 17% to 20%.

CONCLUSIONS

The recommendations included in the ESC guidelines widely differ in terms of quality of evidence, with only 16% supported by the highest quality of evidence. Although a slight global increase in LOE A recommendations was observed in recent years, further scientific research efforts are needed to increase the quality of evidence.

Adoption of Digital Vaccination Services: It Is the Click Flow, Not the Value—An Empirical Analysis of the Vaccination Management of the COVID-19 Pandemic in Germany

This research paper examines the adoption of digital services for the vaccination during the COVID-19 pandemic in Germany. Based on a survey in Germany’s federal state with the highest vaccination rate, which used digital vaccination services, its platform configuration and adoption barriers are analyzed to understand existing and future levers for optimizing vaccination success. Though technological adoption and resistance models have been originally developed for consumer-goods markets, this study gives empirical evidence especially for the applicability of an adjusted model explaining platform adoption for vaccination services and for digital health services in general. In this model, the configuration areas of personalization, communication, and data management have a remarkable effect to lower adoption barriers, but only functional and psychological factors affect the adoption intention. Above all, the usability barrier stands out with the strongest effect, while the often-cited value barrier is not significant at all. Personalization is found to be the most important factor for managing the usability barrier and thus for addressing the needs, preferences, situation, and, ultimately, the adoption of the citizens as users. Implications are given for policy makers and managers in such a pandemic crisis to focus on the click flow and server-to-human interaction rather than emphasizing value messages or touching traditional factors.

A research and development (R&D) roadmap for broadly protective coronavirus vaccines: A pandemic preparedness strategy

Broadly protective coronavirus vaccines are an important tool for protecting against future SARS-CoV-2 variants and could play a critical role in mitigating the impact of future outbreaks or pandemics caused by novel coronaviruses. The Coronavirus Vaccines Research and Development (R&D) Roadmap (CVR) is aimed at promoting the development of such vaccines. The CVR, funded by the Bill & Melinda Gates Foundation and The Rockefeller Foundation, was generated through a collaborative and iterative process, which was led by the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota and involved 50 international subject matter experts and recognized leaders in the field. This report summarizes the major issues and areas of research outlined in the CVR and identifies high-priority milestones. The CVR covers a 6-year timeframe and is organized into five topic areas: virology, immunology, vaccinology, animal and human infection models, and policy and finance. Included in each topic area are key barriers, gaps, strategic goals, milestones, and additional R&D priorities. The roadmap includes 20 goals and 86 R&D milestones, 26 of which are ranked as high priority. By identifying key issues, and milestones for addressing them, the CVR provides a framework to guide funding and research campaigns that promote the development of broadly protective coronavirus vaccines.

Regional convergence analysis of sustainable innovation efficiency in European Union countries

Sustainable innovation strategies have been taken very seriously by the European Union (EU), which aims to reduce energy consumption and environmental pollutants emissions. For the sake of testing the sustainable performance of EU countries empirically, this research evaluates the sustainable innovation efficiency (SIE) of EU countries through a DEA-SBM model and analyzes the convergence trends of the EU regions by convergence analysis. The results show that the EU has attached great importance to sustainable innovation efficiency, indicating that the EU makes a concerted effort in technological innovation, energy saving, and environmental protection. Significant differences exist in SIE among EU regions, even though the southern region has the highest efficiency. In addition, there are distinct convergence trends in regional sustainable innovation efficiency. Control variables have significant impacts on the convergence of SIE in the EU regions. Furthermore, policymakers are also provided with useful decision support for regional sustainable innovation, energy conservation, and emission reduction policies.