1
|
Nasilli G, Verkerk AO, O’Reilly M, Yiangou L, Davis RP, Casini S, Remme CA. Chronic Mexiletine Administration Increases Sodium Current in Non-Diseased Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes. Biomedicines 2024; 12:1212. [PMID: 38927420 PMCID: PMC11200762 DOI: 10.3390/biomedicines12061212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
A sodium current (INa) reduction occurs in the setting of many acquired and inherited conditions and is associated with cardiac conduction slowing and increased arrhythmia risks. The sodium channel blocker mexiletine has been shown to restore the trafficking of mutant sodium channels to the membrane. However, these studies were mostly performed in heterologous expression systems using high mexiletine concentrations. Moreover, the chronic effects on INa in a non-diseased cardiomyocyte environment remain unknown. In this paper, we investigated the chronic and acute effects of a therapeutic dose of mexiletine on INa and the action potential (AP) characteristics in human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) of a healthy individual. Control hiPSC-CMs were incubated for 48 h with 10 µM mexiletine or vehicle. Following the wash-out of mexiletine, patch clamp analysis and immunocytochemistry experiments were performed. The incubation of hiPSC-CMs for 48 h with mexiletine (followed by wash-out) induced a significant increase in peak INa of ~75%, without any significant change in the voltage dependence of (in)activation. This was accompanied by a significant increase in AP upstroke velocity, without changes in other AP parameters. The immunocytochemistry experiments showed a significant increase in membrane Nav1.5 fluorescence following a 48 h incubation with mexiletine. The acute re-exposure of hiPSC-CMs to 10 µM mexiletine resulted in a small but significant increase in AP duration, without changes in AP upstroke velocity, peak INa density, or the INa voltage dependence of (in)activation. Importantly, the increase in the peak INa density and resulting AP upstroke velocity induced by chronic mexiletine incubation was not counteracted by the acute re-administration of the drug. In conclusion, the chronic administration of a clinically relevant concentration of mexiletine increases INa density in non-diseased hiPSC-CMs, likely by enhancing the membrane trafficking of sodium channels. Our findings identify mexiletine as a potential therapeutic strategy to enhance and/or restore INa and cardiac conduction.
Collapse
Affiliation(s)
- Giovanna Nasilli
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (A.O.V.)
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, 1105 AZ Amsterdam, The Netherlands
| | - Arie O. Verkerk
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (A.O.V.)
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, 1105 AZ Amsterdam, The Netherlands
- Department of Medical Biology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Molly O’Reilly
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (A.O.V.)
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, 1105 AZ Amsterdam, The Netherlands
| | - Loukia Yiangou
- Department of Anatomy and Embryology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Richard P. Davis
- Department of Anatomy and Embryology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
- The Novo Nordisk Foundation Center for Stem Cell Medicine (reNEW), Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Simona Casini
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (A.O.V.)
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, 1105 AZ Amsterdam, The Netherlands
| | - Carol Ann Remme
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (A.O.V.)
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, 1105 AZ Amsterdam, The Netherlands
| |
Collapse
|
2
|
Abouarab B, Bazarian C, Ben Chaouch Z, Lo AW, Mourenza Gonzalez G, Novak R, Vigneault F. Financing repurposed drugs for rare diseases: a case study of Unravel Biosciences. Orphanet J Rare Dis 2023; 18:287. [PMID: 37700316 PMCID: PMC10496212 DOI: 10.1186/s13023-023-02753-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/04/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND We consider two key challenges that early-stage biotechnology firms face in developing a sustainable financing strategy and a sustainable business model: developing a valuation model for drug compounds, and choosing an appropriate operating model and corporate structure. We use the specific example of Unravel Biosciences-a therapeutics platform company that identifies novel drug targets through off-target mechanisms of existing drugs and then develops optimized new molecules-throughout the paper and explore a specific scenario of drug repurposing for rare genetic diseases. RESULTS The first challenge consists of producing a realistic financial valuation of a potential rare disease repurposed drug compound, in this case targeting Rett syndrome. More generally, we develop a framework to value a portfolio of pairwise correlated rare disease compounds in early-stage development and quantify its risk profile. We estimate the probability of a negative return to be [Formula: see text] for a single compound and [Formula: see text] for a portfolio of 8 drugs. The probability of selling the project at a loss decreases from [Formula: see text] (phase 3) for a single compound to [Formula: see text] (phase 3) for the 8-drug portfolio. For the second challenge, we find that the choice of operating model and corporate structure is crucial for early-stage biotech startups and illustrate this point with three concrete examples. CONCLUSIONS Repurposing existing compounds offers important advantages that could help early-stage biotech startups better align their business and financing issues with their scientific and medical objectives, enter a space that is not occupied by large pharmaceutical companies, and accelerate the validation of their drug development platform.
Collapse
Affiliation(s)
- Bechara Abouarab
- Sloan School of Management, MIT, Cambridge, USA
- Laboratory for Financial Engineering, MIT, Cambridge, USA
| | - Christian Bazarian
- Sloan School of Management, MIT, Cambridge, USA
- Laboratory for Financial Engineering, MIT, Cambridge, USA
| | - Zied Ben Chaouch
- Department of Electrical Engineering and Computer Science, MIT, Cambridge, USA
- Laboratory for Financial Engineering, MIT, Cambridge, USA
| | - Andrew W Lo
- Sloan School of Management, MIT, Cambridge, USA.
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, USA.
- Laboratory for Financial Engineering, MIT, Cambridge, USA.
- Santa Fe Institute, Santa Fe, USA.
| | | | - Richard Novak
- Wyss Institute, Harvard University, Boston, USA
- Unravel Biosciences, Boston, USA
| | - Frederic Vigneault
- Wyss Institute, Harvard University, Boston, USA
- Unravel Biosciences, Boston, USA
| |
Collapse
|
3
|
Dane A, van Leeuwen R, Hoedemakers M, van der Kuy H, Sleijfer S. Combatting the rising costs of cancer drugs; interventions from a university hospital's perspective. Front Pharmacol 2023; 14:1264951. [PMID: 37701038 PMCID: PMC10493871 DOI: 10.3389/fphar.2023.1264951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/16/2023] [Indexed: 09/14/2023] Open
Abstract
Rapid increase in cost continues to have negative impact on patients' accessibility to life-changing anticancer medications. Moreover, the rising cost does not equate to similar increase in medication effectiveness. We recognise our responsibility as a university hospital to tackle this imbalance and strive to provide high quality, sustainable, affordable and accessible care. An active approach in cost containment of expensive and innovative cancer drugs was adopted in our organisation to safeguard accessibility and improve quality of life for patients. In this article, we described four inverventions: 1) identify right patient and minimise overtreatment, 2) in-house medicine production for selected indications, 3) minimise medicine spillages and 4) effective procurement strategies. We call on other hospitals to take action and, favourably, to collaborate on a European level. Together, we will safeguard the current and future care of our patients.
Collapse
Affiliation(s)
- Aniek Dane
- Department of Hospital Pharmacy, Erasmus MC, Rotterdam, Netherlands
| | | | - Maaike Hoedemakers
- Department of Market Strategy and Healthcare Financing, Erasmus MC, Rotterdam, Netherlands
| | - Hugo van der Kuy
- Department of Hospital Pharmacy, Erasmus MC, Rotterdam, Netherlands
| | | |
Collapse
|
4
|
Altamura C, Saltarella I, Campanale C, Laghetti P, Desaphy JF. Drug repurposing in skeletal muscle ion channelopathies. Curr Opin Pharmacol 2023; 68:102329. [PMID: 36512979 DOI: 10.1016/j.coph.2022.102329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 12/14/2022]
Abstract
Skeletal muscle ion channelopathies are rare genetic diseases mainly characterized by myotonia (muscle stiffness) or periodic paralysis (muscle weakness). Here, we reviewed the available therapeutic options in non-dystrophic myotonias (NDM) and periodic paralyses (PP), which consists essentially in drug repositioning to address stiffness or weakness attacks. Empirical use followed by successful randomized clinical trials eventually led to the orphan drug designation and marketing authorization granting of mexiletine for NDM and dichlorphenamide for PP. Yet, these treatments neither consider the genetic cause of the diseases nor address the individual variability in drug response. Thus, ongoing research aims at the identification of repurposed drugs alternative to mexiletine and dichlorphenamide to allow personalization of treatment. This review highlights how drug repurposing may represent an efficient strategy in rare diseases, allowing reduction of drug development time and costs in a context in which the return on investment may be particularly challenging.
Collapse
Affiliation(s)
- Concetta Altamura
- Section of Pharmacology, Department of Precision and Regenerative Medicine, School of Medicine, University of Bari Aldo Moro, Piazza Giulo Cesare, 70124, Bari, Italy
| | - Ilaria Saltarella
- Section of Pharmacology, Department of Precision and Regenerative Medicine, School of Medicine, University of Bari Aldo Moro, Piazza Giulo Cesare, 70124, Bari, Italy
| | - Carmen Campanale
- Section of Pharmacology, Department of Precision and Regenerative Medicine, School of Medicine, University of Bari Aldo Moro, Piazza Giulo Cesare, 70124, Bari, Italy
| | - Paola Laghetti
- Section of Pharmacology, Department of Precision and Regenerative Medicine, School of Medicine, University of Bari Aldo Moro, Piazza Giulo Cesare, 70124, Bari, Italy
| | - Jean-François Desaphy
- Section of Pharmacology, Department of Precision and Regenerative Medicine, School of Medicine, University of Bari Aldo Moro, Piazza Giulo Cesare, 70124, Bari, Italy.
| |
Collapse
|
5
|
Enzing JJ, Knies S, Engel J, IJzerman MJ, Sander B, Vreman R, Boer B, Brouwer WBF. Do Health Technology Assessment organisations consider manufacturers' costs in relation to drug price? A study of reimbursement reports. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2022; 20:46. [PMID: 36045377 PMCID: PMC9434877 DOI: 10.1186/s12962-022-00383-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/13/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Drug reimbursement decisions are often made based on a price set by the manufacturer. In some cases, this price leads to public and scientific debates about whether its level can be justified in relation to its costs, including those related to research and development (R&D) and manufacturing. Such considerations could enter the decision process in collectively financed health care systems. This paper investigates whether manufacturers’ costs in relation to drug prices, or profit margins, are explicitly mentioned and considered by health technology assessment (HTA) organisations. Method An analysis of reimbursement reports for cancer drugs was performed. All relevant Dutch HTA-reports, published between 2017 and 2019, were selected and matched with HTA-reports from three other jurisdictions (England, Canada, Australia). Information was extracted. Additionally, reimbursement reports for three cases of expensive non-oncolytic orphan drugs prominent in pricing debates in the Netherlands were investigated in depth to examine consideration of profit margins. Results A total of 66 HTA-reports concerning 15 cancer drugs were included. None of these reports contained information on manufacturer’s costs or profit margins. Some reports contained general considerations of the HTA organisation which related prices to manufacturers’ costs: six contained a statement on the lack of price setting transparency, one mentioned recouping R&D costs as a potential argument to justify a high price. For the case studies, 21 HTA-reports were selected. One contained a cost-based price justification provided by the manufacturer. None of the other reports contained information on manufacturer’s costs or profit margins. Six reports contained a discussion about lack of transparency. Reports from two jurisdictions contained invitations to justify high prices by demonstrating high costs. Conclusion Despite the attention given to manufacturers’ costs in relation to price in public debates and in the literature, this issue does not seem to get explicit systematic consideration in the reimbursement reports of expensive drugs. Supplementary Information The online version contains supplementary material available at 10.1186/s12962-022-00383-y.
Collapse
Affiliation(s)
- Joost J Enzing
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands. .,Zorginstituut Nederland, Diemen, The Netherlands.
| | - Saskia Knies
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Zorginstituut Nederland, Diemen, The Netherlands
| | - Jop Engel
- Zorginstituut Nederland, Diemen, The Netherlands
| | - Maarten J IJzerman
- Cancer Health Services Research, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.,Health Technology and Services Research Department, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Beate Sander
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.,Public Health Ontario, Toronto, ON, Canada.,ICES, Toronto, ON, Canada
| | - Rick Vreman
- Zorginstituut Nederland, Diemen, The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Bert Boer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Werner B F Brouwer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
6
|
van der Ree MH, van Dussen L, Rosenberg N, Stolwijk N, van den Berg S, van der Wel V, Jacobs BAW, Wilde AAM, Hollak CEM, Postema PG. Effectiveness and safety of mexiletine in patients at risk for (recurrent) ventricular arrhythmias: a systematic review. Europace 2022; 24:1809-1823. [PMID: 36036670 DOI: 10.1093/europace/euac087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/12/2022] [Indexed: 11/15/2022] Open
Abstract
While mexiletine has been used for over 40 years for prevention of (recurrent) ventricular arrhythmias and for myotonia, patient access has recently been critically endangered. Here we aim to demonstrate the effectiveness and safety of mexiletine in the treatment of patients with (recurrent) ventricular arrhythmias, emphasizing the absolute necessity of its accessibility. Studies were included in this systematic review (PROSPERO, CRD42020213434) if the efficacy or safety of mexiletine in any dose was evaluated in patients at risk for (recurrent) ventricular arrhythmias with or without comparison with alternative treatments (e.g. placebo). A systematic search was performed in Ovid MEDLINE, Embase, and in the clinical trial registry databases ClinicalTrials.gov and ICTRP. Risk of bias were assessed and tailored to the different study designs. Large heterogeneity in study designs and outcome measures prompted a narrative synthesis approach. In total, 221 studies were included reporting on 8970 patients treated with mexiletine. Age ranged from 0 to 88 years. A decrease in ventricular arrhythmias of >50% was observed in 72% of the studies for pre-mature ventricular complexes, 64% for ventricular tachycardia, and 33% for ventricular fibrillation. Electrocardiographic effects of mexiletine were small; only in a subset of patients with primary arrhythmia syndromes, a relative (desired) QTc decrease was reproducibly observed. As for adverse events, gastrointestinal complaints were most frequently observed (33% of the patients). In this systematic review, we present all the currently available knowledge of mexiletine in patients at risk for (recurrent) ventricular arrhythmias and show that mexiletine is both effective and safe.
Collapse
Affiliation(s)
- Martijn H van der Ree
- Department of Clinical Cardiology, Heart Center, Amsterdam UMC-University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Laura van Dussen
- Department of Endocrinology and Metabolism, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
- Medicine for Society, Platform at Amsterdam UMC-University of Amsterdam, Amsterdam, The Netherlands
| | - Noa Rosenberg
- Department of Endocrinology and Metabolism, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
- Medicine for Society, Platform at Amsterdam UMC-University of Amsterdam, Amsterdam, The Netherlands
| | - Nina Stolwijk
- Department of Endocrinology and Metabolism, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
- Medicine for Society, Platform at Amsterdam UMC-University of Amsterdam, Amsterdam, The Netherlands
| | - Sibren van den Berg
- Department of Endocrinology and Metabolism, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
- Medicine for Society, Platform at Amsterdam UMC-University of Amsterdam, Amsterdam, The Netherlands
| | - Vincent van der Wel
- Medicine for Society, Platform at Amsterdam UMC-University of Amsterdam, Amsterdam, The Netherlands
| | - Bart A W Jacobs
- Medicine for Society, Platform at Amsterdam UMC-University of Amsterdam, Amsterdam, The Netherlands
- Department of Pharmacy, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
| | - Arthur A M Wilde
- Department of Clinical Cardiology, Heart Center, Amsterdam UMC-University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Carla E M Hollak
- Department of Endocrinology and Metabolism, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
- Medicine for Society, Platform at Amsterdam UMC-University of Amsterdam, Amsterdam, The Netherlands
| | - Pieter G Postema
- Department of Clinical Cardiology, Heart Center, Amsterdam UMC-University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| |
Collapse
|
7
|
Franzen N, Ziegler A, Romagnoli G, Retèl VP, Offerman TJ, van Harten WH. Affordable Prices Without Threatening the Oncological R&D Pipeline-An Economic Experiment on Transparency in Price Negotiations. CANCER RESEARCH COMMUNICATIONS 2022; 2:49-57. [PMID: 36860697 PMCID: PMC9973423 DOI: 10.1158/2767-9764.crc-21-0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/11/2021] [Accepted: 12/28/2021] [Indexed: 11/16/2022]
Abstract
The high prices of innovative medicines endanger access to care worldwide. Sustainable prices need to be affordable while sufficiently incentivizing research and development (R&D) investments. A proposed solution is increased transparency. Proponents argue that price and R&D cost confidentiality are drivers of high prices. On the contrary, supporters of confidentiality claim that confidentiality enables targeted discounts which make treatments affordable; moreover, pharmaceutical companies argue that R&D investments would suffer with more transparency. Despite the political relevance, limited empirical evidence exists on the effects of transparency regulations. We contribute to fill this gap with an experiment where we replicate the EU pharmaceutical market in a laboratory setting. In a randomized controlled study, we analyzed how participants, 400 students located in four European countries, negotiated in the current system of Price Secrecy in comparison with innovative bargaining settings where either prices only (Price Transparency) or prices and R&D costs (Full Transparency) were made transparent to buyers. We found that Price transparency had no statistically significant effect on average prices or number of patients treated and made R&D investments significantly smaller (-16.86%; P: 0.0024). On the other hand, Full Transparency reduced prices (-26%; P: 0.0004) and held the number of patients constant at the level of Price Secrecy. It produced price convergence between countries with low and high health budgets, and, despite lower prices, had no effect on R&D investments. Our findings provide novel evidence that combining price and R&D cost transparency could be an effective policy to contribute to sustainable medicine prices. See related article by Franzen et al. (Cancer Discov 2022;12:299-302).
Collapse
Affiliation(s)
- Nora Franzen
- The Netherlands Cancer Institute, Department of Psychosocial Research and Epidemiology, Amsterdam, The Netherlands.,University of Twente, Department of Health Technology and Services Research, Enschede, The Netherlands
| | - Andreas Ziegler
- Center for Research in Experimental Economics and Political Decision Making, University of Amsterdam, Amsterdam, the Netherlands
| | - Giorgia Romagnoli
- Center for Research in Experimental Economics and Political Decision Making, University of Amsterdam, Amsterdam, the Netherlands
| | - Valesca P. Retèl
- The Netherlands Cancer Institute, Department of Psychosocial Research and Epidemiology, Amsterdam, The Netherlands.,University of Twente, Department of Health Technology and Services Research, Enschede, The Netherlands
| | - Theo J.S. Offerman
- Center for Research in Experimental Economics and Political Decision Making, University of Amsterdam, Amsterdam, the Netherlands
| | - Wim H. van Harten
- The Netherlands Cancer Institute, Department of Psychosocial Research and Epidemiology, Amsterdam, The Netherlands.,University of Twente, Department of Health Technology and Services Research, Enschede, The Netherlands.,Rijnstate Hospital, Arnhem, the Netherlands.,Corresponding Author: Wim H. van Harten, Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Ansterdam 1066, the Netherlands. Phone: 318-8005-7544; E-mail:
| |
Collapse
|
8
|
van den Berg S, de Visser SJ, Timmers L, Hollak CEM. Author Reply. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:158-159. [PMID: 35031095 DOI: 10.1016/j.jval.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 08/03/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Sibren van den Berg
- Medicine for Society, Amsterdam UMC - University of Amsterdam, Amsterdam, The Netherlands; Department of Endocrinology and Metabolism, Amsterdam UMC - University of Amsterdam, Amsterdam, The Netherlands.
| | - Saco J de Visser
- Medicine for Society, Amsterdam UMC - University of Amsterdam, Amsterdam, The Netherlands
| | - Lonneke Timmers
- National Health Care Institute (Zorginstituut, Nederland), Diemen, The Netherlands
| | - Carla E M Hollak
- Medicine for Society, Amsterdam UMC - University of Amsterdam, Amsterdam, The Netherlands; Department of Endocrinology and Metabolism, Amsterdam UMC - University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
9
|
Zozulya Weidenfeller A, Eslami B, Van Aswegen M, Gladish J, Oliveira R, Volle T. A Perspective on Suitability of a Cost-Based Pricing Methodology for Repurposed Orphan Medicines: A Consideration of the Overall Value Proposition. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:157-158. [PMID: 35031094 DOI: 10.1016/j.jval.2021.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 06/14/2023]
Affiliation(s)
| | - Behruz Eslami
- Lupin Neurosciences, Zug, Switzerland; Lupin Atlantis Holdings SA, Zug, Switzerland
| | - Mariska Van Aswegen
- Lupin Neurosciences, Zug, Switzerland; Lupin Atlantis Holdings SA, Zug, Switzerland
| | | | - Rosa Oliveira
- Lupin Neurosciences, Zug, Switzerland; Lupin Atlantis Holdings SA, Zug, Switzerland
| | | |
Collapse
|
10
|
van den Berg S, de Visser S, Leufkens HGM, Hollak CEM. Drug Repurposing for Rare Diseases: A Role for Academia. Front Pharmacol 2021; 12:746987. [PMID: 34744726 PMCID: PMC8564285 DOI: 10.3389/fphar.2021.746987] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 09/15/2021] [Indexed: 11/19/2022] Open
Abstract
Background: The European Commission highlights in its Pharmaceutical Strategy the role of academic researchers in drug repurposing, especially in the development of orphan medicinal products (OMPs). This study summarizes the contribution of academia over the last 5 years to registered repurposed OMPs and describes barriers to success, based upon three real world cases. Methods: OMPs granted marketing authorization between January 2016 and December 2020 were reviewed for repurposing and whether the idea originated from academia or industry. Three cases of drug repurposing were selected from different therapeutic areas and stages of development to identify obstacles to success. Results: Thirteen of the 68 OMPs were the result of drug repurposing. In three OMPs, there were two developments such as both a new indication and a modified application. In total, twelve developments originated from academia and four from industry. The three cases showed as barriers to success: lack of outlook for sufficient return of investments (abatacept), lack of regulatory alignment and timing of interaction between healthcare professionals and regulators (etidronate), failure to register an old drug for a fair price, resulting in commercialization as a high priced orphan drug (mexiletine). Conclusion: While the majority of repurposed OMPs originates in academia, a gap exists between healthcare professionals, regulators and industry. Future strategies should aim to overcome these hurdles leading to more patient benefit through sustainable access of repurposed drugs. Potential solutions include improved regulatory and reimbursement knowledge by academia and the right for regulators to integrate new effectiveness data into product labels.
Collapse
Affiliation(s)
- Sibren van den Berg
- Medicine for Society, Platform at Amsterdam UMC-University of Amsterdam, Amsterdam, Netherlands.,Department of Endocrinology and Metabolism, Amsterdam UMC-University of Amsterdam, Amsterdam, Netherlands
| | - Saco de Visser
- Medicine for Society, Platform at Amsterdam UMC-University of Amsterdam, Amsterdam, Netherlands
| | - Hubert G M Leufkens
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, Netherlands
| | - Carla E M Hollak
- Medicine for Society, Platform at Amsterdam UMC-University of Amsterdam, Amsterdam, Netherlands.,Department of Endocrinology and Metabolism, Amsterdam UMC-University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
11
|
van der Ree MH, Postema PG. What's in a name? further classification of patients with apparent idiopathic ventricular fibrillation. Eur Heart J 2021; 42:2839-2841. [PMID: 34151362 DOI: 10.1093/eurheartj/ehab382] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Martijn H van der Ree
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam, UMC, University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Pieter G Postema
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam, UMC, University of Amsterdam, Cardiovascular Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| |
Collapse
|