The Soul of Biotech

The next session I attended was the personalized medicine panel, which was new this year. The panelists spoke to a standing-room-only crowd in an HBS lecture hall. The panelists briefly explained what personalized medicine was, and emphasized its importance as technology began to deliver whole genome sequences for less and less money. The first human genome cost about $3 billion dollars to sequence. As of March 2008, that price had dropped to $60,000. More recently, SingularityHub predicted that whole genome sequencing would fall to $1,000 before the end of 2009.

So what are some of the consequences of a high volume of genetic data becoming rapidly available?

• Noubar Afeyan provided an overview of the current diagnostics market. One company recently did a deal with Humana to develop simple treatment response markers (non-predictive) — the kicker is that patient co-pays will depend on the values of the treatment response marker.

• Dr. Teresa DeLuca, Medco’s VP of Personalized Medicine, capably explained not only how personalized medicine can achieve improved outcomes in targeted patient populations, but also how the technology can reduce costs for payors. Payors may not be able to make a patient go into wellness program or enforce a patient’s compliance, but they will soon be more able to get the right patient the right drug at the right dose at the right time. Medco is working to create diagnostics reports for doctors that provide medication recommendations for patients.
• Mara Aspinall, president of Genzyme Genetics, emphasized the need to more deeply understand the pathways and MOA for the drugs we already have, and add the right diagnostics and pharmacoeconomic data to deliver a total value package for payors.

Curiously, Afeyan also mentioned current research into biomarkers that may predict response to anti-TNF medications such as Enbrel.

Later on, I also spoke with Wayne Rosenkrans, the panel moderator and the chairman of the Personalized Medicine Coalition, which works on evolving healthcare policy in this area. He agreed that the Genetic Information Nondiscrimination Act was a promising step forward, but insufficient protection for most patients. Case law will have to fill in the gaps left by the law, which is only months old.

I’ve been thinking about non-personal promotion a bit more since my previous post on Novartis’ FluFlix contest.

A casual search of Facebook for the top ten best-selling pharmaceutical brands of 2006 reveals that social groups already exist for most:

1. Lipitor
2. Advair
3. Plavix
4. Nexium
5. Norvasc
6. Remicade
7. Enbrel
8. Zyprexa
9. Diovan
10. Risperdal

Primarily, these groups seem to provide an opportunity for support and treatment discussion among patients across the world. So far, no promotional messages are visible other than those along the lines of “Yeah, I take this drug and it works for me.” But it’s not a stretch to imagine pharmaceutical brand teams eventually getting involved in order to inform patients and, of course, promote product.

In fact, it has already started. Take a closer look at the Norvasc group above. Of the links above, only the Norvasc group was not, as far as I can tell, started by patients. It was actually started by some students as part of a pharmaceutical marketing project! I guess I’m not the only one who thought of this.

The number of people in any of these groups isn’t very big yet. Most contain fewer than 100 members. That’s not surprising, because most people taking these medications are older, and Facebook users are, well, not. But what happens when that 13-28 set currently dominating Facebook and other social media sites begin running brand teams in 5-10 years? Or what happens when enough users get to the point where they too require all these medications? And which pharmaceutical company will be first to untangle the regulatory hassle that creating a social media pharmaceutical promotion could entail?

You may have already heard that the Republican party recently announced a new motto: “The Change You Deserve.” Politics aside, some brouhaha has been made of the fact that this slogan is already in use by Wyeth’s Effexor antidepressant. High comedy, of course. In fact, Pharmalot, one of my favorite pharma blogs, wondered if Wyeth should sue the Republicans for copyright infringement. I feel such an idea is ludicrous.

Look at some of the coverage of the Republican Party / Effexor tangle-up:

• Washington Post
• NY Times
• The Daily Show

The Post article in particular includes:

• Pictures of Effexor
• Copies of Effexor’s marketing messages
• The starting dose
• Coverage of side effects

If I was the Effexor brand director, I would have been dancing when the news was announced. It resulted in some completely free DTC advertising in most major media outlets. I might have provided the reps who carry Effexor with some guidelines for reactive answers to physician questions about the news, simply to clarify that the move by the Republicans was not in concert with Wyeth, and Wyeth has no position on the issue. Other than that, I’d sit back, enjoy the free press, the new hits on my website, and the resulting bump in sales. It’s a nice treat for an off-patent medication.

I would only sue the Republicans over this in order to get it back in the papers again a couple of months from now. But even then, I’d be reluctant to potentially damage relations with either political party over something that has been fairly positive for the company (Wyeth has donated evenly to both parties, Pharmalot reports).

By the way, if there are any political parties looking for another idea, I suggest “Enough is Enough,” which is Enbrel’s DTC slogan. I think the bump in our sales would probably net me at least a new iPod.

My name is Jonathan Sheffi, and I approved this blog post.