This comes from an article in Fierce Biotech that is talking about BMS' attempts to shame Gilead into a combination study for the two companies respective hepatits C treatments. I like this article as it likely is a harbinger of things to come in industry and healthcare over the coming years and raises a host of interesting issues --- at least from my point of view. I shall elaborate.
First off, I think the idea of combination therapies is much more common and regulatory bodies are more attuned to considering how you set up clnical trials to establish this will benefit patients and set a new standard of care. Soooo -- if you have evidence or reasonably founded strong belief that a combination of two companies therapies will actually radically benefit patients? Aren't you ethically bound to try it? You will help people.
Moreover, in this day and age of more intrusive goverment funding of therapies, and the cost issues this raises, wouldn't we expect more goverment pressure or public policy to evolve toward forcing these types of marriages on companies even if they don't want to (and we'll get to their possible reasons)? A shotgun clinical trial so to speak? I would think 3rd party payers would also jump on this bandwagon if they felt the combined therapy was going to be much more medically effective and especially if the perception was that it would be more cost effective. I can't see anything bucking trends to make therapies more cost effective -- comparatively effective.
From the individual compaines persepctives, I still think they have the better standard of care issues and medical ethics issues to provide patients better treatments, but they also have fiduciary motives and responsibilities as well. They do need to reasonably maximize rreturns for their shareholders. You can see where they might have reason to believe this is best doen through their solo therapy or by combining with one of their own therapies that they can see in their own pipeline -- that's harder to evaluate from the outside -- certainly from financial point of view but even from an availability angle. The counter argument is that the two company combined therapy might be more rapidly available and it may even be medically better -- if not financially better for eeither individual company. On the other hand, a combined approach may actually enlarge the pie for either individual company with their own drug? Again, I can't really tell without more specific data on the situation being examined.
Nonetheless, I woud expect this type of issue to arise more often in the future, and it would not surprise me to see public policy pushing to make this type of multi-company combination approach more likely to happen with either a carrot or a stick if necessary. Economics will increasingly drive some of these decisions in my view.
Posted by Bruce Lehr Jan 16th 2014.