A week ago, a former farmer told his Georgia Sunday school class that he had some good news. Outside the small town church’s doors, 14 million Americans and their families were listening.
They were listening because, when he announced that he was cancer-free, Jimmy Carter gave them the hope that they, too, could harness the power of breakthrough medicines and treatments to join him in remission. I’m glad to confirm that their hope is justified.
It’s a special time for biopharmaceutical research. Science is moving at greater speed, the biopharmaceutical industry is harnessing its strength against disease, and the potential benefits to patients like President Carter and so many more are becoming more clear. Since peaking in 1991, cancer death rates are down 22 percent, while the 5-year survival rate of cancer patients has climbed to 68 percent. Carter’s disease, advanced melanoma, has had a 15 to 20 percent 5-year survival rate in recent years but new medicines now make long term survival a possibility for more patients.
Much of this progress is attributed to a deeper, molecular-level understanding of all different kinds of disease.
Hepatitis C – the leading cause of liver transplants and the reason why incidence of liver cancer is rising – is now curable in more than 90 percent of treated patients. The death rate from HIV/AIDS has fallen 85 percent since its peak in 1995 and it is now considered by many to be a chronic, manageable condition. And just last Wednesday, we reported that PhRMA member companies have 190 new medicines in development for heart disease, stroke and other cardiovascular diseases.
More than 7,000 medicines are in clinical development around the world right now – more than there have ever been – and 70 percent of those medicines have the potential to be first-in-class therapies. From 2000 to 2014, this pipeline spawned more than 500 new medicines that were approved by the Food and Drug Administration.
This progress is generating a ripple effect across the entire health care system – and surprising some who never saw the wave coming.
In the early 1990s, life expectancy for HIV/AIDS-patients was measured in weeks or months. It was such a bleak time that some said not only was a cure impossible, but the acute care needed for patients with the disease would also bankrupt the U.S. health care system. That never happened, as researchers across industry redoubled their work, and, in 1995, the FDA approved the first protease inhibitors. Today, those receiving appropriate treatment for HIV/AIDS are expected to live about as long as those free of the disease and costs have been sustainable with medicines taking the place of costly end-of-life care.
We’ve heard the same doomsday predictions about treating stubborn high cholesterol – the root of serious heart disease and stroke – and hepatitis C: “Financial havoc,” one predicted, “the costliest therapy this country has ever seen,” another scolded, while still another darkly foretold that these new treatments would unleash “a tsunami effect across our entire health care system.”
They were all wrong. Two weeks ago – just 18 months after it prophesied new medications would “break the country” – top U.S. pharmacy benefits manager Express Scripts’ CEO Steve Miller admitted that hepatitis C treatment is less expensive here than western countries. The firm also recently tweet-quoted Miller as boasting, “We are able to save Americans $4 billion and cure more patients with [hepatitis C] than any time in history.”
What a difference a powerful market makes.
But as much as predicted events didn’t materialize, there’s still likely turbulence ahead.
On the market side, shorter product lifecycles, patent expirations and earlier-than-ever competition are generating cost pressure and creating market uncertainty. The smaller end of the market is also being squeezed, as an increased cost of capital is suffocating emerging companies. The sheer complexity of diseases and higher regulatory hurdles generate matching pressure on the science side, amplified by the rapidly escalating costs of research and development.
In addition, the market is evolving rapidly to demand greater value for our health care spending. These changes – such as new “value-based” payment models and tools for assessing evidence on value – hold real promise as part of the solution. At the same time, they are at an early stage and it is essential we get them right so that they help patients, health care practitioners and consumers choose the care options most valuable for them rather than imposing one-size-fits-all value assessments. Biopharmaceutical research companies are committed to working as partners with payers, providers, and patients in value-driven health care.
There’s clearly a lot of work to do. But when President Carter’s cancer-free diagnosis gives us great hope, it also gives us even more: A reminder of the many doctors, researchers, caregivers and others involved in the process leading to such a diagnosis – whether you are the onetime leader of the free world or one of 318 million other Americans looking only to live.
We know we don’t have all answers. It will take all of us, working together, to truly find them.
Stephen J. Ubl is president and CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA).