Fugel Hans-Joerg, Nuijten Mark, Postma Maarten
University of Groningen, FarmacoEconomie/Epi., 9731 AV Groningen, The Netherlands.
Ars Accessus Medica, 1546 LG Jisp/Amsterdam, The Netherlands.
N Biotechnol. 2016 Dec 25;33(6):860-867. doi: 10.1016/j.nbt.2016.09.003. Epub 2016 Sep 21.
Stratified Medicine (SM) is becoming a natural result of advances in biomedical science and a promising path for the innovation-based biopharmaceutical industry to create new investment opportunities. While the use of biomarkers to improve R&D efficiency and productivity is very much acknowledged by industry, much work remains to be done to understand the drivers and conditions that favour using a stratified approach to create economically viable products and to justify the investment in SM interventions as a stratification option.
In this paper we apply a decision analytical methodology to address the economic attractiveness of different SM development options in a cost-contained healthcare environment. For this purpose, a hypothetical business case in the oncology market has been developed considering four feasible development scenarios.
The article outlines the effects of development time and time to peak sales as key economic value drivers influencing profitability of SM interventions under specific conditions. If regulatory and reimbursement challenges can be solved, decreasing development time and enhancing early market penetration would most directly improve the economic attractiveness of SM interventions. Appropriate tailoring of highly differentiated patient subgroups is the prerequisite to leverage potential efficiency gains in the R&D process. Also, offering a better targeted and hence ultimately more cost-effective therapy at reimbursable prices will facilitate time to market access and allow increasing market share gains within the targeted populations.
分层医学(SM)正成为生物医学科学进步的自然结果,也是创新型生物制药行业创造新投资机会的一条充满希望的途径。虽然利用生物标志物提高研发效率和生产力已得到行业的广泛认可,但仍有许多工作要做,以了解有利于采用分层方法来创造具有经济可行性的产品的驱动因素和条件,并证明将分层医学干预措施作为一种分层选择进行投资的合理性。
在本文中,我们应用一种决策分析方法来探讨在成本受限的医疗环境中不同分层医学发展选项的经济吸引力。为此,我们针对肿瘤学市场构建了一个假设的商业案例,考虑了四种可行的发展情景。
本文概述了开发时间和达到销售峰值的时间作为关键经济价值驱动因素,在特定条件下对分层医学干预措施盈利能力的影响。如果能够解决监管和报销方面的挑战,缩短开发时间并提高早期市场渗透率将最直接地提升分层医学干预措施的经济吸引力。对高度差异化的患者亚组进行适当划分是在研发过程中利用潜在效率提升的前提条件。此外,以可报销价格提供更具针对性、因而最终更具成本效益的疗法,将有助于缩短进入市场的时间,并在目标人群中提高市场份额。