Health Care Costs: Issues for Business Economic Summit & Outlook 2006 presented by CBIA and...
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Transcript of Health Care Costs: Issues for Business Economic Summit & Outlook 2006 presented by CBIA and...
Health Care Costs: Issues for Business
Economic Summit & Outlook 2006presented by CBIA and MetroHartford Alliance
Thursday, January 5, 2006The Connecticut Convention Center, Hartford, CT
Connecticut United for Research Excellence, Inc. (CURE)
Paul R. Pescatello, President & CEO
• CURE, as an educational organization and trade association, seeks to foster connectedness among pharma companies, biotech firms, colleges & universities, and firms that help core members do business, especially R&D.– Represent the biotechnology and pharmaceutical sectors
before the state legislature and policy makers– Build a critical mass of biotech and pharmaceutical
companies– Foster relationships between academic and industry
research that lead to technology transfer– Be the “go to” source for information about bioscience in
Connecticut
CURE Mission
The Mission, distilled
• Advocate
• Build critical mass
• Facilitate tech transfer
• Resource
• BioBus
Often, the same thing
At legislatures and administrative agencies and/or with news media/opinion makers
For the public, opinion makers, state economic development efforts
Workforce development and public education
–Build student interest in science–Relay new scientific techniques to educators
–Show how bioscience is relevant
–Show students bioscience careers other than M.D. and nursing programs
CURE
&
The
BioBus
Programs
Changing Face of Biotech
Pharmacogenomics – the study of how genes affect the way individuals respond to drugs.
Diagnostics, then Therapeutics
XDx’s AlloMap
From 10+ cardiac tissue biopsies to blood test
Genomic knowledge creates cheaper, less invasive diagnostic
What we’re really talking about - costs of illness
• Medications
• Hospitalizations
• Doctor visits
• Physical therapies
• Surgeries
• Lost productivity
Healthcare costs are rising . . .
– But share of healthcare dollar attributable to medicines has held steady at 10%
U.S. Annual Health Care Spending
$1.6 TRILLION$1.6 TRILLION
1.41.4
1.21.2
1.01.0
0.80.8
0.60.6
0.40.4
0.20.2
00‘‘6565 ‘‘7070 ‘‘7575 ‘‘8080 ‘‘8585 ‘‘9090 ‘‘9595 ‘‘0000 NOTE: 2001 AND 2002 DATA PROJECTEDNOTE: 2001 AND 2002 DATA PROJECTED
RESEARCH AND CONSTRUCTIONRESEARCH AND CONSTRUCTION PERSONAL MEDICAL EQUIPMENT PERSONAL MEDICAL EQUIPMENT AND NON-PRESCRIPTION DRUGSAND NON-PRESCRIPTION DRUGS
NURSING HOME AND HOME NURSING HOME AND HOME HEALTH CAREHEALTH CARE
PRESCRIPTION DRUGSPRESCRIPTION DRUGS
NET COST OF PRIVATE HEALTH NET COST OF PRIVATE HEALTH INSURANCE, ADMINISTRATIVE COSTS, INSURANCE, ADMINISTRATIVE COSTS, AND PUBLIC HEALTH PROGRAMSAND PUBLIC HEALTH PROGRAMS
HOSPITAL CAREHOSPITAL CARE
DOCTORS, DENTISTS, AND OTHER DOCTORS, DENTISTS, AND OTHER PROFESSIONAL SERVICESPROFESSIONAL SERVICES
Source: Health And Human Services DepartmentSource: Health And Human Services Department
Drug Discovery Basics
5 Number of compounds investigated that are tested in clinical trials
=
Number of compounds in clinical trials that are approved for patient use
10,000
1=
5
Cost of researching and developing a drug from idea to pharmacy:
$800,000,000 to $1,500,000,000$800,000,000 to $1,500,000,000
Drug Development - A Risky and Expensive Proposition
Source: Tufts Center for the Study of Drug DevelopmentSource: Tufts Center for the Study of Drug Development
5,000–10,000Screened
5,000–10,000Screened
250Enter Preclinical
Testing
250Enter Preclinical
Testing
5Enter
Clinical Testing
5Enter
Clinical Testing
1Approved by
the FDA
1Approved by
the FDA
Compound Success Rates by Stage
Compound Success Rates by Stage
16
14
12
10
8
6
4
2
0
Phase II100–300 Patient Volunteers Used to Look for Efficacy and Side Effects
Phase II100–300 Patient Volunteers Used to Look for Efficacy and Side Effects
Phase III1,000–5,000 Patient Volunteers Used to
Monitor Adverse Reactions to Long-term Use
Phase III1,000–5,000 Patient Volunteers Used to
Monitor Adverse Reactions to Long-term Use FDA Review ApprovalFDA Review Approval
Additional Post-marketing
Testing
Additional Post-marketing
Testing
Phase I 20–80 Healthy
Volunteers Used to Determine Safety and
Dosage
Phase I 20–80 Healthy
Volunteers Used to Determine Safety and
Dosage
Preclinical TestingLaboratory and Animal Testing
Preclinical TestingLaboratory and Animal Testing
Discovery(2–10 Years)
Discovery(2–10 Years)
YearsYears
1 –2 1 –2 ProductsProducts
1 –2 1 –2 ProductsProducts
Attrition is High in theKnowledge BusinessAttrition is High in theKnowledge Business
DiscoveryDiscovery Exploratory DevelopmentExploratory Development
IdeaIdea DrugDrug11 - 15 Years11 - 15 Years-----TIME----------TIME-----
Full DevelopmentFull Development
Phase I Phase II Phase III
00 151555 1010
Preclinical Pharmacology
Preclinical Safety
Millions ofCompounds Screened
Clinical Pharmacology& Safety
Healthcare Economics:Prescription Drugs Save Money
• Stroke – 40,000 fewer strokes per year
• HIV/AIDS – Death rate cut by 70%
• High Cholesterol – 1/3 fewer hospitalizations
• Cancer – Survival rate up to 62.7% from 50% in 1971
Impact of Drugs on Spending and Mortality for HIV/AIDS
Source: Costs - Bozette et al., New England Journal of Medicine Vol. 344, No. 11, March 15, 2001; Mortality - Centers for Source: Costs - Bozette et al., New England Journal of Medicine Vol. 344, No. 11, March 15, 2001; Mortality - Centers for Disease Control; data on drug development from PhRMA and the NIH Office of Technology transfer; Pfizer.Disease Control; data on drug development from PhRMA and the NIH Office of Technology transfer; Pfizer.
HIV Mortality Declined Dramatically HIV Mortality Declined Dramatically after Introduction of First after Introduction of First
“Expensive” Antiretrovirals . . .“Expensive” Antiretrovirals . . .
0
3
6
9
12
15
18
82 86 90 94 98
Year
Dea
ths
per
100
,000
Po
pu
lati
on
First new Drugs First new Drugs Introduced, 1995Introduced, 1995
Highly Active Highly Active Antiretroviral Antiretroviral Therapy (HAART) Therapy (HAART) introduced, introduced, 1996-971996-97
Total: $1804Total: $1804
Total: $1521Total: $1521
Drug Drug Costs Costs IncreaseIncrease by 34%by 34%
Other Other Costs Costs DecreaseDecrease by 41%by 41%
. . . While Monthly Costs for AIDS . . . While Monthly Costs for AIDS Patients Decreased by 16% after Patients Decreased by 16% after
HAART IntroducedHAART Introduced
New Drugs Reduce Visits to Hospital and ER: Asthma Management Program Improves
Outcomes for Children with Asthma
Concept that Leads to Cures
Revenues from
successful medicines cover
the cost of much, much
“unsuccessful” research
Not the NIH
2004 NIH Budget for administration,government research & grants (total): $27.9 billion
Biotech/pharmaceuticaltotal R&D spending: $49 billion
Biopharma does the clinical trials, translates basic science into practical medicines
Why risk investment in a company needing tens of millions of dollars and a decade or more to have a chance of marketing a product?
Commensurate reward
The answer to high drug costs?
Importation?No, only shorthand way for politicians to show empathy for high cost of health care
But side effect worse than cure:– Importation of price controls– Innovation stagnation
What are we really talking about?
An international relations/trade issue.– Motivating other developed economies to pay more for
the R&D that makes up the price of prescription drugs
– Figuring out a way to spread the cost of healthcare across the entire population
Hint #1: Greatest cost components of healthcare are the 1st and last six months of lifeHint #2: The annual tab for a daily cup of Starbucks is $1,003.75