Has the influence of finance in biopharma helped or hindered addressing unmet needs and getting treatments to patients?
Roy Victor’s book is a brilliant tour de force on the evolution of the modern system of financing that underpins drug development.
He uses Gilead’s Hepatitis C cures as the central case study, starting with the history of the drug’s development on the back of publicly funded knowledge at a small biotech; Pharmasset.
Following acquisition and finalization of development, Gilead launched the oral tablet at an exorbitant price, that it claimed as a fair value.
However many Hep C patients across the world weren’t able to access it as health systems could not afford it for the 1,000s or 10,000s in their country.
Meanwhile, Gilead sent huge amounts of money to stock market speculators, many of whom had not risked anything at an earlier stage of the development, whilst its executive leadership walked away with massive payouts.
But was this an isolated case of the modern financial system that backs biopharma failing to benefit patients?
Not really.
Roy argues against the ‘maximising shareholder value’ axiom that governs capital markets, that results in huge outflows of capital away from drug development (either internal R+D or BD+L to support biotechs) and into shareholders’ pockets while simultaneously claiming drug prices must remain high or innovation will be stifled.
Breaking down the conventional lobbying points that have prevented price control, the author proposes an alternative model intentionally designed for equitable and affordable access and investment toward the future medicines needed.
In summary, regardless of whether you work in pharma, professional services or finance, or have a general interest in this space this is a highly recommended read.