In the wake of all the price gouging antics we’ve seen at Valeant Pharmaceuticals and Turing Pharmaceuticals, Bruce Bloom’s Cures Within Reach provides a breath of fresh, philanthropic air.
The organization’s all about generic drugs – but unlike, say, Martin Shkreli, Bloom’s big idea is to repurpose existing drugs and lessen the overall costs of healthcare. It’s reliant on the idea of a government that pays industry for measurable improvements in public health – which, in Cures Within Reach’s case, involve the treatment of rare diseases.
Bloom spoke today at INVEST, MedCity News’ healthcare investment conference in Chicago. He laid out the mission of Cures Within Reach: To re-examine research and gather information on off-label drug use, and deploy generic drugs to treat rare diseases.
The model has shown some success. For example, Bloom says the organization was able to help bring the treatment cost of the rare disease Autoimmune Lymphoproliferative Syndrome, or ALPS, from $100,000 to $5,000. Researchers found that by repurposing the drug sirolimus, they were able to bring remission rates up to 85 percent – while reducing the spend by $95,000.
“The thing is, no one is utilizing those savings for any particular purpose,” Bloom said. This led to the idea that if researchers could get their hands on the money that was saved, it could pay for the original research – and pursue future projects.
“That was the Eureka! moment we had – that there might be a new economic engine for the repurposing of generic drugs for rare diseases,” Bloom said.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
The United States payer system has proven too complicated to launch this concept, so Cures Within Reach is working with the British government, which has more of a single payer model. It’s developing Social Impact Bonds – that is, a “pay-for-success contract,” Bloom said. “Basically says, the government wants something done, but doesn’t want to put the money up front – or has no ida how to accomplish it.”
There are about 60 social impact bonds in play in the United Kingdom. This model lets private business or philanthropy get government contracts to develop solutions to social problems.
“Investors pay for the project at the start, and the repayments from the government come based on the results,” Bloom said. “There’s no success, there’s no payment.”
Shkreli suggested a vaguely similar model – charging exorbitant prices up front for seldom-used generic drugs, and diverting the revenue to develop future drugs. However, Cures Within Reach proposes lowering medication costs – and using the savings to improve global health.
This model, which remains largely theoretical but certainly compelling – could ultimately be extrapolated to include Big Pharma and global health initiatives alike. He addressed Gilead’s curative Hepatitis C drug Sovaldi, saying that with an $80,000 price tag per patient, it remains widely inaccessible for the 130 million patients around the world with the disease.
However, Bloom suggests that with a Cures Within Reach approach, the drug cost could certainly be lowered if Gilead could up the global penetration rate. That’s a daunting task, of course, for a single drugmaker that’s relying on recouping R&D costs with patent exclusivity and high branded drug prices.
“If you were able to buy that that patent out, you could think about a wider distribution at a lower cost,” Bloom said.
That is, similar bonds could buy out the patents of big pharma’s proprietary drugs, however, the newly freed and curative drugs could be used as generics – and the costs could become substantially lower.
Cures Within Reach is a not-for-profit organization, with philanthropic aims to improve public health – but such a model could prove powerful for the private sector as well.
“We’re trying to push out some creative solutions to see how we might solve some of the world’s problems,” he said.
