Market Access in Asia: What Role for Health Economics?

market-access-in-asiaThe pharmaceutical, medical device and diagnostics industries are very interested in the changing market access landscape in South and East Asia because of the vast commercial potential of this area. This region has a large proportion of the world’s population (~60%), a 2011 gross domestic product (GDP) growth that is almost triple the average of Europe and North America, and a huge opportunity for improvements in healthcare.

Market access requirements
Current market access requirements vary considerably among the countries in South and East Asia. Many of them – including China and India – do not have any formal comparative effectiveness or health economic criteria for national pricing and reimbursement submissions. Health economics generally plays a minor role in their decision-making. Continue reading

Increase Compound Efficacy with an Integrated Approach

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Iteration is the key for earlier and better decisions
The great inventor Thomas Edison once said, “I have not failed. I’ve just found 10,000 ways that won’t work.” While he was not talking about compounds, he could have been. The likelihood of success for any given compound is less than one percent. Aggravating the situation are several other factors, including constant pressure on decreasing pricing, quickly diminishing point of return at the 20-year mark, and along the way, inherent risk and large investments.

Still, we persevere. But to be successful in today’s environment requires a different, non-linear approach. The status quo will not work. We recommend taking a holistic view of the drug development process and an integrated approach. Continue reading

Detecting and Quantifying Mycotoxins with LC-MS/MS

mycotoxinWith the availability of sensitive mass selective instruments, such as tandem mass spectrometers and high-resolution mass spectrometers, today’s food safety chemists have the ability to accurately analyze multiple classes of mytotoxins simultaneously with minimal sample preparation. Mycotoxins, which are low-molecular weight, chemically diverse toxins, are produced naturally by molds commonly found in grains and fruit and have been linked to a wide range of negative health effects.

Performing mycotoxin analysis has been a long-standing challenge for food safety chemists. Stringent requirements from governing bodies demand accurate limits of quantification at low ug/kg levels and test the limits of standard laboratory instruments and typical extraction and purification techniques. The task is further complicated when the simultaneous analysis of multiple classes of mytocoxins is desired. However, with the advent of liquid chromatography/mass spectrometry/mass spectrometry (LC/MS/MS) methods, food chemists are now able to analyze food products for accurate and reproducible quantification of very low levels of several mycotoxins at once.

Regulating Mycotoxins

Mycotoxins are secondary metabolites produced by various species of fungi under certain environmental conditions. These toxins display numerous adverse physiological responses in plants, animals and humans. For example, mycotoxins may act as carcinogens, teratogens, genotoxins, nephrotoxins, nerotoxins, hepatoxins and immunosuppressors in mammals. Mycotoxins have been implicated as causes of cancer and mutagenicity, as well as estrogenic, gastrointestinal, urogenital, vascular, kidney and nervous disorders.

Due to these detrimental health effects of mytotoxins, regulatory bodies have instituted action levels for various mycotoxins in foods and feed worldwide. For example, the EU has regulated the content of aflatoxins, fumonisins, selected trichothecenes, ochratoxin A, zearalenone and patulin in differing commodities. In the U.S., the FDA has regulated the level of aflatoxins, deoxynivalenol and patulin in foods and feed.

Advantages of LC-MS/MS for Mycotoxin Testing

Historically, individual mycotoxins or their classes have been analyzed with analyte/specific methods. Typical techniques of analysis have included HPLC with floresence or UV detection, GC with FID or EC detection and ELISA. Mass spectrometry has also been used for targeted analysis of individual or similar groups of mytotoxins. With the introduction of sensitive, fast scanning tandem mass spectrometers, multi-mycotoxin analysis for routine samples after non-targeted extractions is now feasible.

Overall, LC-MS/MS is a highly specific and extremely sensitive technique for testing food products with superior accuracy and higher throughput than traditional analytical methods. LC-MS/MS allows the potential monitoring of hundreds of contaminants in a single run, plus it requires less sample preparation due to its level of sensitivity. For mycotoxins specifically, LC-MS/MS is a powerful tool as it allows laboratories to confirm the presence and structure of multiple mycotoxins simultaneously, in less time, with greater accuracy. Food chemists can screen for, quantitate and identify several mycotoxins in a single run on a single system.

For more information on our mycotoxin testing capabilities, please visit Covance.com.

Multi-Criteria Decision Analysis in Health Technology Risk-Benefit Analysis: The Future?

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Current trends in health technology assessment (HTA) indicate a shift away from the use of cost-effectiveness to value-related measures. A suite of analysis methods, collectively referred to as “risk-benefit analysis”, can be used to address these requirements. Of these, multi-criteria decision analysis (MCDA) is considered a leading candidate for practical application in HTA.

Limitations of cost-effectiveness analyses
The quality-adjusted life-year (QALY), frequently used in cost-effectiveness analyses and once the gold-standard outcome measure for economic evaluation in healthcare, is coming under heavier criticism than ever before. While appropriate in certain situations, the instruments used to generate QALYs have been shown to lack the required sensitivity to capture all benefits of interventions in some therapy areas, including hearing loss and schizophrenia. Continue reading

What to Look for When Recruiting Patient Arms for Phase I

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A five-point checklist for early, positive studies

Now more than ever, there is increasing pressure to bring new drugs to market more efficiently. With so much at stake when introducing a drug into the human body for the first time, you need to consider safety and efficacy and an ability to make a decision whether and how to proceed at every turn. As a result, you want to improve the earlier stages of drug development to enhance the quality of compounds that progress to Phase III. The end goal? To increase the success rate of molecules in Phase III. Continue reading

Price Disparity: Will It Ever Truly Disappear?

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Geographic price disparity between pharmaceutical products exists due to the variation in national economies and the unique ways that each country determines the price of pharmaceuticals. Price disparity still exists even in areas of “free trade” or in a single combined market of multiple countries, such as the European Union. This has led to parallel trade, where products are purchased in countries with lower prices and sold in those with higher prices. The fact that such disparities can develop seems contrary to the concept of a simple, free market, and it raises the question of whether price disparity will ever truly disappear.

The principle of free trade and tariff-free access to economic goods across borders is a founding principle of the EU and other regional trade agreements. Therefore, the continued existence of legal parallel trade combined with international referencing could lead to the end of price disparity, with prices converging to an average regional price. Continue reading

LC-MS/MS Emerges As New Method of Analysis for Vitamin B Testing

BVitaminsAnalytical test methods for vitamin testing in foods have been in existence for decades, including microbiological and high performance liquid chromatography (HPLC) methods. While these methods are still considered the “gold standards” for vitamin testing, a new method, liquid chromatography tandem mass spectrometry (LC-MS/MS), is emerging. LC-MS/MS can offer several advantages over the older methods, including greater sensitivity, precision, simplified sample prep, quantitative dynamic range, and most importantly multiplexing.

This new method is an important solution for our food manufacturer sponsors, as it provides you with faster and more reliable data, as well as potential cost savings if you need a full B-vitamin profile. Continue reading

The Affordable Care Act – Who Has It Helped The Most?

Prescription pills

A new data set has been published that paints a clear picture of who gained insurance coverage during the 2014 open enrollment period, which ended on April 15, 2014.  Recently featured in the New York Times, the data come from Enroll America, a non-profit organization focused on enrolling Americans in health insurance plans, and Civis Analytics, a data analysis firm.

This data set provides insight into the 10 million previously uninsured individuals who now have health insurance.  Overall, these newly-insured people reduced the national uninsured rate for adults under the age of 65 from 16.3% in 2013 to 11.4% in 2014.

Continue reading

Your Target Product Profile Can Be the Key to Regulatory Success

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Regulatory strategy hinges on having the end in mind from the outset
“Begin with the end in mind” has become a popular catchphrase, but only because it proves itself to be true time and time again. You can more easily comply with regulatory requirements by expending increased effort into your target product profile. The target product profile is the foundation of your regulatory strategy and sets the stage for future development considerations. It is the second of ten elements of regulatory strategy:

  1. Summary of guidelines/precedents from multiple agencies
  2. Target product profile
  3. Agency interaction plan and timeline
  4. Identification of regulatory data requirements
  5. Assessment of registration routes and mechanisms globally
  6. Consideration of country registration timelines to meet business objectives
  7. Early market access and reimbursement plan
  8. Consideration of external influencing
  9. Lifecycle support and supplemental application plan
  10. Risk management and post-marketing plans

Continue reading

Leverage Modern Analytical Methods and Instrumentation to Protect Consumers from Pesticide Residues

101830_15794754_XL2Considering the current level of extensive international food trade, food safety has become a significant global issue. Many people are increasingly concerned about chemical residues in their foods. Hundreds of pesticides, including herbicides, insecticides and fungicides, are among the most hazardous chemical compounds extensively applied in agriculture to increase food production. They are intended for destroying and controlling pests, weeds or plant diseases. Pesticide application is strictly regulated to protect consumers and the environment. However, the misuse of pesticides, lack of good agricultural management and/or cross-contamination during food processing, storage or transportation may result in unwanted or even illegal pesticide residues in foods. Some compounds, such as polychlorinated pesticides, have been banned for crop use but they are still present in the environment due to their long-term persistence and can bioaccumulate in the food chain. There is evidence that chronic exposure to pesticides can cause health risks to humans even at trace concentrations, for instance having adverse effects on endocrine system or causing behavior modification. Continue reading