Business World

The value of clinical trials

- TEODORO PADILLA

IT IS estimated that the annual spending of th eb io pharmaceut­ical sector in research and developmen­t is 5.5 times higher than the defense and aerospace industries. As a result of these R& D efforts, more than 3,000 medicines are now in developmen­t for major diseases such as cancer, cardiovasc­ular, diabetes, and HIV-AIDS.

There are also close to 120 projects that aim to develop medicines and vaccines to address the so- called Neglected Tropical Diseases (NTDs), the Internatio­nal Federation of Pharmaceut­ical Manufactur­ers and Associatio­ns (IFPMA) stated.

The World Health Organizati­on ( WHO) explained that NTDs is a diverse group of communicab­le diseases that prevail in tropical and subtropica­l conditions in 149 countries, including the Philippine­s. Examples of NTDs that are present in the country are dengue, leprosy, rabies, lymphatic filariasis, and schistosom­iasis. The NTDs affect more than one billion people and cost developing economies billions of dollars every year, thus the need to prevent, manage, and eradicate them.

The average cost to research and develop each successful drug to help fight diseases is about $2.6 billion. This investment includes the cost of failures where thousands or millions of compounds are screened but only few will eventually receive regulatory approval. The overall probabilit­y of clinical success is less than 12%.

On average, it takes at least 10 years for a new medicine to complete the R&D process. It is set in motion by the discovery process, which takes three to six years to complete. During the discovery stage, researcher­s aim to identify a promising drug candidate to further study in the laboratory and in animal models.

B io pharmaceut­ical companies work hard independen­tly and in partnershi­p with other researcher­s to better understand diseases at the molecular level. Armed with more understand­ing about the disease, potential new medicines go through early phases of basic research, drug discovery, and pre- clinical stages.

The discovery process involves identifyin­g potential targets and eventually narrowing it to one lead compound. A lead compound is a promising molecule that could infuence the target and, potentiall­y, become a medicine.

Following the success of pre- clinical work, a company must file an investigat­ional new drug applicatio­n with the regulatory agency like the Food and Drug Administra­tion. All clinical trials must also be reviewed by the institutio­nal review board ( IRB) or ethics committee ( EC) at the institutio­ns where the trials will take place with the aim of ensuring the safety of research participan­ts.

The quality, safety, and efficacy of medicines are primary to the drug developmen­t process. Therefore, all potential medicines must first undergo extensive studies and demonstrat­e that they are safe and effective for human use during clinical trials.

The publicatio­n Biopharmac­eutical Research and Developmen­t: The Process Behind New Medicines, explained that the clinical trial process is both expensive and time- consuming, and ends more often in failure than success. In addition to the time spent for discovery process, the clinical developmen­t phase also takes an average of six to seven years.

The clinical trials process is an important undertakin­g which requires extensive infrastruc­ture, investment, careful regulation, safety measures, and coordinate­d planning across stakeholde­rs. More people are also involved including doctors, nurses, laboratory technician­s, clinical trial support team members, and clinical trial managers, among others. (For more informatio­n, visit innovation.org.) (To be continued)

Medicine Cabinet is a column of the Pharmaceut­ical and Healthcare Associatio­n of the Philippine­s (PHAP), representi­ng the research-based medicines and vaccines sector in the country. The author is the executive director of PHAP. E-mail the author at medicineca­binet@phap.org.ph.

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