In the first part of this series we took at look at the journey of a new treatment, from bench to bedside, and how a complex web of factors affects its final price.
Now, let’s turn to look at the role we play in supporting drug development and encouraging innovation, and how we aim to get new treatments to patients faster.
So, let’s explore our partnerships with pharma companies, why they’re important, and how we try to influence the way drugs get to patients.
Everybody’s doin’ a brand new dance now
We’re often asked why we work with pharma companies, given that we’re a charity and they’re businesses. The short answer is that we have to – we need their expertise and resources, and it’s the only way of getting lifesaving discoveries developed by our scientists into the hands of cancer doctors and patients.
We’ve already mentioned that taking a new drug all the way from a bright idea in the lab to patients in the clinic costs on average around £1 billion.
We may be the biggest charitable funder of cancer research in the UK, and one of the biggest in the world, but the £350 million we spent on research last year – covering everything from fundamental cancer biology, prevention and early diagnosis to developing and trialling new treatments across hundreds of different types of cancer – still falls well short of the investment needed to bring even a handful of potential drugs to the market.
We simply can’t afford to run large-scale drug manufacturing facilities, or pay the multi-million pound costs required to take new treatments all the way through late-stage clinical trials and legal regulatory processes. It certainly wouldn’t be an effective use of our supporters’ donations to effectively set ourselves up as a pharma company to produce a couple of drugs every few years.
But while we can’t go it alone, there are ways we can – and do – support drug development and encourage innovation to speed up and streamline the process.
Will you, won’t you join the dance?
We join forces with all sorts of organisations, including universities and institutes, other charities and research funders, the NHS and devolved Departments of Health, and pharma companies to gather together all the skills, resources and infrastructure needed to develop and test new drugs.
Working together gives us more ‘bang for the buck’ – pooling money and resources means we can support bigger, more ambitious projects. But we will only enter a joint venture if it will help us achieve our goal of improving the outlook for cancer patients and meets our high scientific standards.
One important player in many of these commercial partnerships is Cancer Research Technology (CRT) – our wholly-owned commercialisation and development company. CRT acts as the meeting point between public or charity funded research and industry, to develop and commercialise exciting new discoveries in cancer research for the benefit of cancer patients. And since CRT is entirely owned by Cancer Research UK, all of the profit that it generates is returned back to us to fund more lifesaving research.
Here are some of the ways we’re working to bring new, more effective, kinder treatments to cancer patients as quickly as possible:
1. Drug discovery
We fund research up and down the country looking for potential new treatments. Some of this research is carried out in CRT’s labs, where our researchers work alongside scientists from pharma companies, to share expertise and speed up discovery.
2. Making the most of existing drugs
As well as looking for new potential drugs, we also focus on resurrecting drugs that have stalled during development (sometimes drugs are de-prioritised by pharma companies for strategic reasons).
3. Bridging the gap from the lab to clinic
We provide the expertise, infrastructure and funding to help researchers take a promising new drug through the necessary lab testing and into ‘first in man’ clinical trials. We even have facilities to manufacture drugs on a small scale for these early trials.
4. Brokering partnerships
As an independent charity we’re in the perfect position to support clinical trials testing different drugs from rival companies – either in competition with each other, or in combination (you can read more about our lung cancer trial here). Testing drugs side by side in this way makes clinical trials cheaper and speeds up answers. This is something that simply wouldn’t happen without a neutral arbitrator.
5. The right drug for the right patient
We support research looking for ‘biomarkers’ – molecular signposts – with the goal of improving clinical trials by ensuring drugs are tested in patients most likely to benefit, and helping doctors to give patients the optimal dose.
6. Backing high-quality trials
We ‘approve’ good quality clinical trials led by doctors receiving drugs free of cost from pharma companies. Our seal of approval means the doctors leading the trial can use NHS infrastructure and expertise – a cost they could not otherwise afford, which would prevent the trial from going ahead.
7. On the campaign trail
In addition to supporting research, it’s also important that we campaign and lobby MPs on issues such as excessive red tape in clinical trials and drug approval, fair drug pricing and equal access to new treatments. We also support initiatives to make data more accessible and open, including publications of research we fund, genetic information, and clinical trial results. Improvements in these areas could make a big difference to the speed at which new treatments reach patients, and who can get them.
Strictly boardroom – the business side
A new drug can make huge profits. But if we had a hand in its development, how do we ensure we get a fair slice of the financial pie back? And what happens to the proceeds?
This is where CRT comes in. They ensure that we have exclusive rights to the discoveries from all Cancer Research UK funded research (in legal terms, this means we own the Intellectual Property). CRT staff work closely with scientists to identify the most promising research projects to take forward for development, and provide expertise and access to funding, technology, infrastructure, and the specialist skills needed to help get potential new cancer therapies and diagnostics to patients.
CRT also works hard to identify the best commercial partner to take a new treatment forward for patients. The legal agreements they put in place ensure that the company commits to the continued development of our discovery and a fair share of any royalties from the sale of a drug that has benefited from our research comes back to the charity. And because CRT is wholly owned by Cancer Research UK (rather than having shareholders), these royalties, and any other profits that are made, are invested back into our life-saving research.
CRT has ploughed a large amount of money straight back into scientific and clinical studies to beat cancer sooner. In a win-win situation, drugs developed from CRUK science – temozolomide, abiraterone and vismodegib – have extended or improved the lives of cancer patients, and raised vital funds to support more research too.
Nobody puts non-profitable treatments in the corner
Because we are charity and not constrained by making profits for shareholders, we are also free to support research and clinical trials testing promising drugs that might not be expected to make money for a pharma company. This includes drugs that cannot be patented, or are old enough to be outside of patent.
One good example is the research we’re funding into aspirin – a very old drug with potentially important benefits for preventing cancer and even treating cancer, as well as reducing side effects from chemotherapy. But like all the other research we fund, it needs to be based on solid evidence and judged on the quality of the science.
We also fund a large amount of research into non-drug based treatments, like surgery and radiotherapy – which remain cornerstones of cancer therapy. And we’re spending millions of pounds on fundamental research into the biological ‘nuts and bolts’ of cancer – ranging from specific types to more general biology – which will lead to new ways to prevent, diagnose and treat many different cancers in the future.
That’s what it’s all about
Our aim is to see more people survive cancer through earlier diagnosis and better treatment, and to prevent the disease happening in the first place. To do this, we need to be fighting on all fronts and working together with other organisations that can make a difference.
There will always be people who disagree with the way the pharmaceutical industry works, and object to our involvement with it.
But, although they’re not without their problems, it’s important to remember that every single drug used to treat cancer patients today has been developed with the aid of a pharma company. These treatments have helped to save lives and buy patients more time with their loved ones. And, in many cases, Cancer Research UK and other non-profit organisations have played vital roles along the way.
That’s not to say there aren’t aspects of the way the system works that could, and should, be improved for the sake of patients.
As we discussed in part one, discovery and development of a new drug could be made much more efficient by addressing the number of drugs that fail throughout the process.
The price of a new drug should better reflect its cost. After all, there are very few industries that price previous failure into its current products in the way the pharma sector does. And there is no good reason why a ‘me too’ drug, based on a current successful treatment, should cost a lot.
There’s also a lot of red tape and regulation that could be changed to make it easier and cheaper to make new drugs available in the clinic.
But let’s get one thing straight. There is a popular misconception that pharmaceutical companies are in possession of, but hiding, the “cure for cancer” in order to make money.
Logically, this makes no sense at all.
Pharmaceutical companies are in fierce competition with one another and are answerable to their directors and shareholders. If any one of them did find a vastly more effective treatment they would start selling it as soon as they possibly could, as they would stand to make vast sums of money very quickly or risk losing out to a rival.
We have even heard accusations that we too are hiding “the cure”. This is not only absurd, it’s offensive and deeply hurtful to the global community of dedicated scientists, doctors and nurses researching the complex and challenging problem of cancer, to our staff and supporters and, most importantly, to cancer patients and their families.
Here at Cancer Research UK we have seen loved ones and colleagues go through cancer. Many of them have survived. Many have not. This is what drives us to try and make a difference.
There’s still much more to do until we have effective, kinder treatments for all types of cancer – that’s why it’s vital that we carry on looking for ways to make things better. Research over many decades has led to the treatments we have today, which have already made a big impact on survival, and the research that’s happening today will change the picture even more in the future.
We are 100 per cent committed to saving lives from cancer and, thanks to advances in research by our scientists and others around the world, long-term (10 year) survival has doubled since the 1970s. We know we still have a long way to go, particularly with cancers such as pancreatic, lung, oesophageal and brain tumours. But we will work as hard as we can – with whomever it takes – to keep making progress and save more lives.
- Read part one of this series – Why are drugs so expensive?
- Teamwork by DI, via Flickr under CC-BY-NC-SA 2.0
- Conga by Jasperdo, via Flickr under CC-BY-NC-ND 2.0
- Ballroom dancing by Marrickville Library, via Flickr under CC-BY-ND 2.0
- Hokey Cokey by Auntie P, via Flickr under CC-BY-NC-SA 2.0