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When interviewed by PME back in March 2011, Roch Doliveux, CEO of UCB, said his best decision at the helm of the Belgium-headquartered biopharma firm, was to “create a truly patient-centric” company.
“Patient-centricity is really nothing more than putting the patient at the heart of everything we do,” he said at the time, putting into succinct terms a concept that every player in the healthcare industry – from industry to governments to healthcare professionals – now seems to be trying to realise.
For UCB, this notion is especially important considering its focus on severe diseases, including the recent launches of Cimzia (certolizumab pegol) for rheumatoid arthritis and Crohn’s disease; Vimpat (lacosamide) for epilepsy; and Neupro (rotigotine) for Parkinson’s disease and restless legs syndrome.
Creating a patient-centric firm isn’t just about communicating a message or making sure the right pill gets to the right patient though. Instead, when it comes to thinking about how a biopharma company can affect the life of a human being, it has to be part of the very beginning of a drug’s development.
Putting the patient first
Ensuring this concept is put into practice is Dr Neil Weir, UCB’s senior vice president of discovery, who is just as confident as his CEO that the needs, wants and physiological make-up of a patient are as strong an influence on the men and women in lab coats as they are on reps in suits and ties.
“We’re looking to bring an understanding of what the patient’s needs are and what the patient’s physiology is and how a disease affects humans,” says Dr Weir, who joined UCB when his former company Celltech was acquired in 2008.
This approach complements UCB’s strong scientific focus, says Dr Weir, with the company reinvesting almost a quarter of its income back into R&D.
“You’ve got some part of the scientific community that’s fascinated by a molecule and fascinated by technology,” he explains. “And then you’ve got other parts of the organisation that are really in touch and close to an understanding of a patient’s challenges and how various diseases impact them.
“Finding the overlap between where the cutting edge science impacts on the areas that we feel we can most effectively contribute to and our understanding of the patient is very helpful in informing us where we should go next.”
This breaks down into three facets at UCB, according to Dr Weir; one of inspiration, one of intellect and one of focus.
Acknowledging the first point, Dr Weir notes that understanding what a patient goes through can inspire researchers who may be 15 years away from their work being translated into something that can be used for clinical benefit.
The second point, involving intellect, is a more straightforward relationship between scientific advances and engagement from informed patients. According to Dr Weir, if a patient is taught about the basis of his disease, he is more willing to collaborate on the research side, providing blood or genetic testing at a very early stage of drug development.
Lastly, UCB often has patients at its science advisory board meetings, providing input that can help focus the work of researchers.
“What the patient offers in those circumstances is to make sure we apply enough urgency, because sometimes a scientist will want to add another route and make their research more sophisticated or do another study,” says Dr Weir.
Avoiding failure
By taking this approach to research, it’s possible to avoid one of the major pitfalls facing pharma today – the high cost of late-stage trial failure.
“I think that one of the main challenges of the pharma industry is not being terribly efficient. Particularly when we have high failure rates in late stages in clinical studies, it’s very, very expensive,” he says.
“It’s perhaps avoidable in many instances if you understand the disease better, and I think you understand the disease better by understanding the patient better.”
Providing an example, he explains UCB’s use of genetics in its development of romosozumab, currently in phase III investigation in partnership with Amgen for use in the treatment of post-menopausal osteoporosis.
According to Dr Weir, by understanding the genetic make-up of patients with the condition – where one gene was found to be pivotal in regulating the way body builds bone – UCB’s scientists were able to create a sound hypothesis that interacting with this gene could have a therapeutic benefit.
“That’s an example of learning from real human physiology and disease physiology,” he says, “and applying those learnings back to the drug discovery process.
“We hope to give ourselves a better chance of finding the really critical point to intervene,” adds Dr Weir, who explains that it is still a lot to ask from a molecule to interact with one drug target and to have a significant therapeutic effect.
UCB’s work on romosozumab with Amgen is also an example of the company’s approach to partnership and collaboration when it comes to innovation in research.
Dr Weir extols the virtues of working with a company that can bring “tremendous knowledge of bone biology”, and this praise of collaboration should be no surprise considering his CEO Doliveux is chair of the Innovative Medicines Initiative (IMI) – a partnership between the European Commission (EC) and industry trade body the European Federation of Pharmaceutical Industries and Associations (EFPIA) to encourage collaboration in early drug research.
UCB is involved in several IMI-backed projects, including the European Lead Factory to provide an accessible library of small molecules, and different companies working together in such ways is now essential to allow innovation, according to Dr Weir.
“Any company as arrogant to think that they have all the expertise that is required to optimally find new therapeutic solutions, and understand the disease and to understand how you optimally might deliver that to the right population, is probably wrong,” he states.
This isn’t just about companies working with each other though, and Dr Weir is a champion of working with partners in academia – holders of a “terrific, extensive knowledge of fundamental biology”.
Academic sphere
This includes an extensive collaboration with Harvard University, but UCB also has strong links within its two research bases of the UK and Belgium, where the company has ongoing collaborations with the University of Oxford, the University of Dundee, the University of Liège and the Katholieke Universiteit Leuven among others.
“There is some great cutting edge science that covers what we call translational medicine, from understanding what’s happening at a molecular level, or perhaps even in an animal model, and translating that concept into patients,” says Dr Weir.
Beyond access to universities, both countries are supportive of research in their own way, according to Dr Weir, although the Belgian government is more likely to directly benefit companies with the standing of UCB.
“We benefit in both cases from a government that has a strong ambition to support and is appreciative of what we are attempting to do and the benefit to society from having quality pharma R&D in a the country,” he says.
“In Belgium, what we have found is that, in terms of direct financial support, Belgium has been more supportive of what we do. What we find in the UK is that support tends to be in a form that goes to academic partners rather than directly to any company of our size.”
And whereas some companies, such as AstraZeneca and Pfizer, have cut back in the UK in recent years, Dr Weir says UCB will “continue to invest” in the country, provided its research operations continue to produce results.
“I think it’s just a function of the pharma industry having to sharpen up and be much more cautious about where it invests and where companies have not been successful,” he suggests, giving his take on the situation.
As for what the UK can do to improve its standing in research, it’s not an easy problem to solve, although a more positive commercial environment could encourage more companies to invest.
“What’s clear to me is that companies do feel most comfortable about operating where they feel their drugs are appreciated,” he says.
Improving the research environment is Dr Weir’s focus though, and it’s something he is involved directly in as chair of the innovation board of trade body the Association of the British Pharmaceutical Industry (ABPI).
“The objective is to get a group of people together to understand how we can operate more effectively in the UK, and in doing so, perhaps we can also provide better clarity to governments about what is really important and what would make a difference,” he says, explaining the board’s function.
Two areas stand out as current focuses for the board: reversing the UK’s declining standing in clinical trials and improving and expanding the use of electronic data.
The former is essential to boosting investment and patient access to cutting edge drugs in the UK, says Dr Weir, and could be improved by shortening the approval process to initiate studies, amongst other actions, while effective use of NHS databases could help researchers better determine differences between patients and how to target treatments more effectively.
Use of any large set of patient data comes with concerns though, acknowledges Dr Weir, and the right measures need to be taken to ensure it has handled appropriately.
Issue of transparency
It’s a similar story when it comes to pharma’s hot topic of the past 12 months – transparency of clinical trial data.
UCB’s CEO Roch Doliveux raised some eyebrows when he compared the growing demand for all clinical data to “voyeurism” earlier this year, but Dr Weir has a more pragmatic take on the matter.
“There are very strong views on this and it is all driven by people who passionately want to do the right thing,” says Weir, who sat on an EMA panel discussion on transparency as part of his role on EFPIA’s research directors group.
Part of the problem is that a large amount of data is already in the public domain, it’s just not communicated well, says Dr Weir.
“I think this is an area where we have to explain what we already do,” he says. “Most companies have policies that demonstrate the intent to publish and share information, particularly of drugs that are approved.”
Agreeing with EFPIA’s stance, Dr Weir is cautious about who has access to what information, there should be limits about the level of data accessible.
“At the most extreme end what is essentially being asked for is all data … and this could potentially include how the drug was made and how it was characterised. So therefore this potentially includes information that is legitimately commercially sensitive.”
Nevertheless, Dr Weir is on board with regulated access to researchers with legitimate interests.
“I think that’s something that we and the industry are very open to,” he says.
As for the future of the company, Dr Weir is pleased with the success of Cimzia, Vimpat and Neupro, allowing the company to reinvest in its pipeline, and embrace an open innovation approach to finding future treatments in key for UCB areas, such as neurology and autoimmue disorders.
“I think in there are are some really exciting things where we have managed to bring together and synergise. It is open collaboration that can occur within a company as well as outside a company to ensure you’ve got great scientific minds thinking together.
“We’ve got some examples of that, and I’m confident they will bring important breakthroughs.”