Mike: Hello David. So we’ve had a good day today here at MS Life and at ECTRIMS this morning, what do you think have been some of the good pieces of work that’s happened today and information that you think that people should know about?
Professor David Baker, Neurologist: Well, I think probably the most interesting thing that’s happened today is the news that for the first time they’ve shown that you can have a drug that affects progressive MS. So there was a drug called siponimod and it was shown that it can slow the rate of disability accumulation in people with secondary progressive MS and that’s the first time that’s happened. And this is a phase three trial, which means they’re probably ready to go to the regulators, so it may not be that far from becoming a real drug. So that was, I think, probably one of the highlights of the meeting. But there have been a few others and one thing I was really, really interested in was a study in Sweden.
So we know that there’s a drug coming along called Ocrelizumab which is pretty effective as a disease modifying drug and there’s a drug called Ocrelizumab that’s probably with the regulators at the moment. But the interesting thing was… the problem with drugs is that it’s generally the cost kind of influences whether people can get access to them. So what they’ve been doing in Sweden is they’ve been using like the cheap version of the Ocrelizumab and they’ve got thousands of people who’ve been given access to this drug and it obviously looks like it works. Now, the other interesting thing is that when they look at how long the people are on the drug for, they actually only take it for a couple of years, whereas the pharmaceutical companies want you to take it every six months forever, so you might not have to. So this is kind of really good news, because it could mean that if it’s effective you might not have to take the drug for a long, long time, which will reduce side effects.
And it also suggests, you know, that doctors are willing to try things outside the box, which is a good thing, because I think there are drugs that may be of benefit for people with MS but they’re not used because they’re not produced by or marketed for MS by pharmaceutical companies, but nevertheless if you use, say, an epilepsy drug, it might be of value for multiple sclerosis. So that was one of my highlights, it was like sticking it to the man, which was like, great.
Mike: On that topic, do you not think that there might be a risk that if we’re moving away from big pharmaceutical companies and moving into the sort of generic area that there might be less of an acceleration in terms of the funding that’s coming through for those kind of treatments?
Professor David Baker: Definitely, definitely. And I think my worry I guess, is there’s going to be a burst of the bubble and for many years the pharmaceutical industry has been investing very heavily in MS drugs and it’s one of the few neurological diseases where there are treatments available and that’s because pharmaceutical companies can make money. But eventually what happens with those drugs, they’re protected by patents, the patents run out and then the generics come along.
Now, what’s happened historically is the drugs have been biologicals which have been more difficult to manufacture than just a straight chemical, but the first chemical will be coming out of patent in about 2019, which could potentially mean the prices will plummet and therefore pharmaceutical companies may show less interest. And that’s kind of potentially a good thing in terms of getting access to drugs where there’s a restriction or a rationing because of the cost, but it could be a bad thing is that the pharmaceutical company may disinvest from MS. So that could well happen.
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