IQVIA's Global R&D Report Shows That R&D Investments Are Getting Bigger (and Paying Off)

Pretty much every page of the new IQVIA “Global Trends in R&D 2024” report is worth deep consideration. It is the definitive atlas of how and where biopharma is investing in innovation (and what it’s getting for that investment). 

I’m tempted to summarize the whole thing, chart-by-chart, because there is so much that caught my eye on first read (and, I’m sure, so much more that will catch my eye when I look through it again). 

But I don’t want to deprive you of the chance to explore it yourself. Really worth the read. 

Still, here are a couple of items that I lingered on. 

First, the overall numbers on R&D spending are pretty amazing. We’re at $161 billion in annual spending among the 15 largest companies. That’s up nearly 50% from 2018, when the industry first broke the $100 billion mark. And industry is spending more of its sales on R&D than ever before. Those are outcomes to be celebrated and protected. And this is just 15 companies!

Second, there are 113 medicines approved in the United States over the past five years that haven’t been launched yet in Europe (page 33). That’s 42% of all approvals. When Bernie Sanders wonders why prices are higher in the United States, it is, in part, because the United States prioritizes getting medicines to patients more quickly than other countries. 

(I don’t want to suggest that the whole debate boils down to a price vs. speed of access tradeoff, but the IQVIA numbers make clear that such a tradeoff is absolutely happening.)

Anyway: take a look through and let me know the elements that you found most fascinating.

• I’m struggling a bit with this Bloomberg piece about how gene therapies are struggling a bit. On the one hand, there are clear headwinds that gene therapies are facing, some of them financial, some logistic, some linked to the inherent challenges of changing the practice of medicine. On the other hand, “gene therapy” isn’t a monolith, and it's not a static part of medicine, commercially or scientifically. Generalizations and extrapolation should be viewed with great caution, and it feels like there are some generalizations and extrapolation in the Bloomberg piece. 

• I try to avoid linking to too much paywalled stuff, but this Axios piece on 340B is a great roundup of the current state of play, summarizing the issues (contract pharmacies, definition of “patient”) and giving a sense of how various political factions are aligning. It’s not clear to me that either side has the upper hand or a clear mandate, which makes me wonder: is 340B a place where the solution is some sort of grand compromise, a la Hatch-Waxman? Something to noodle on.

• Big news on the innovation front, with a new cell therapy approach -- one targeted at solid tumors, no less -- getting the green light from the FDA. Iovance said that the therapy, Amtagvi, would carry a list price of $515,000, disclosing the price on a conference call. There was a little discussion of value -- the company mentioned the lack of other treatment options as core to the medicine’s value -- but media didn’t delve into the subject. (There was, however, some amplification of company comments around market access -- e.g. this Managed Healthcare Executive piece -- which I always find worthwhile.)

• I like it when headlines make clear exactly what you’re going to get. Today’s example: a blistering op-ed from Rep. Brett Gutherie titled “Biden’s coming for your cures.”