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that questions don’t get asked continuously. Any buyer has the right to ask the question, “Are you giving me good value for what I’m paying?” That will never stop. It’s completely OK. The industry will be able to stand up to that challenge, as long as we can say, “Yes, we do provide good value, come and have a look at the data.”
It’s not a popularity contest. This is something where societies are working out their priorities. We just need to deliver.
X: Do you think some companies have overreached a bit on pricing of their drugs? You took a lot of heat for a lot of years over your pricing at Genzyme. But now you see lots of other companies coming out with similarly very high-priced drugs. They may or may not offer the same kind of value. Is the industry running the risk of going too far on price?
HT: If you are not delivering value, you will lose. You cannot win. It’s only a matter of time. At Genzyme, we had records of making sure we delivered value. We were able to sustain it everywhere, in Europe, in Brazil, in Russia. We invited the question. I’d go personally there, and be challenged many times. I thought that was completely OK, completely normal for any society to deal with this question. Any company afraid of that, that feels they can’t quite make the case, ought to be careful. You won’t be able to sustain the product. I can’t generically make a statement that the industry is going this way, but there are cases—which you and I both know—where you say, “Wow, that’s a tough case to make” for a given drug.
X: Drug R&D seems to be stuck in a rut, where there’s too much time, money, and risk involved to be sustainable in many therapeutic categories. Do you see any technology coming along, or any real change in the system, that will make drug R&D more efficient?
HT: Yes, absolutely. You can see it happening. The timelines of some of the highly specific care products are shortened. The FDA is putting in different activities to make these kinds of products go through faster. The Vertex drug went through very fast for cystic fibrosis. The statistics are completely different. There was good evidence, very good evidence, both of a willingness to act, and a willingness to look at a diagnostic component. But we are in the early stages of it.
We are not in a rut. That’s the wrong way to look at it. In my vocabulary, a rut means that you don’t know quite where to go. We are in a transition. It’s moving from many decades of broad-based wellness drugs that have done extremely well. Things like Lipitor, and so on. The cash is now moving to much more specific disease situations.
New companies have a chance there. Large companies don’t have a natural competitive advantage here. They have the money. That’s a big advantage. But they don’t have the organizational advantage. They [Big Pharma] are applying—and I think AstraZeneca is a good example—they are applying many of their resources to the outside and reducing their inside R&D investment.
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