India produces brilliant engineers, scientists, and physicians and represents a major generic drug development and manufacturing center worldwide but few original branded drugs derive from the country. The chief scientist of the World Health Organization (WHO) recently noted this reality, emphasizing that not one cancer drug has originated in India. Soumya Swaminathan suggests partnerships are required to bring innovation to drive novel and economical drugs while offering a speech at Dr. S Kirshnamurthi’s Centenary Memorial recently.
A Nexus of Drug Development Human Capital
As reported in The Hindu, the vast wealth of human capital in the country not to mention medicinal plants that could be explored for new therapies—including cancer—continue to go untapped. Perhaps it truly is the time to rev up “the National Cancer Mission to make a dent on India’s cancer burden in the future.”
What will change Cancer Therapy Investment Dynamics?
In India, Swaminathan noted that private companies were the key drivers for developing oncology drugs. The concern is that without some form of governmental intervention, the same R&D and commercialization dynamics will continue. Will India’s public sector get organized, committed, and mobilized to foster oncology R&D there?
Indian Patient Access a Major Concern
Swaminathan challenges the current status quo in India when it comes to drug pricing, access, and affordability. Presently, a great majority of the population lacks sufficient access to advanced therapies. As cancers rise and new advanced drugs, such as immunotherapies, come on the market, it becomes increasingly apparent that many of these drugs are priced far outside the reach of most Indians. So, the net result is that the significant breakthroughs benefit the private firms’ returns/profits, but she is unsure how many Indian patients have truly benefited. A real issue to look at includes access and affordability along with innovation. Is it possible in India?
The Cervical Cancer Vaccine
Dr. Swaminathan offers an example involving a vaccine for cervical cancer—ones that are more economical and available—presently this represents a material hurdle. Frankly, there just aren’t enough vaccines for the nations that seek to vaccinate their girls. Out of 11 new products in this class, one is an Indian product likely to complete its clinical trials by 2022—known as the Indian quadrivalent vaccine, it has entered Phase III clinical trials.
Swaminathan suggested that it is critical to get Indians the HPV vaccine schedule in India. She reports that the early detection and prevention of future cancers and that by strengthening health and wellness centers and primary health centers—with a big push—this could be a good step forward. Leveraging the Cancer Institute approach was a good start.
India has been an incredible force in the evolution of the biosimilar and generic drug manufacturing, for example, not to mention as a prime global location for bundled outsourcing deals for relatively high-end, value-added clinical trials data management, safety data processing, custom clinical data warehouse systems, and the like. And the Indian tech consultancies (e.g. Wipro, Infosys, etc.) engage the biggest pharma companies worldwide for projects ongoing.
But Indian drug sponsors, whether from the public sector or private sector, haven’t produced too many original, branded drugs out of the Indian subcontinent—not at least in proportion to their population of talented scientific and technical people, nor to its massive population and, hence, market size. Advocates, such as Dr. Swaminathan and others, seek to finally drive change so that there is a level of ownership and innovative pedigree native to India. The time has come that it does this.