FierceBiotech's 2016 Fierce 15

Fierce 15

My mother recently asked me if I’m uncomfortable covering the biopharma industry given how unethical it is. Wait, what? The wearing daily news drumbeat has gotten to her. It’s focused on everything from massive price increases for non-innovative products from the likes of Mylan and Valeant to not-so-cheap, FDA-approved biosimilars blocked from use by patent disputes.

The most crucial insight from all this coverage boils down to one thing: Americans are paying much more for drugs while everything else in the consumer universe is getting cheaper--and they really, really don’t like doing that, especially while their wages are stagnant. The biopharma industry is at its lowest recorded popularity; my mom is hardly alone.

The long-standing unspoken agreement between the biopharma industry and the U.S. government goes a little like this: The U.S. will pay massively more for drugs because it will conduct only very limited price negotiations, unlike European nations. In exchange, well-insured Americans get the fastest and best access to innovative medicines and clinical trials.

This is somewhat akin to the price of having a standing military. It’s one of those superpower country sorts of obligations; if the U.S. finances it, eventually other places will get it, too--the logic goes. A sort of trickle-down theory of drug development, if you will. Americans pay more to ensure that global biopharma advancements continue.

That basic premise remained almost entirely unchallenged throughout President Obama’s healthcare overhaul. But in the last year or so, elements that fall along the edges of this framework--like major price hikes on noninnovative medicines--have become the subject of widespread American outrage as well as national political commentary, if not action.

The American public is also waking up to the corollary long-standing fact that the U.S. and its profligate, largely non-negotiated drug spending almost entirely undergird the profits at major biopharmas--with their ranks of highly compensated, easy-to-disdain CEOs.

All that makes the biopharma industry a very easy target, particularly in a presidential election year.

The biopharma industry has a trio of counterarguments that it usually trots out to defend itself, none of which seem particularly appealing to Americans right now: 1) Drugs are only a small fraction of healthcare costs--and when they are used correctly often result in less patient suffering and expense. 2) Drug development costs a lot and is unpredictable, necessitating billions in spending that may or may not pay off. 3) Innovation!

It is in the spirit of the last point, which I obviously find compelling given my profession, that we deliver to you the 14th iteration of our annual Fierce 15 list. The irony, amid all the ongoing public dislike of biopharma, is that right now, the industry is actually doing all sorts of amazing R&D that is treading into the near-miraculous.

Immuno-oncology could cure cancer--or at least make it a manageable long-term condition. Our shadow self, the microbiome, is being assessed and put to work on our behalf. Gene editing could put an end to some genetic disorders and offer the means to leap forward in rational drug development.

So, that means a lot is riding on the shoulders of the Fierce 15 and their innovative startup ilk as they work to make all this a reality.

Dazzle us.