In the lead up to the annual One Nucleus ON Helix conference, which aims to bring together the network to discuss the main innovation and technology trends in healthcare research and development, we dedicated this ‘My Question Is…’ to addressing questions along the theme of Medicines Discovery in a Brave New World.
Our ‘My Question Is…’ sessions have continued to serve to recreate the serendipitous meetings that our network have missed from face-to-face gatherings. Groups are randomly allocated to different breakout rooms on Zoom and each group has a host who poses a question for discussion. This creates a forum for some to show expertise and for others to learn. Delegates from our most recent session gave positive feedback about the “high calibre discussions”, “interesting topics” and “thought-provoking discussions”. It is always a pleasure to share the outputs from the discussions in the form of a One Nucleus blog as a way of dissemination to our wider network. The importance of asking the right questions is reflected in a famous quote by virologist and medical researcher, Jonas Salk: "What people think of as the moment of discovery is really the discovery of the question."
I hope you enjoy reading the outputs.
Question one facilitated by Paul Branthwaite, Senior Partner, tranScrip: “What are the 'new world' technologies paving a new era in medicines development?” The group assessed seven areas that they thought would be impactful: ATMPs, gene therapy, personalized medicine, therapeutics at a distance, prophylaxis (or preventative healthcare), AI and diagnostics and rare disease. Martyn Postle also suggested quantum biology. The group talked mostly about gene therapy and application across all therapeutic areas. In particular, the group spent time discussing gene replacement, genomic profiling and changing expression. Coincidentally, one of members of the group worked in recruitment and highlighted that there had been an upward trend in the amount of recruitment in gene editing, which is somewhat reassuring to know. Paul then talked a bit about the drug/diagnostic piece, which is now key to a lot of new drug development. New companies being formed in diagnostics are there to inform science and the public, e.g., 23andMe. The group then moved onto talking about data capture and key questions such as whether genetic information can be used for insurance purposes, hostile data use and privacy issues. The group wrapped up their discussion on the suggestion that there is a requirement for a new informed consent in terms of how data is used and captured.
Question two facilitated by Matt Smith, Director, Biomed Realty: “Do you think the concept of 'ecosystem' is more or less relevant after over a year of not travelling?” Matt highlighted straight away that life science clusters are here to remain and important for scientific advancement. Co-location of academic, government, industry and investment communities can make a successful cluster. Focusing more on the travel piece, most of the group felt that it was possible to replicate face-to-face meetings using the array of digital tools that we have now become accustomed to. This is evident in the amount of collaboration and open communication which we have seen over the past 15 months, and which enabled progress in the fight against Covid-19. The group also raised an interesting point around VCs. Last year, investment into UK life science companies was record breaking, but most of those companies were at later stage. It could be deduced therefore, that it is the smaller companies that have suffered the most from the lack of face-to-face. These newer companies do not have the benefit of being able to leverage existing networks, which could potentially hamper progress. The group reached the conclusion that having an ecosystem is important for drug discovery and progress across the sector and although, travelling isn’t seen as the prerequisite (as perhaps it once was), the consensus was that most people would be keen to resume face-to-face and reinforce the digital networks that they had made.
Question three facilitated by Vicki Hayes, Director, DLRC: “Are we likely to see faster drug development processes and approvals outlive the pandemic as it was demonstrated it works?” The group was optimistic that “possibly” and “hopefully” faster drug approvals were likely to outlive the pandemic. A comment was made that we have seen some benefits of faster drug development processes and regulatory procedures for Covid related products, but it is important to acknowledge that this has probably come with some impact on non-covid related products. Reflecting on some specific examples from the last 18 months or so, Vicki talked more about drug repurposing. The group agreed that this was a very useful tool, however, there should be a strategy and scientific rationale applied to ensure resource is not wasted. From a regulatory perspective, the group acknowledged the success of the rolling review process for Covid vaccines. However, the question now is whether this can be applied to other therapy areas with consideration of who will pay for the implementation and additional resources to do so. Vicki touched upon the point that big pharma could benefit from being more agile in decision making processes to see acceleration of drug development and perhaps could take lessons from smaller start-ups that are leaner. An interesting point was raised around the profile and reputation of the life science industry. We have certainly seen an increase in the profile and participation in clinical trials for Covid treatments, which is supporting faster drug development. Finally, the group touched upon the political situation and how we could benefit from more collaboration across the political environment and different countries, which has also been demonstrated during the pandemic. Looking to the future and with more scenario planning in place, this will hopefully be the case.
Question four facilitated by Nadia Shivji-Brown, Business Development Manager, Public Health England: “Prevention vs. Cure: Will we see a new balance in the brave new world?” Nadia’s group highlighted many ways in which the “brave new world” was shifting more towards prevention. For example, there had been a shift into diagnostics due to the pandemic. The Government also seems to be moving towards the prevention side and good examples of this are initiatives such as the Covid-19 Genomics UK Consortium (COG-UK) and the Office for Health Promotion. There had been an acceleration in vaccine technology which was used to halt the current pandemic, and this represents a form of prevention as opposed to cure. The group pointed out however, that as well as preventing disease it is also important to cure symptoms. In the initial stages of an illness, medical professionals will seek to treat and cure a disease, if possible, to do so. So, progress towards cures are just as important. Nadia moved onto discussing what prevention was like in the UK and the group felt that it was not as good compared to other countries. For example, the shortage in funding doctors is probably not helping with the situation. Another important factor that comes into play is education and communication. We potentially “live in a bubble” as a science community. The pandemic, for example, highlighted the public’s perception of science, e.g., with spread of conspiracy about chips in vaccines. It is important to understand what the public is thinking so that as a science community we can do more to tackle misinformation. Big diagnostic companies appear to be fearing well in the pandemic which reflects that the prevention strategy is currently paying well. However, one caveat is that prevention is probably more difficult than cure, as you need to understand the pathways that lead to disease. Finally, when considering one of the major milestones in preventative medicine, which is genetic testing, the group asked the question, is this really a form of prevention? I guess that could lead into a separate debate…
Question five facilitated by Kate Hickinson, Partner, Appleyard Lees: “What role [does/should] the patent system play in access to innovative medicines?” As with most things, there is a good and bad side to every debate. Kate’s group discussed whether the patent system incentivized innovation, as the need for a return on investment can lead to high costs and mean that medicines are not available to everyone. But is it entirely the patent systems’ fault? It could, for instance, be down to the behaviour of the patent owners, as just because you have a patent does not mean that you must stop others doing the same thing. For example, there has been some very positive behaviours during the pandemic of companies granting royalty free licenses and behaving in a responsible way. The group also discussed the alternatives to the patent system. Would there have to be new economic models to enable things to work without a patent system in place? For example, if everyone reverted to trade secrets then could this have a detrimental effect on the scientific community because the science would not be shared? Patents are granted in return for disclosure and as a way of helping science move on. An interesting point raised was whether patents help or hinder collaboration and although, there was no straightforward answer, it can be helpful if people set out right at the start who owns what and how the work will be carried out.
One Nucleus is very grateful to those facilitators and attendees that participated in this session.
Blog by Alicia Gailliez, Business Development Manager, One Nucleus.