Clinton tells pharma to explain drug prices

Bill Clinton spoke at the Klick Ideas Exchange.
Bill Clinton spoke at the Klick Ideas Exchange.

PHILADELPHIA: As a precursor to the 2015 Bio International Convention in Philadelphia, which started Monday, a group of heavy hitters across the healthcare spectrum gathered at the National Museum of American Jewish History to mull over the state of healthcare—specifically, biotechnology and pharma.

Among more than three dozen speakers at the Klick Ideas Exchange was one last-minute addition: former president Bill Clinton. Though Clinton was billed as the opening act, he was delayed by fog at his local airport in White Plains, NY. He arrived two hours later after driving to a less fog-ridden departure point.

There was plenty to hear before Clinton spoke, however. The 500-odd invited guests, all leaders in the biopharma industry, were treated to a rapid-fire series of panels and 20-minute presentations on a wide array of topics.

“We are lucky to be living in an amazing time,” Leerom Segal, CEO of Klick Health and the event curator, said when he kicked off the proceedings. “We're approaching changes that will basically redefine what healthcare is,” he said, calling his audience “a roomful of biotech leaders who see obstacles as something to be overcome—and refuse to miss moments of opportunity.”

Dr. Eric Topol's crowd-pleasing address was as accessible as his acclaimed book, The Patient Will See You Now. After mentioning the average wait to get an appointment with a primary-care doctor is 2.6 weeks and the average time spent in the waiting room is 61 minutes, Topol suggested, “We can probably do better than that.”

For laughs, he showed a New Yorker cartoon in which a nurse advises patients, "We're running a little behind, but we'd be happy to have our anesthesiologist put you under for a few hours, until the doctor is ready to see you."

On the other hand, said Topol, the Internet will see you now—as will the smartphone, robot, avatar, Google, and so on. With all the telehealth tools and services available today, he said there will soon be healthcare on demand. And then there's the ever-increasing number of electronic sensors, from wearable to embeddable, ingestible, biodegradable and injectable. Forget Google's driverless car: in the future, we may have the doctorless patient—a whole new healthcare model that will signal the end of medicine as we know it.

Next up was Ryan Olohan, Google's healthcare industry director, who spoke about “Thinking 10X.” That means seeking solutions to global problems, like the four billion people in the world not connected to the Internet (one solution: hot-air balloons that act like cell-phone towers), giving away wireless access and Android One smartphones to the masses, and creating phone apps to monitor vision problems and other preventable health issues.

More speakers followed, each feeding off the ideas of those who went before them. Dr. Daniel Kraft, medicine and neuroscience chair for Singularity University, spoke about “exponential medicine,” tracking the rise of today's digital devices (“lab-on-a-chip”) and what he called the grand challenge: how to address the inefficient use of data.

Following Kraft was Dr. Ezekiel Emanuel, author of Reinventing American Health Care. He struck a discordant note by saying, “The others who spoke before me can be called techno-utopians—I fill the role of techno-skeptic.” A lot of technologies fail, don't work or never get adopted, he said. In general, healthcare technology does not lower healthcare costs; it raises them, he said. And he warned that there will be increasing pressure to address the high prices of drugs that fight rare diseases and the adoption of medical technologies that aren't cost-effective.

Next, Jim Greenwood, president and CEO of the Biotechnology Industry Organization, interviewed Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, on the subject of the 21st Century Cures Act.

Woodcock also sounded a cautionary note on the legislation, saying medical technology has moved ahead of the healthcare system and ahead of medical knowledge. However, she praised the bill's attention to patient-focused drug development. Her biggest concern? The FDA's understaffed workforce—“We're 700 people short,” she said. She sees promise in the way technology is transforming healthcare, saying, “Nothing could be more desirable. Our system doesn't work; if it can be improved, that will be a tremendous benefit to the community.”

Attendees also explored technology demos that included 3-D printing, a headset that offered a virtual-reality ride through a human blood vessel and a holographic version of Larry King. (And yes, these do have medical applications.)

Then it was time for keynote speaker Bill Clinton. His presentation touched on global initiatives to reduce hunger, provide clean water and low-cost energy, and improve health systems around the world. Bringing his unique perspective to this country's politics, he declared, “What works best is inclusive leadership, and the best person I ever saw at this was Nelson Mandela. Cooperation is a better working model than conflict."

Clinton showed himself to be acutely aware of challenges faced by the pharma industry and was mindful of its invaluable place in society. “The challenge is to manage the growth without losing the vision,” he said. “What you're doing will shape the future.”

Later, when the discussion moved to the Human Genome Project, Clinton admitted, “I spent three billion dollars of your tax money to sequence the human genome. But it's something that has had provable economic benefits. We've seen a huge change in cancer treatments—now we can treat tumors by the genome rather than the location in the body. And we're getting close on Parkinson's.”

Incoming BIO chairman Dr. Ron Cohen, CEO of Acorda Therapeutics, responded, “While people love our industry when we're helping, there's still a constant barrage of criticism over pricing. But to do what we do requires long timelines and high investments, and in order to attract investors we need to offer large returns. Are we explaining these issues well enough to stakeholders in society?”

“American people are proud that you do this work,” Clinton replied. “But they don't understand why people around the world are paying less. Everybody expects big healthcare increases in the next year or two, largely due to drug prices. My advice is to explain, explain, explain; disclose, disclose, disclose. Not everybody is going to love you.”

Speakers continued into the evening, including a panel discussion on pharmacogenomics and human cell therapy by Martine Rothblatt, founder of United Therapeutics; Dr. Bob Hariri, founder of Celgene's cellular therapeutics division; and RJ Kirk, Intrexon's president and CEO and a self-described stem-cell guy. When asked what medical advances he sees coming in the next five years, Hariri boldly predicted, “By far the majority of cancers will be curable. We are going so fast.”

In general, a tone of wonder pervaded the event. Even Google's Olohan was heard to say: “Massive changes are happening faster than we can keep up.” And like many others, Clinton expressed the thought that this is the most exciting time in history to be alive.

“Did you ever think disruptor would be a popular word?” Clinton asked. “I was a disruptor in school, too, but all it got me was bad grades for conduct.”

Correction: An earlier version of the story incorrectly attributed comments made by Bob Hariri to geneticist Craig Venter, who could not attend the event.