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Saturday, March 19, 2016

Cost to Develop and Win Marketing Approval for a New Drug Is $2.6 Billion



Developing a new prescription medicine that gains marketing approval, a process often lasting longer than a decade, is estimated to cost $2,558 million, according to a new study by the Tufts Center for the Study of Drug Development.
The $2,558 million figure per approved compound is based on estimated:
  • Average out-of-pocket cost of $1,395 million
  • Time costs (expected returns that investors forego while a drug is in development) of $1,163 million
Estimated average cost of post-approval R&D—studies to test new indications, new formulations, new dosage strengths and regimens, and to monitor safety and long-term side effects in patients required by the U.S. Food and Drug Administration as a condition of approval—of $312 million boosts the full product lifecycle cost per approved drug to $2,870 million. All figures are expressed in 2013 dollars.
The new analysis, which updates similar Tufts CSDD analyses, was developed from information provided by 10 pharmaceutical companies on 106 randomly selected drugs that were first tested in human subjects anywhere in the world from 1995 to 2007.
“Drug development remains a costly undertaking despite ongoing efforts across the full spectrum of pharmaceutical and biotech companies to rein in growing R&D costs,” said Joseph A. DiMasi, director of economic analysis at Tufts CSDD and principal investigator for the study.
He added, “Because the R&D process is marked by substantial technical risks, with expenditures incurred for many development projects that fail to result in a marketed product, our estimate links the costs of unsuccessful projects to those that are successful in obtaining marketing approval from regulatory authorities.”
In a study published in 2003, Tufts CSDD estimated the cost per approved new drug to be $802 million (in 2000 dollars) for drugs first tested in human subjects from 1983 to 1994, based on average out-of-pocket costs of $403 million and capital costs of $401 million.
The $802 million, equal to $1,044 million in 2013 dollars, indicates that the cost to develop and win marketing approval for a new drug has increased by 145% between the two study periods, or at a compound annual growth rate of 8.5%.
According to DiMasi, rising drug development costs have been driven mainly by increases in out-of-pocket costs for individual drugs and higher failure rates for drugs tested in human subjects.
Factors that likely have boosted out-of-pocket clinical costs include increased clinical trial complexity, larger clinical trial sizes, higher cost of inputs from the medical sector used for development, greater focus on targeting chronic and degenerative diseases, changes in protocol design to include efforts to gather health technology assessment information, and testing on comparator drugs to accommodate payer demands for comparative effectiveness data.
Lengthening development and approval times were not responsible for driving up development costs, according to DiMasi.
“In fact,” DiMasi said, “changes in the overall time profile for development and regulatory approval phases had a modest moderating effect on the increase in R&D costs. As a result, the time cost share of total cost declined from approximately 50% in previous studies to 45% for this study.”
The study was authored by DiMasi, Henry G. Grabowski of the Duke University Department of Economics, and Ronald W. Hansen at the Simon Business School at the University of Rochester.
ABOUT THE TUFTS CENTER FOR THE STUDY OF DRUG DEVELOPMENT
The Tufts Center for the Study of Drug Development (http://csdd.tufts.edu) at Tufts University provides strategic information to help drug developers, regulators, and policy makers improve the quality and efficiency of pharmaceutical development, review, and utilization. Tufts CSDD, based in Boston, conducts a wide range of in-depth analyses on pharmaceutical issues and hosts symposia, workshops, and public forums, and publishes Tufts CSDD Impact Reports, a bi-monthly newsletter providing analysis and insight into critical drug development issues.

Targeted microbubbles in the experimental and clinical setting


TARGETED MICROBUBBLES IN THE EXPERIMENTAL AND CLINICAL SETTING
Ahmed Alzaraa, M.R.C.S.a,*, Gianpiero Gravante, M.R.C.S., Ph.D.a,
Wen Yuan Chung, Ph.D.a, Dhya Al-Leswas, M.R.C.S.a, Morgan Bruno, M.D.b,
Ashley R. Dennison, M.R.C.S., M.D.a, David M. Lloyd, M.R.C.S., M.D.a

Abstract
BACKGROUND: Microbubbles have improved ultrasonography imaging techniques over the past 2 decades. Their safety, versatility, and easiness of use have rendered them equal or even superior in some instances to other imaging modalities such as computed tomography and magnetic resonance imaging.Herein, we conducted a literature review to present their types, general behavior in tissues, and current and potential use in clinical practice.
METHODS: A literature search was conducted for all preclinical and clinical studies involving
microbubbles and ultrasonography.
RESULTS: Different types of microbubbles are available. These generally improve the enhancement of tissues during ultrasonography imaging. They also can be attached to ligands for the target of several conditions such as inflammation, angiogenesis, thrombosis, apoptosis, and might have the potential of carrying toxic drugs to diseased sites, thereby limiting the systemic adverse effects.
CONCLUSIONS: The use of microbubbles is evolving rapidly and can have a significant impact on the management of various conditions. The potential for their use as targeting agents and gene and drug delivery vehicles looks promising.

Combined endocrine and exocrine tumours of the pancreas


Ahmed Alzaraa*1, Valeri Udom2, Husam Mousa1, Abdulhalem Alzein1,
Abduljalil Benhamida1 and Neha Dalal3
Address: 1Department of General Surgery, Tameside General Hospital, Manchester, UK, 2Department of Radiology, Tameside General Hospital,Manchester, UK and 3Department of Histopathology, Tameside General Hospital, Manchester, UK
Email: Ahmed Alzaraa* – ahmedwahabf@gmail.com; Valeri Udom – vudom52@aol.com; Husam Mousa – hmousa2006@hotmail.co.uk;Abdulhalem Alzein – aelzein73@yahoo.com; Abduljalil Benhamida – abduljalil.benhameda@tgh.nhs.uk; Neha Dalal – neha.dalal@tgh.nhs.uk
* Corresponding author
ABSTRACT
Background: Cystic neoplasms of the pancreas comprise 10%–15% of pancreatic cystic lesions,with the serous cystadenoms being the commonest. The association of exocrine and endocrine tumours of the pancreas unrelated to Von Hipple Lindau disease is very rare. Very few cases have been reported in the literature. We present another case of both these tumours in one patient.
Case presentation: A female patient was seen in the surgical clinic for a pain in the right groin.Clinical examination and investigations confirmed a diagnosis of combined endocrine and exocrine tumours of the pancreas. She underwent surgery and is under regular follow-up in the surgical clinic.
Conclusion: Biphasic differentiation of pancreatic stem cell during embryological development could happen and may result in combined endocrine and exocrine tumours of the pancreas. Imaging studies are excellent in diagnosing theses lesions. Surgery has a central role and could be curative.

Coexistence of carcinoma and tuberculosis in one breast



Case report
Coexistence of carcinoma and tuberculosis in one breast
Ahmed Alzaraa*1 and Neha Dalal2
Abstract
Background: The coexistence of breast cancer and tuberculosis is very rare. This can create a dilemma in the diagnosis and treatment as there are no pathognomonic symptoms or signs to
distinguish both diseases.
Case presentation: A female patient was seen in the breast clinic for a right breast lump. Clinical examination and investigation confirmed cancer and tuberculosis of the right breast. She underwent right mastectomy and axillary clearance and received chemo and radiotherapy.
Unfortunately, she died of wide spread metastases.
Conclusion: The simultaneous occurrence of these two major illnesses in the breast can lead to many problems regarding diagnosis and treatment. Though rare, surgeons, pathologists and
radiologists should be aware of such condition.

Sebaceous carcinoma of the skin of the breast: a case report


Ahmed Alzaraa*1, Imran Ghafoor1, Andrew Yates2 and Alhad Dhebri1
Abstract
Introduction: Sebaceous gland tumours are rare and their presence should be considered as a
marker for Muir-Torre Syndrome, alerting to search for an occult malignancy.
Case presentation: A 43-year-old Caucasian female patient underwent excision of a sebaceous cyst. Histopathology confirmed a sebaceous carcinoma. Further investigations revealed multiple intra-abdominal malignancies. She has been under regular follow-up in the relevant clinics.
Conclusion: Sebaceous carcinoma should be excised completely and followed-up for the
detection of possible metastases. Surgical removal of primary or metastatic cancers may be curative and should be attempted wherever possible. It is very important for clinicians not to miss such skin lesions as they may precede the presentation of internal malignancies.



Ahmed Alzaraa, Aleksandar Vodovnik3, Hugh Montgomery,Mohammed Saeed and Narinder Sharma
Abstract
Background: Metastases to the breast from extramammary tumours are uncommon, and
metastatic renal cell carcinoma to the breast is extremely rare. We report a metastasis to the
breast from a renal primary with the radiological and histopathological features.
Case presentation: An 81-year-old lady was seen in the breast clinic for a right breast mass after sustaining a fall. Clinical examination and investigations revealed a metastatic cancer from a renal primary. She received surgical treatment only and is under regular follow-up in the oncology clinic.
Conclusion: The treatment strategy for metastatic breast diseases is based on a proper
assessment of such cases by surgeons, radiologists and histopathologists

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Hi,I,m Basim from Canada I,m physician and I,m interested in clinical research feild and web development.you are more welcome in our professional website.all contact forwarded to basimibrahim772@yahoo.com.


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