Research Question; The One-Off Cure

Whilst Trying to Gag and Complaining About Prof G to our Bosses You Wrote: "Under what conditions could anyone [even a Neurologist] propose a one-time cure [not a more effective maintenance and management drug regime] for MS without falling victim to pharmaceutical influence? How do MS families work through their elected representatives to ensure such conditions exist?”

The considerable costs of clinical trials, which is an essential part of drug development mean that they are difficult to undertake without pharmaceutical company support. However, the infrastructure is already there to undertake investigator-led studies that are motivated by science and not profit. Indeed there are many studies ongoing at the moment that are fulfilling this aim.

To come up with the idea and get funding to show proof of principle for a one-off cure is readily achievable, without the pharmaceutical industry knowing anything about it, so they can't influence it. Doing the clinical trials are the costly bits.

There are agencies such as the MS Societies (which you can lobby to undertake studies and indeed do so given the evidence of some of the studies they are supporting) and the Medical Research Council in the UK and NIH in the USA, and others, that have the capacity to fund such studies. However, these studies will take a considerably longer period of time to adequately fund and get off the ground compared to the speed that big pharma can do it. Therefore, if you have a one-time cure then it is feasible to undertake studies, without being in the pocket of current companies.

In animal models this one-time cure is probably already achievable, but in MS it is more complex, but the earlier you start treatment the greater is the chance of success. Team G is in the process of testing such a strategy, developed in our lab! However, if you need to generate a new drug, manufacture of clinical grade chemicals is hugely expensive. You will probably need to set up a company to manage the funds and the study, so do you become the pharmaceutical industry?

Would pharmaceutical companies go for a one-time cure, well maybe if the price is right. If you look at Alemtuzumab at the moment then you may be only getting a couple of courses of drug. This may be not that far from a one-off treatment. We will have to wait and see if it is a cure. We have seen in previous posts how much Pharma may be planning to charge. This may have been very different had Merck Serono not withdrawn their oral version of cladribine (movecto), which would have probably been sold at a considerably cheaper price. Cladribine would have been taken in a similar way to Alemtuzumab, and may be as effective as Alemtuzumab in some groups of patients, but lacks some of the serious adverse side effects of Alemtuzumab. There may be a cancer risk with cladribine but this is going to be a possibility with any immunosuppressive drug of this nature.

However, the success of oral cladribine, would have woken people up to the fact that intravenous cladribine would be just as good and would be several times cheaper and could be supplied by any generics drug company, as intravenous cladribine is off-patent. This could kill the golden goose that MS has become for companies, as you could have a cheap, effective drug. So you MSers should lobby your MS Societies to investigate this and get it licensed! Cladribine is not a toxic evil, but a potential opportunity that should not be missed.

There are enough people out there, me included, that would bite your arm off for the chance to find and bring a one-off cure to people with MS, irrespective of what the pharmaceutical industry would do. If the pharmaceutical industry come up with it, it will cost, but they have been doing one-off vaccinations that are cures and saves millions of lives for many, many years. The difficultly in not the conspiracy, it is finding the one-off cure, to do that it would help to know the cause, then you can Think Prevent.

CoI: None

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