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Live-Licensing & In-life
testing:
R&D Processes and Regulation for New
Drugs, 2008-2020
Publication
Date
February 2008
Publisher
VISIONGAIN
Product Type
Report
Pages
not applicable
ISBN Number
not applicable
Product Code
VISG04
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Current phase I to IV clinical testing
process will eventually be selectively or
wholly replaced by a system known as
“in-life” testing or “live” licensing. Those
proposals involve cumulative testing of the
drug throughout its lifecycle. The industry
would continually test drugs with smaller,
more focused clinical trials. If a trial
shows efficacy and safety, a live license
would be given, allowing the company to
market the drug in a limited manner.
Already, the FDA and the EMEA have shown
favourable interest in such developments -
amongst other amendments to current
practice.
In particular, R&D Processes and Regulation
for New Drugs, 2008-2020, concentrates on
the following essential aspects of the
market:
Forward-looking
development of R&D methods and regulatory
policies in theory and practice
Discussion
of the relevant technology and methods,
including accompanying diagnostic tests (theranostics/companion
diagnostics)
Discussion
of un-met/under-met therapeutic needs and
relative advantages of emerging
developmental methods and regulatory policy
Discussion of the current global
pharmaceutical market and where it is
heading
Drivers and restraints facing new
drug development from 2008-2020
Opportunities and threats facing
drug development from 2008-2020, with SWOT
analysis
Detailed interviews with leading
experts in regulatory affairs in academia
and industry
Why you should buy this report:
To receive a comprehensive analysis of the
prospects for new drug development from
2008-2020
The views of leading experts in regulatory
affairs concerning present and future issues
in new drug development and regulatory
trends
To discover the most important existing and
potential future regulatory developments
Predictions for key developmental metrics
that can be improved via the new methods and
regulatory initiatives
To determine the forces that influence new
drug development:
Competitive characteristics
Drivers
Restraints
Strengths,
weaknesses, opportunities and threats
To find out where pharmaceutical R&D is
heading - both technologically and
commercially, with emphasis on all
healthcare stakeholders.
Further clinical testing during the
marketing of the drug could allow the
marketing restrictions to be gradually
lifted, providing access to greater numbers
of patients, including an expansion of
indications. This proposed testing system
has the advantage of allowing companies to
gain revenues from the drug candidate
earlier, while benefiting patients earlier
as well. The tests combined with treatment
could also cut developmental costs
significantly, since large-scale clinical
testing is very costly and time consuming.
This is a win-win situation for you and your
company – you must be fully informed of it
now.
We believe that in life testing/live
licensing will be fully operative next
decade.
The future of current and potential
blockbusters is therefore vitally important
to all companies in the pharmaceutical
sector, especially in this period of
economic pressures and regulatory
uncertainty. This report concentrates on
arguably the most exciting challenge facing
the industry and regulators: how to adapt
medicine to patient sub-populations and
emerging regulatory demands, improving
safety and efficacy markedly.
No pharmaceutical company can afford to
ignore those issues.
Table of Contents
1 Executive
Summary: R&D Processes and Regulation for
New Drugs, 2008-2020
1.1 Aim of this Report
1.2 Pharmaceutical Development and
Regulation are Continually Evolving
1.3 An Overview of the Report
1.4 Economic Pressures and Regulatory
Uncertainty
2 The Global
Pharmaceutical Market Has Entered a Crucial
Phase – Where Threats and Opportunities Meet
2.1 The Pharmaceutical Sector is a Leading
Technological Industry: However, It Faces
Marked Economic Pressures
2.1.1 Number of Blockbusters
Has Increased Along With Competition
2.1.2 Current Pressures on
Industry – Blockbuster Business Model Under
the Spotlight
2.2 The World Pharmaceutical Market
Continues to Grow, But Faces Mounting
Challenges
2.3 Pharmaceutical
Development is a High Risk High Gain
Business
2.3.1 R&D Strategy is Crucial to Success
2.4 The Continuing Success of the
Pharmaceutical Industry is Dependent upon
Important Drivers and Restraints
2.5 Companies Are Gradually Changing Their
Strategic Focus to Overcome Challenges in
the Worldwide Market
2.6 Unmet Needs and Specialist Uses Will
Continue To Drive Innovation
2.7
Patent Protection Strategies Form a
Cornerstone of Lifecycle Management
2.7.1 Falling Numbers of Drug
Approvals are Accompanied by Fewer Patents
Submitted
2.7.2 Life Cycle Management
Requires a Combination of Strategies
2.8 Drug Developers Face Increasingly
Difficult Therapeutic Challenges
2.9 Increasing Developmental Times is a
Serious Problem
2.10 Reducing Efficiencies in R&D Result in
Concerns over Thinning Pipelines
2.10.1 Is Innovation Declining
in the Pharmaceutical Industry?
2.10.2 Follow-on Products are
Very Appealing to Companies
2.10.3 Calls for a
More-Collaborative Approach to
Pharmaceutical Regulation
2.10.4 Reform of Pharmaceutical
Patenting Laws is Demanded
2.11 Healthcare Stakeholders Can Benefit
from Radical Changes to Regulatory Processes
2.12 Greater Regulatory Co-operation
2.13
Biomarkers and Theranostics
2.13.1 Pharmacogenomics is
Increasingly Relevant to Pharmaceutical
Development
2.13.2 Proteomics Constitutes
the "Next Step" After Genomics
2.13.3 Personalised Medicine
Will Rely Heavily Upon Theranostics
2.13.4 The Completion of the
Human Genome Project Has Been a Major Driver
of Molecular Diagnostics and
Personalised Medicine
2.13.5 Personalised Medicine
Supported by Theranostics Could Supersede
the Existing Blockbuster Model, With
Sustainable Revenue Flows Continuing
2.14
Mandatory Price Reductions Continue to Beset
the Pharmaceutical Industry
2.14.1 There Are Strong
Downward Pressures on Pricing Strategies
2.14.2 Pricing is a Key Issue – One
that is Often Contentious
2.14.3 In Europe Governments
are Exerting a Growing Influence on
Pharmaceutical Prices
2.14.4 It Is Possible That
Mandatory Cost-Controls in Germany Will
Serve As a Precedent for Wider Governmental
Controlling of Prices
2.14.5 Governmental Price
Controls Are an Established Part of the
Japanese Pharmaceutical Market
2.15 Is the Blockbuster Business Model
Sustainable?
3 Clinical Development and Approval
of Pharmaceuticals in 2007
3.1 A Brief History of Clinical Trials
3.1.1 The Nuremberg Code and
the Declaration of Helsinki
3.1.2 Establishing Standards
for Good Clinical Practice and the
International Conference on Harmonisation
(ICH)
3.2
Stages of Clinical
Testing
3.2.1 Clinical Testing Follows
a Rigorous Internationally-Recognised Code
3.2.2 Phase I Trials
3.2.3 Phase II Trials
3.2.4 Phase III Trials
3.2.5 Phase IV Trials
(Post-Marketing Surveillance)
3.2.6 Further Division of Clinical Trials
3.3 Market Pressures are Driving the Need
for Rationalisation of Clinical Testing
3.4 The
FDA - Gatekeepers to the Largest
Pharmaceutical Market in the World
3.4.1 The FDA is the Most
Important Pharmaceutical Regulatory Body in
the World
3.4.2 The CDER Oversees Drug
Safety in the US
3.4.3 The FDA Is Under Pressure
to Tighten-Up Drug Approval Procedures
3.4.4 Changes to Regulation of
Off-Label Prescribing
3.5 The European Medicines Agency (EMEA)
Controls a Diverse Range of Countries
3.5.1 The EMEA Combines and
Harnesses National Medical Expertise
3.5.2 The EMEA Makes the
European Market More Accessible to Companies
– a Win-Win Situation
3.5.3 Structure of the EMEA
3.5.4 Approval Process of the
EMEA and the EC
3.5.5 New Pharma Legislation in
the EC
3.5.6 The EU Clinical Trials
Directive
3.5.7 Provision for Joint
Scientific Advice from the EMEA and FDA
3.5.8 Consultation Paper on
Future of Healthcare in EU
3.6
Japan Has a High Level of Regulation
3.6.1 Approval of Foreign
Pharmaceuticals in Japan was Traditionally a
Daunting Process
3.6.2 Japan has Rigorous
Post-Marketing Drug Regulation
3.6.3 The Japanese System
Accommodates Re-Evaluation of Drugs
3.7 Safety and Speed Are Now Pressing Issues
for Regulatory Authorities
3.8 The
Use of phase IV Clinical Trials Is Set to
Increase Significantly
3.8.1 Post Marketing
Surveillance is High on the Agenda Worldwide
3.8.2 Post Marketing
Surveillance Can Benefit the Marketing of
Products
3.8.3 Safety is Driving Phase
IV Studies
3.8.4 Growth in Fast-Track
Applications will also Stimulate
Developments in Post Marketing Studies
3.8.5 Self-Monitoring of
Patients Will Become More Established
3.8.6 The UK Yellow Card System
Is a Long-Established Example of
Post-Approval Monitoring
3.9 Stringent Assessment of Risk Will
Require More Patients and Better Indicators
of Risk
3.10
Education Is a Key Issue
3.10.1 Public Mistrust of the
Pharmaceutical Industry is a Serious Problem
3.10.2 Problems with Vioxx and
Other COX-2 Inhibitors Had a Major Impact
3.10.3 Open and Trustworthy
Communication from both Companies and
Regulators is Vital
3.11 Changes in the Way Drugs Are Regulated
Will Change the Nature of Clinical Trials
3.12 Pharmacogenomics and Molecular
Profiling Will Change Pharma
3.12.1 Pharmacogenomics Has the
Potential to Revolutionise the
Pharmaceutical Industry
3.12.2 The Progress of
Pharmacogenomics Has Been Slow
3.12.3 Identification of
Expression Profiles in Pre-Clinical Models
3.12.4 A More Iterative
Approach will Result in Greater Synergies in
R&D
3.13 The
Organisation of Clinical Testing is Changing
3.13.1 Phase I and II Clinical
Trials Will Incorporate More Complex
Screening Techniques
3.13.2 Post-Regulatory Approval
will Become More Prominent
3.14 Safety Concerns and Development
Pressures Will Change the Structure of
Clinical Trials
4 How Pharmaceutical Development and
Supporting Regulation Will Evolve from 2008
to 2020
4.1 Reducing Developmental Times and
Late-Stage Failure are Crucial –
Developments in Testing and Regulation Will
Aid the Process
4.1.1 Drugs Ineffectiveness in
Sub-Populations is a Significant Obstacle to
Current Drug Development
4.1.2 There Are Steps that Can
Reduce Developmental Times
4.1.3 R&D Will Change Due to
New Developmental Models Supported by
Regulatory Reforms
4.1.4 Leading Industry Figures
Call for More Flexible Approach to Drug
Approval
4.1.5 Regulators Acknowledge
the Need for Stratification of Treatment
Populations
4.1.6 Visiongain Predicts
Stratification of Patient Populations
Leading to Live-Licensing/In-Life Testing
4.1.7 There Will Be Greater
Co-Operation between Regulators and
Pharmaceutical Developers from Now Onwards
4.1.8 Uncertainties over
Political and Legislative Will to Achieve
Reform of Pharma Approval Processes
4.2 A SWOT Analysis
for New Developments in the Pharmaceutical
Market Framework
4.2.1 SWOT Chart for
Developmental and Regulatory Changes from
2008-2020
4.2.2 Efficient Use of
Resources is Essential to R&D in the Years
Ahead
4.2.3 Stratification of
Patients is Key to More Personalised
Medicine Sought by Developers and
Increasingly Required by Regulators
4.2.4 Traditional Clinical
Development has a Significant Disadvantage –
Better-Targeted Studies will Take Precedence
4.2.5 Live
Licensing/In-Life Testing is the Way Forward
4.2.6 Regulatory Systems are
Already Becoming Closer Together – But
Global Convergence is Still Far from Certain
4.2.7 Electronic Patient
Records Will Be an Important Facilitating
Tool of In-Life Testing
4.2.8 Evidence-Based Medicine
will Become Increasingly Demanded by Pharma
Stakeholders
4.3 Adaptive Clinical Trial Design Will
Facilitate Interaction with Regulators and
Provide Increased Rationalisation of Drug
Development
4.3.1 Adaptive Clinical Trial
Design Uses Accumulating Data
4.3.2 Regulators Should be
Involved in the Process
4.3.3 Adaptive Trial Design
will Gain Acceptance by Early Next Decade
4.4 Personalised Medicine Driven by
Theranostics and Live Licensing/In-Life
Testing Will Become Established by 2020
4.4.1 Drivers for
Better-Targeted Medicine
4.4.2 The Prospects for
More-Personalised Medicine and Related
Diagnostics are Good
4.4.3 FDA Critical Path
Initiative is a Progressive Move in the
Right Direction
4.5
Personalised Medicine Aided by Regulatory
Reform will also Face Significant Obstacles
4.5.1 The Complex, Disparate
Pharma Industry Will Prove Difficult to
Reform, Especially in a Revolutionary Manner
4.5.2 It is Unclear How
Extensively New Clinical Testing Models and
Supporting Regulation will be Applied
4.6 Calls for New Global Harmonization
Effort from Influential Sources
4.6.1 Calls for Greater Regulatory
Consensus
4.6.2 Agreements Between the
FDA and EMEA are Already Taking Shape
Encouragingly
4.6.3 FDA-EC Co-Operation in
Pharmacogenomics, Vaccines, Paediatric
Medicine, Oncology, Counterfeiting and
Pharmacovigilance
4.6.4 Implementation Plan for
Medicinal Products for Human Use and Other
Transatlantic Developments
4.6.5 Globalisation Facilitates
Harmonisation of Pharmaceutical Regulations
4.6.6 Design of a Supranational
Regulatory Regime Should Protect National
Interests
4.6.7 Developing Nations
Adopting ICH Guidelines
4.6.8 Increasing Willingness
for Regulators to Collaborate on a Global
Scale – But No Sign of Global Regulatory
Harmonisation
4.7
While Personalised Medicine and Better
Targeted Clinical Trials are Emerging, Such
Developments are Welcomed by the FDA and
EMEA
4.7.1 Emerging Developments are
Welcomed by Pharma Stakeholders
4.7.2 Cancer Drug Development
Leads the Way in its Merging of Drug
Development and Treatment of the Disease
4.7.3 FDA's Critical Path
Initiative and Personalised Medicine
4.7.4 Theranostic Solutions
Will Aid the Development of Personalised
Medicine and Improve Support from Regulators
through Evidence-Based Medicine
4.8 Pricing of Personalised Medicine
4.8.1 Personalised Medicine
will Lead to Changes in Pricing and
Reimbursement
4.8.2 Onus is on Companies to
Prove Benefits of their Drugs Including
Comparative Cost-Benefits
4.8.3 Biomarkers Can Create Value
4.8.4 Non-Compliance is a Major
Problem that Can be Ameliorated via
More-Personalised Medicine
4.8.5 The Developments are
Complex and Systemic, Posing both
Opportunities and Challenges for Healthcare
Stakeholders
4.9
Evidence-Based Medicine and Pharmacoeconomic
Analyses
4.9.1 Comparative Testing is
Prevalent
4.9.2 Electronic Medical
Records are a Major Priority for Leading
Nations
4.9.3 GSK Leads Way in
Evidence-Based Medicine
4.9.4 Personalised and
Evidence-Based Medicine Will Require Time
for Acceptance
4.10 Changes to Regulation Governing
Paediatric Medicine
4.11 Visiongain Believes that the New
Developments Will Cut Developmental Time and
Provide Better Healthcare
4.11.1 Shift from General to
Personalised Healthcare is an Inevitable
Trend with Significant Potential Gains for
Industry and Society
4.11.2 Increased Use of
Conditional Acceptance Based upon Live
Licensing and In-Life Testing Constitute a
Logical Progression
4.11.3 Pharmaceutical
Developers Must Understand the Needs and
Preferences of Other Healthcare Stakeholders
5 Emerging
Technology Will Underpin Changes to
Developmental Processes and Regulatory
Policy
5.1 Personalised Medicine is a Prime Aim for
Healthcare
5.1.1 An Introduction to
Pharmacogenomics
5.1.2 The Aim of
Pharmacogenomics
5.1.3 Pharmacogenomic Drugs as
Personalised Medicines
5.1.4 The Economic Potential of
Pharmacogenomics
5.2
The Advantages of
Pharmacogenomics Drugs and Benefits to the
Pharmaceutical Industry
5.2.1 Pharmacogenomics is Attracting a Great
Deal of Interest from Pharma Stakeholders
5.2.2 Improved Drugs Through
Better Targeting
5.2.3 Reduced Deaths from
Adverse Drug Reactions
5.2.4 Personalised Drugs are
More Likely to Work Safely and Efficaciously
5.2.5 Advanced Screening for
Disease Leading to Quicker Diagnoses
5.2.6 Improved Vaccines
5.2.7 Improvements in Drug
Discovery and Reduced Cost of Clinical
Trials
5.3
Adverse Drug Reactions are a Serious Problem
5.3.1 Economic and Other
Consequences of ADRs
5.3.2 ADR and Genotype: Tacrine,
a Case Study
5.4 The Human Genome Project (HGP) and its
Influence on Pharmacogenomics
5.5 Barriers to the Growth of
Pharmacogenomics
5.5.1 The Complexity of Finding
SNP Gene Variations that Affect Drug
Responses
5.5.2 Limited Therapeutic
Alternatives
5.5.3 Disincentives for Drug
Companies to Develop and Produce Multiple
Treatments for a Disease
5.5.4 Educating Healthcare
Providers
5.6
Advances in Computing and Electronic
Communications Will Benefit Pharmaceutical
R&D
5.6.1 There are Prominent
Examples of Electronic Solutions Benefiting
Pharmaceutical Development
5.6.2 Electronic Data Capture (EDC)
Promises to Streamline Clinical Trials
5.6.3 Training and Security are
Barriers to EDC Conversion
5.6.4 The Clinical Trials Industry
Must Take the Initiative on EDC Standards
5.6.5 Governments Working Hard
to Establish e-Health Records
5.7
Electronic Submission of Post-Marketing
Safety Data is Another Important Development
5.8 Proteomics Constitutes the "Next Step"
After Genomics
5.9 Advanced Diagnostics Will Aid
Personalised Medicine and In-Life Testing
5.9.1 Theranostics – The
Combination of Therapy and Diagnostics
5.9.2 Exciting Developments in
Molecular Biology Can Bring Two Healthcare
Industries Closer Together
5.9.3 Personalised Medicine
Will Rely Heavily Upon Theranostics
5.9.4 Theranostic Applications
Will Exhibit Rapid Market Growth from
2007-2012
5.9.5 Personalised Medicine
Will Become More Prominent in Healthcare
with Theranostics Benefiting as a Result
5.9.6 The Completion of the
Human Genome Project Has Been a Major Driver
of Molecular Diagnostics
5.9.7 Personalised Medicine
Supported By Theranostics Could Supersede
the Existing Blockbuster Model, With
Sustainable Revenue Flows Continuing
5.9.8 Theranostics
will Benefit from FDA’s Guidance on
Pharmacogenomic Data Submission
5.9.9 Distinguishing Patients
at a Greater Risk is Vital
5.9.10 In Future Parallel Use
of Markers and Drugs Will Become Prevalent
5.9.11 The EDMA Cites
Theranostics as a Medium-to-Long-Term Driver
for Healthcare
5.9.12 Personalised Medicine is
a Strong Driver of the Theranostics Sector
5.9.13 While Personalised
Medicine Is Still a Goal for the Future, the
Technology Is Already Emergent
5.9.14 Identifying Suitable
Biomarkers Remains a Significant Challenge
5.9.15 Theranostics Bill
Introduced in the US Senate During 2006
5.9.16 Funding for Theranostics
R&D Efforts May Be Limited by Low
Reimbursement Rates
5.9.17 Cancer Diagnostics is an
Important Growth Area with Relevance to
Theranostics
5.9.18 Collaboration among
Stakeholders is Essential
5.9.19 Intra-Industry
Collaboration is Important to Achievement of
Innovation in the Years Ahead
5.9.20 Nucleic Acid Testing
Will Be Decisive in the Development of the
Theranostics Market
5.9.21 The Outlook for
Theranostics
6 Interviews
with Experts in Pharmaceutical Regulatory
Affairs: Drug Development - Present and
Future Trends
6.1 Respondent 1: US-Based Academic
Specialising in US Pharmaceutical Regulation
6.1.1 The Most Important Unmet
Regulatory Needs
6.1.2 What Changes are Going to
Occur?
6.1.3 Will the Changes Become
Widespread, Geographically and in Disease
Area?
6.1.4 Potential Resistance from
Payers
6.1.5 How Will Pharma R&D
Benefit?
6.1.6 The Obstacles to
Regulatory Reform
6.2 Respondent 2:
US-Based Academic Specialising in
International Pharmaceutical Regulation
6.2.1 The Most Important Unmet Regulatory
Needs
6.2.2 What Changes are Going to
Occur?
6.2.3 Will the Changes Become
Widespread, Geographically and in Disease
Area?
6.2.4 Potential Resistance from
Payers
6.2.5 How Will Pharma R&D
Benefit?
6.2.6 The Obstacles to
Regulatory Reform
6.3
Respondent 3: Analyst from a European
Pharmaceutical Industry Representative Group
6.3.1 The Most Important Unmet
Regulatory Needs
6.3.2 What Changes are Going to
Occur?
6.3.3 Will the Changes Become
Widespread, Geographically and in Disease
Area?
6.3.4 Potential
Resistance from Payers
6.3.5 How Will Pharma R&D
Benefit?
6.3.6 The Obstacles to
Regulatory Reform
6.4
Respondent 4: US-Based Academic Specialising
in US and European Pharmaceutical Regulation
6.4.1 The Most Important Unmet
Regulatory Needs
6.4.2 What Changes are Going to
Occur?
6.4.3 Will the Changes Become
Widespread, Geographically and in Disease
Area?
6.4.4 Potential Resistance from
Payers
6.4.5 How Will Pharma R&D
Benefit?
6.4.6 The Obstacles to
Regulatory Reform
6.5
Respondent 5: Regulatory Affairs Analyst
from an International Business Consultancy
Specialising in the Pharmaceutical Industry
6.5.1 The Most Important Unmet
Regulatory Needs
6.5.2 What Changes are Going to
Occur?
6.5.3 Will the Changes Become
Widespread, Geographically and in Disease
Area?
6.5.4 Potential Resistance from Payers
6.5.5 How Will Pharma R&D
Benefit?
6.5.6 The Obstacles to
Regulatory Reform
6.6 Respondent 6: Representative from
Regulatory Affairs in an International
Pharmaceutical Company
6.6.1 The Most Important Unmet
Regulatory Needs
6.6.2 What Changes are Going to
Occur?
6.6.3 Will the Changes Become
Widespread, Geographically and in Disease
Area?
6.6.4 Potential Resistance from
Payers
6.6.5 How Will Pharma R&D
Benefit?
6.6.6 The Obstacles to
Regulatory Reform
6.7 Respondent 7: Head of Regulatory Affairs
in a Top-10 Pharmaceutical Company
6.7.1 The Most Important Unmet
Regulatory Needs
6.7.2 What Changes are Going to
Occur?
6.7.3 Will the Changes Become
Widespread, Geographically and in Disease
Area?
6.7.4 Potential Resistance from
Payers
6.7.5 How Will Pharma R&D
Benefit?
6.7.6 The Obstacles to
Regulatory Reform
7 Conclusions
of this Study
7.1 The Prevailing Development of
Pharmaceuticals is Under Increasing
Commercial and Regulatory Pressure
7.2 Pharmaceutical Regulatory Authorities
Play a Vital Role in Healthcare
7.3 Personalised Medicine and
Rationalisation of the Developmental Process
7.4 Developmental Processes and Regulatory
Policy Need to Accommodate Stratified
Patient Populations
7.5 Visiongain Predicts Stratification of
Patient Populations Leading to
Live-Licensing/In-Life Testing
7.6 There Will Be
Greater Co-Operation between Regulators and
Pharmaceutical Developers
7.7 Uncertainties over
Political and Legislative Will to Achieve
Reform of Pharma Approval Processes
7.8 Greater Regulatory Co-Operation –
However, No Sign of Global Harmonisation in
Pharma in Sight
7.9 Theranostic Solutions Will Aid the
Development of Personalised Medicine and
Improve Support from Regulators through
Evidence-Based Medicine
7.10
Increased Use of Conditional Acceptance
Based upon Live Licensing and In-Life
Testing Constitute a Logical Progression
from 2008-2020
Appendix A: Glossary
Appendix B: About visiongain
Appendix C: visiongain report evaluation
form
List of Tables
Table 2.1 Major Drugs Losing Patent Expiry
in Near Future
Table 2.2 Revenue Generation ($bn) by the
World Pharmaceutical Industry, 2000-2006
Table 2.3 Forecast Revenue Generation ($bn)
by the World Pharmaceutical Market,
2006-2012
Table 3.1 Key Stages in the History of
Clinical Trials
Table 3.2 Drug Approvals Agencies within the
EU
Table 4.1 Greater Use of Disease Knowledge
and Biomarkers Will Benefit Pharmaceutical
Development
Table 4.2 SWOT Chart for Developmental and
Regulatory Changes, 2008-2020
Table 4.3 Visiongain’s Predictions of How
Changes to Pharma Development Will Benefit
the Industry and Other Stakeholders,
2007-2020
Table 5.1 Assessment of EDC Solutions
Table 5.2 Share (%) of the World Molecular
Diagnostics Market Held by Theranostics,
2006 & 2012
List of
Figures
Figure 2.1 Revenue Generation ($bn) by the
World Pharmaceutical Industry, 2000-2006
Figure 2.2 Forecast Revenue Generation ($bn)
by the World Pharmaceutical Market,
2006-2012
Figure 2.3 The Drug Development Process is
Long, Complex and Costly
Figure 2.4 Increasing Average Cost ($m) of
NCE Development, 1976-2005
Figure 4.1 The Current Framework for Drug
Development
Figure 4.2 How Pharmaceutical Development
Will Evolve into a More Progressive System
Figure 4.3 The Dynamic Integrated Regulatory
System of the Future
Figure 4.4 Systemic Changes to
Pharmaceutical Regulation Involve all
Healthcare Stakeholders
Figure 5.1 Progressive Technological
Developments in Medicine
Figure 5.2 World Revenues ($m) for
Theranostic Applications, 2006-2012
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