06Jun

The amazing speed with which the pharmaceutical industry developed, tested and won emergency approval for the COVID-19 vaccine was not just surprising, but in at least one way, misleading.

As the new report, Clinical Development Success Rates and Contributing Factors 2011 – 2020 from Bio.org makes clear, the COVID vaccines and therapeutics that became available mere months into the pandemic were a dramatic and rare exception.

On average, the report tells us it takes almost 11 years to go from a Phase I program to regulatory approval. And that’s only for those drugs and therapies that make it through. Over the 10 years from 2011, the likelihood that a drug in a Phase I trial would ultimately win approval was 7.9%.

That may be better odds than winning the Powerball lottery, however, the investment in a drug’s development can dwarf all but the largest jackpots. Making it even more of a gamble for a pharmaceutical firm is that the average success rate has declined since Bio’s 2016 report. Then the average for the previous 10 years was 9.6%.

Heavy with tables, charts and graphs, the Bio.org report (in conjunction with Informa Pharma Intelligence and QLS Advisors) reviews success rates across 21 major diseases. It reports specifics on 14 of them, combining the balance into an “Other” category. The detailed diseases are: Allergy, Autoimmune, Cardiovascular, Endocrine, Gastroenterology (non-IBD), Hematology, Infectious disease, Metabolic, Neurology, Oncology, Ophthalmology, Psychiatry, Respiratory, and Urology.

Comparing the success rates in the current report to the previous one, Bio found 12 categories had a lower likelihood of progressing from Phase 1 to approval. The largest decline was in urology. In the 2016 report, therapeutics in this category averaged 11.4% success. In the recent report, the average fell to 3.6%.

Hematology has the highest likelihood of approval at 23.9%, though it too saw a decline from 26.1%.

Drugs to treat rare diseases fared better than other therapies. The report said these drugs had a 17% likelihood of success.

The decrease, explains a Bio.org discussion of the report, “Can be attributed to two main factors: A greater participation from smaller firms participating in drug candidate development and their willingness to disclose early failures.”

Said David Thomas, BIO VP, industry research, “That all ties into what we see, which is a lower success rate overall from our last paper in 2016.”

Drug development remains difficult with far less than 1 in 10 clinical drug programs ever reaching patients,” says the Bio.org account. “It usually takes 10 to 10.5 years to develop a vaccine, which makes the existing COVID-19 vaccines on the market all the more incredible.”

Success, adds Thomas, takes “many shots on goal.”

Photo by ThisisEngineering RAEng on Unsplash

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Jun 6, 2023

What’s the Difference Between the COVID Vaccines?

With the approval last month of the Moderna vaccine by the Food and Drug Administration, we now have two COVID-19 vaccines available. Two more – one from Johnson & Johnson the other from AstraZeneca – are on the way and could be approved as soon as February.

Healthcare workers, residents of nursing facilities and some first responders have already received the Pfizer vaccine, the first one approved by the FDA. Moderna has begun shipping its vaccine with the first of the 25 million initial doses administered last month.

People eager to be immunized have inundated doctors’ offices and clinics asking when the vaccine will be available. The best answer is soon.

Which one, though, will you receive? And does it make any difference?

The answer to the first question is whichever vaccine can be obtained the quickest or, in some cases, whichever your health plan recommends. It really doesn’t make any difference to you.

Both vaccines require two separate doses to reach maximum effectiveness 21 days apart for Pfizer and 28 days for the Moderna version. Both protect about equally well. The FDA data shows Pfizer is 95% effective after both doses. Moderna is 94.1%.

Unlike most other vaccines, these two vaccines use pieces of protein from the SARS-CoV-2 virus to prompt the body to create antibodies. Conventional vaccines, like the annual flu shot, are manufactured from viruses typically grown in chicken eggs. These chicken grown viruses are then killed or weakened to become vaccines.

The COVID vaccines employ messenger RNA (mRNA), a newer technology. These vaccines “teach” the body to replicate the little bit of the CoV-2 protein, which, in turn, creates an immune response causing the body to make the antibodies that provide the protection against the virus.

The most significant difference between the Moderna and the Pfizer vaccines is how they must be stored. Both can survive for a few days in standard refrigeration. For longer periods, the less stable Pfizer vaccine must be kept in ultra-low temperatures below -94 F. That makes shipping and storing Pfizer’s vaccine somewhat more complicated, especially outside urban areas where the low temperature refrigeration is not easily available.

“At the end of the day, these two vaccines are pretty similar,” Dr. Thomas Russo, professor and chief of infectious disease at the State University of New York, tells Health. “Grab it while you can.”

Photo by Hakan Nural

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