This week, Jason Colodne, Managing Partner at Colbeck, spoke with Adriann Sax, co-founder and CEO at Vetigenics, a prominent innovator in animal health that is one of the first companies to produce antibody-based immunotherapies for canines. She formerly served as CEO of Orsenix, a clinical stage biotech company focused on developing novel therapies to treat hematologic cancers.
With nearly three decades of pharmaceutical and biotech experience, Sax has overseen the global launch of leading oncology and immunotherapy drugs. She has held executive roles at Roche, BMS, Merck, King Pharmaceuticals, and Kadmon, and is continuously recognized for her commitment to the advancement and professional development of women within the pharmaceutical industry. Sax is a passionate advocate of the One Health movement, and believes it is our best hope for tackling animal and human disease challenges of the future.
Human and Animal Health are Converging
Colodne: Early on in your career, you started out with a background in animal science. How did you transition into pharmaceuticals?
Sax: I wanted to be a veterinarian since I was very young. I worked for a veterinarian starting at the age of twelve just cleaning out cages and doing all the grunt work. I really developed a passion for health, and animal health in particular, and so I went to undergrad for animal science with the hopes of going to vet school.
At the time, there were only 9 vet schools in the US and female vets from out of state were not a high priority, so it was difficult to get in. Instead, I pursued a job in veterinary pharmaceuticals and that's where I got a better understanding of the pharmaceutical industry and how drugs to treat animal diseases are developed. While in this job, I met a human pharmaceutical sales rep, and realized that there were tremendous opportunities on the human side of the business. As much as I enjoyed animal health, pharma was appealing because it seemed like I could really help people by treating disease.
I touched on most aspects of large pharma—sales, marketing, business development—before moving into startup biotech. I transitioned into biotech when the first antibodies to treat cancer hit the market and the science of antibody therapeutics was exciting to me. I also wanted to have more direct influence and hands-on experience with building companies and influencing the development path and commercialization of drugs. My primary expertise was in cancer, but I worked in other specialty therapeutic areas as well, predominantly with antibody therapeutics.
Over a year ago, I was recruited to transition Vetigenics from an academic startup to an independent animal health biotech. It was a wonderful full circle moment, because I could bring what I've learned in biotech to benefit pets suffering from cancer and other chronic diseases with very few treatment options.
Colodne: How has the distinction between human health and animal health changed over the course of your career?
Sax: Historically, most of the drugs that have been used to treat animals—with the exception of things like flea and tick treatments—were really repurposed drugs or generic drugs used in human medicine, and then used to treat those same diseases in animals. Now companies are much more focused on developing species-specific drugs. These drugs are clinically tested in the intended animal species with disease to ensure meaningful efficacy and safety of the drug for the animal patient. These drugs are specifically developed to address the individual needs of animals based on their underlying disease mechanisms versus trying to take human medicines and repurpose them.
Vetigenics actually started out as an initiative to develop fully canine antibody drugs for translational research using pet dogs with cancer as pre-clinical models of cancer. Humans and dogs have lived and evolved together over thousands of years with the same environmental exposures and genetic susceptibilities. So, it is not surprising that canine cancers occur spontaneously with similar presentation, molecular makeup, pathophysiology and natural progression of human cancers. By using pet dogs as parallel patient populations to accelerate human cancer drug development, we can reduce the high failure of drugs that may show efficacy when tested in a mouse but fail when tested in humans.
Vetigenics works very closely with the National Cancer Institute to ensure canine antibodies are available to advance human translational research. At the same time, we further develop these same antibodies as animal therapeutics to treat cancer and other chronic conditions. Thanks to the pandemic, the whole pet industry has seen a huge boost, so the timing is really optimal right now to introduce these types of therapies because the market is primed to consider them and to pay for them.
Is Pharma R&D in Decline?
Colodne: Since the 1990s, the return on investment in pharma R&D has steadily fallen, leading many to predict the industry’s “terminal decline.” Despite this, the past decade has seen a number of record-breaking years in terms of new drug approvals. Last year, the FDA approved 53 novel drugs. How are companies remaining productive?
Sax: I think that pharma is just as productive, but there is a change strategically. At one time there was a holistic focus on treating chronic diseases with millions of patients such as hypertension, diabetes and high cholesterol. These drugs enabled patients to live long, productive lives with chronic disease, but they were disease specific, not patient specific. There were a lot of “me too” drugs, or similar molecules offering incremental benefit compared to the innovator drug. Payers no longer reimburse patients for new drugs with minimal benefit when a cheaper generic alternative is available which can get the job done safely and effectively for MOST patients.
Now, pharma is really focused on meaningful innovation and patient-targeted therapies where new treatments cure disease, extend survival, substantially improve treatment outcomes, and reduce overall cost to the healthcare system. Although these innovations may treat smaller groups of patients, their impact is significant and pharmaceutical companies can recoup their investment in risk, time, and cost with higher prices. Payers have had the greatest effect on biopharma innovation. Despite the transformational role pharma and biotech have played on changing the course of lethal and rare disease, payers still make it exceedingly difficult for patients to receive these novel therapies and create obstacles for physicians to prescribe them. Payers have evolved to control drug pricing, making it much more difficult for pharmaceutical companies to bring to innovative products to market.
The decline in productivity is still high, but much of it occurs in early translation from animals to humans. There is a lot of work being done to validate the right target, to understand underlying disease mechanisms, and to select clinically relevant animal models of disease that can more accurately predict how different patients will respond to treatment. Identifying specific biomarkers of disease and response to treatment has also helped improve the productivity and cost of drug development, but for some disease areas the process is still very time consuming and costly.
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