Glaucoma 360: Promising data as the industry considers value

Glaucoma 360: Promising data as the industry considers value

“Innovation remains the largest driver of healthcare cost increase,” said David Parke II, MD, American Academy of Ophthalmology CEO, during the Glaucoma Research Foundation’s (GRF) Glaucoma 360 New Horizons Forum keynote. That’s a dark introduction for a one-day forum designed to highlight new and emerging drugs, diagnostics and devices.

Yet the data back Dr. Parke’s statement. The Congressional Budget Office estimates new technology—use of any new procedure, drug or device—accounts for somewhere between 38% and 65% of new healthcare spending.1

What does this mean for startups and pharmaceutical companies working on new drugs, devices and diagnostics? For the experts speaking at the Forum, it means innovate with an eye toward reducing cost to patients and to society. Innovate with consideration toward value, improving patient outcomes and delivering the ultimate safety and effectiveness.

Short learning curves — for the physician and the patient — seemed to be an ongoing theme throughout the day as companies presented data on new approaches to lowering intraocular pressure (IOP) and stimulating the optic nerve.

Glaucoma Startups Get Smart
Qlaris Bio, winner of the Forum’s “Perfect Pitch Presentation,” discussed its plans to stand out in a competitive space with multiple effective mechanisms of action. Rather than focus solely on IOP, Qlaris Bio’s QLS-101 targets elevated episcleral venous pressure (EVP) said CEO Thurein Htoo, MS, MBA. Will this approach help Qlaris Bio claim a spot in the glaucoma global drug market, expected to reach $20.5 billion globally by 2022? Time will tell.

Using rho-kinase inhibition, Qlaris Bio’s QLS-101 targets EVP in people with normal-tension glaucoma. The novel compound is also targeting Sturge-Weber Syndrome said Mr. Htoo. . (Aerie Pharmaceuticals’ IOP-lowering drugs work on the same MOA as Qlaris Bio’s do, although they’re indicated for open-angle glaucoma. Formularies seem to like the novel approach so far…)

Qlaris Bio is a spinout company of Qrativ, a biotechnology incubator formed as a joint venture between Mayo Clinic and nference, a pharmaceutical-focused artificial intelligence company.

Other companies presenting during the “Show Me the Money” panel included Diopter Corp., developer of a contact lens drug delivery device (self-funded to date by CEO Chris Adams) and SmartLens, an IOP-measuring contact lens. CEO Savas Komban explained that users simply take a smart phone selfie of their eye while wearing the lens. A “smart” imaging application does the rest.

New Horizons in Devices & Diagnostics
While the presenters during the medical device panel pitched new approaches to, and alternatives to, minimally invasive glaucoma surgery (MIGS), the panel discussion that followed centered on how to keep patients out of the doctor’s office. Angelo Rago, global head of ophthalmologic diagnostics for Carl Zeiss Meditec, said he’s optimistic about technology that compliments surgical procedures, “bringing technology to nontraditional settings that are connected back to the doctor, so there is a more holistic view of how that patient is progressing.”

Discussing the future of injectable long-term drug delivery, Jane Rady, MBA, senior vice president, corporate strategy and business development for Glaukos, said the success of these types of devices will depend on safety duration and clinical burden. If those two variables are positive, it’s possible the injectable products will replace topical applications.

Panelists in multiple forums discussed artificial intelligence (AI). The same questions remain: how (and who) would manage volumes of IOP data? Monika Fischer, senior market manager perimetry for Haag-Streit Diagnostics, noted that much of this data are nonstructured, which means a huge effort on the part of data scientists and others to translate that data into usable insights.

While AI may help physicians make more accurate treatment decisions, does it meet the objective of lowering healthcare costs? As the industry moves toward value-based pricing—which, Dr. Parke said, has yet to be well defined— more data have its place, provided it doesn’t increase patient or physician burden.

“We are all going to benefit from more granular data on processes and outcomes,” Dr. Parke said, “so we can get to a sustainable equilibrium that rewards innovation and ultimately moves our profession forward.”

Norbeck TB. Drivers of health care costs. A Physicians Foundation white paper – second of a three-part series. Mo Med. 2013;110(2):113–118.