Orange County again proved it’s the center for ophthalmology. Heavy hitters like Aerie Pharmaceuticals Inc., Alcon, Johnson & Johnson Vision, Carl Zeiss Meditec Inc. and Allergan PLC shared their perspectives at OCTANe’s annual Ophthalmology Technology Summit on June 29 at Fashion Island Hotel.
Robert Dempsey, head of global ophthalmics franchise at Shire, traveled from Boston as a first-time participant. He said he was surprised by how good the event was, adding that he sees Boston and Orange County as the two U.S. ophthalmic meccas, the former for pharmaceutical innovation, the latter for medical devices.
The event featured an interview with Allergan Chief Executive Brent Saunders, Jim Mazzo, global president of ophthalmic devices at Carl Zeiss Meditec, was moderator.
OCTANe Chief Executive Bill Carpou said he plans to keep the summit intimate and selective, and never “too big.” He plans to grow doctor participants and launch an aesthetics summit next year.
Allergan Sees …
Saunders acknowledged that Allergan is likely to lose exclusivity “on an important drug, Restasis,” but he pointed out that it is “not the first pharma company nor the last pharma company that will lose intellectual property [of its drugs].”
Allergan fell from investor favor after it announced a patent deal with the Saint Regis Mohawk Tribe in New York in September. The transaction, intended to leverage the Native American tribe’s sovereign immunity protection to prevent Allergan from fighting a dry-eye eye drug Restasis patent dispute with generic drugmakers in two courts, backfired.
A federal district court ruling last year invalidated exclusivity protections for the drug.
Last month, activist shareholders Appaloosa LP in Miami and New York-based Senator Investment Group LP issued a public letter calling for Allergan to implement corporate changes, including splitting up the office of chief executive and chairman or breaking up the company altogether.
The Business Journal reported that the development was premature.
Sanford C. Bernstein & Co. LLC Senior Analyst Aaron (Ronny) Gal wrote that “Allergan is looking at two critical read outs in the next nine months, (aCGRP and Rapastinel)”—late-stage clinical drugs designed to treat migraine and depression, respectively.
Allergan didn’t act on the radical changes outlined by activist investors, but the news bumped up the company’s stock.
Its shares recently traded at $175 for a $58 billion market cap.
Saunders highlighted the market opportunities of treating depression and suicide, as well as gastrointestinal disorders. The company last year announced a collaborative deal with Assembly Biosciences Inc., that broadened its research and development pipeline through an option to buy four potential gastrointestinal treatments targeting ulcerative colitis, Crohn’s disease and irritable bowel syndrome, including conditions with diarrhea, constipation or a mix.
OC is home to Allergan’s U.S. specialized therapeutics unit which includes aesthetics and therapeutics Botox, dermal fillers, and eye care, which Saunders confirmed will remain here.
He said ophthalmology will change dramatically, with emphasis on personalized and genetic medicine. “The eye is the perfect laboratory for leading this revolution,” he said.
Digitalization
“He or she who owns the data, wins,” said Zeiss’ Mazzo, adding that the company is focused on using artificial intelligence and big data to assist with diagnosis.
“We are going to have more patients, and less ophthalmologists,” he said.
The Association of American Medical Colleges estimates that more than 6,000 ophthalmologists will be needed by 2020 to meet demand. He said the company’s screening and imaging devices are designed to help ophthalmologists make decisions early in the process.
Zeiss introduced Veracity in November. The cloud-based cataract surgery planning platform is designed to develop a cataract surgery plan in real time, integrating electronic medical records systems and diagnostic devices.
“Let’s say you get a diagnosis of red, yellow, green. Red, you send your patients to specialists, green, they go home. What ophthalmologists care about are those in the yellow [group],” said Mazzo of the future.
He said he does not discount the possibility of bringing the technology to the home so patients in the green won’t even need to come in.
Change in Care
Aerie Chief Operating Officer Tom Mitro said innovation lies in drug delivery, as compliance and adherence remain a challenge for eye drops.
The company bought PRINT, a drug-release technology, from Envisia Therapeutic Inc. in October. It said its initial focus will be using the technology to manufacture injectable implants, with drug candidates to treat conditions in the back of the eye, such as wet age-related macular degeneration and diabetic retinopathy.
Aerie launched FDA-approved glaucoma drug Rhopressa in April. It anticipates other glaucoma drug, Roclatan, will get FDA approval next year.
Jonathan Talamo, chief medical officer of J&J Vision, echoed Mitro’s sentiment, pointing out that the issue of drug delivery efficacy is not going away. “With patients getting older, it’s going to be very important in the coming years.”
Laurent Attias, Alcon senior vice president, said patient monitoring is another area to address. “Glaucoma patients visit their physicians on average 20-plus times. That’s not a very effective patient condition and information management,” he said.
Allergan Senior Vice President of Eye Care Jag Dosanjh echoed Saunders’ statement that the future lies in personalized, genetic medicine.
“To get something to the marketplace, you’ve got to shoot higher than you were used to shooting before,” he said, highlighting healthcare reforms that altered reimbursement and risk-sharing structure.
The industry, like all aspects of healthcare, must demonstrate compelling value of new products, pharmaceutical or devices, he added.
