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A new generation of therapeutic medicines provides much-needed respite for patients and overburdened health services alike by affording alternative methods at home.

The astounding speed with which highly effective Covid-19 vaccines were developed and put into action may have captured global headlines, but it is only one strand of the medical community’s response to the pandemic. As Professor Laurent Peyrin-Biroulet, Head of the Inflammatory Bowel Disease (IBD) group at the Gastroenterology Department of the University Hospital of Nancy, France, explains, the deadly virus has proven to be a lightning rod for innovation in the field of therapeutic medicine and health system approaches to care.

“The Covid-19 pandemic is one of the greatest challenges ever faced, and the scientific and healthcare community responded by innovating,” he says.

“While researchers were able to identify treatments, vaccines and testing directly for Covid-19, the healthcare community also had to innovate to keep healthcare systems functioning under significant strain.”

There is no shortage of statistics to make the case for the need to find ways to deliver care outside mainstream healthcare settings during the ongoing pandemic. As wave after wave of Covid-19 infections cause repeated surges in hospital admissions, vital operations as well as non-urgent medical appointments have been cancelled. Many serious health conditions have also gone undiagnosed as would-be patients have not only found it more difficult to access doctors’ surgeries but also had to endure ever longer wait times for hospital appointments, with sometimes devastating consequences. The UK Office for National Statistics found that an extra 26,000 people died at home across England and Wales between March and September

2020 compared to the past five years, with heart disease accounting for 18.8 per cent of all male deaths during that period.

"Wave after wave of Covid-19 infections caused surges in hospital admissions…appointments have been cancelled and patients have found it difficult to access doctors."

One important group of people at higher risk of Covid-19 infection are those with autoimmune conditions including rheumatoid arthritis or inflammatory bowel disease. Depending on the complexity of their condition some of these patients are reliant on receiving treatment via regular hospital-based intravenous infusion therapy, which during the pandemic put them at increased risk. In that period, new guidance was issued in the UK to ensure that patients receiving intravenous treatment were assessed for possible switching to the same therapy in subcutaneous form, meaning it could be provided outside of the hospital setting.

This switch from hospital-based intravenous infusion therapy to administration via subcutaneous injection is an example of how biobetters, a new generation of innovative therapeutic medicines, could become an important tool to help ensure that patients can gain access to the treatment they need in a timely fashion. Mimicking the characteristics and functions of existing biologic drugs, they are characterised by specific improvements that may give them an advantage over the original reference drug, whether through lower immunogenicity (immunogenicity is the ability of a foreign substance, for example a medicine or vaccination, to enter a person’s body and cause an immune response) or new delivery methods.

Mimicking the characteristics and functions of existing biologic drugs, they (biobetters) are characterised by specific improvements that may give them an advantage over the original reference drug.

The impact of delays to therapies for life-threatening and chronic conditions is not only potentially devastating for patients but may also inflate the cost of care. McKinsey & Company estimates that deferring treatment for diabetes would increase costs by three per cent every year, while delaying cancer treatment would add eight per cent annually.

A financial analysis looking at administration costs for subcutaneous versus infusion routes has shown the former to be 50 per cent lower, with most patients administering subcutaneous medicines themselves. Other indirect benefits to treatments delivered outside of the hospital setting included less pressure on infusion unit waiting times and a lower risk of Covid-19 infection, along with reduced costs to the patient themselves.

As such, biobetters have the potential to transform lives by offering more choice to help patients manage severe conditions such as rheumatoid arthritis or inflammatory bowel disease, Professor Peyrin-Biroulet explains.

“This innovation, while driven by pressures from the pandemic, could also have a longer-term benefit for patients in that they can receive their medicine with a reduced impact on their day-to-day life,” he says. “In addition, biobetters can provide more favourable patient satisfaction, as going to the hospital for infusions is part of the burden with a chronic, lifelong disease; hence treatment at home is associated with better quality of life and can further improve adherence to treatment.”

This article was originally published in FT.com on December 14, 2021.

Disclaimer : This content was paid for by Celltrion Healthcare and produced in partnership with the Financial Times Commercial department.