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The pharmaceutical industry's concerted efforts to fight COVID-19 might represent "a remarkable, perhaps once-in-a-generation opportunity to reset our reputation in the broader public mind," claims Novartis AG CEO Vas Narasimhan.

Speaking after the Swiss major unveiled a strong set of financials for the 2020 first quarter on 28 April, Narasimhan said, "We’re in a moment in time where our industry, combined with the work of academia and the broader ecosystem, has stepped up to make unprecedented collaborations." He added that over 170 drug candidates are "somewhere in the clinic or in preclinical testing," as well as over 90 potential vaccines, and more than 500 clinical trials are now running.

These initiatives have involved "massive efforts to do this on a non-profit or donation basis" and the pharmaceutical industry has "really led the charge in trying to overcome this pandemic," Narasimhan said. "I think what that’s leading to is, as you see already in survey data, a shift in the perception of the value of this sector."

He added, "I hope we can seize this moment to remind the world that this industry is why, or part of the reason at least, we’ve seen such remarkable gains in life expectancy over the last 100 years. It’s why we were able to withstand pandemics of the past and we will be ultimately able to withstand this pandemic, so I think it’s a remarkable opportunity to reset our reputation as an industry."

The CEO told reporters about "historic levels of collaboration within the biopharmaceutical industry and an unprecedented willingness to share compound libraries and research and manufacturing capacity." Narasimhan co-chairs a consortium of 15 companies set up with the Gates Foundation a month ago "to accelerate the next generation of treatments" and the firm is involved in collaborations across governments and academia in the US and Europe.

He added that Novartis has contributed upwards of $40m to over 60 projects to support local communities impacted by the crisis, including donations to strengthen medical infrastructure, and provide onsite support in Italy, Croatia, Brazil, and across Africa. It has also committed to donate over 130 million doses of the malaria drug hydroxychloroquine for COVID-19, with 50 million having already been shipped to 25 countries.

Novartis is running its own trials on hydroxychloroquine. Despite initial enthusiastic if ill-informed support from President Trump, aspirations about the potential of the drug and chloroquine to become a widespread treatment for COVID-19 are in decline with the US Food and Drug Administration recommending only limited use of the products. (Also see "US FDA Safety Alert For Hydroxychloroquine Is Latest Turn In Drug's Strange Journey" - Pink Sheet, 26 Apr, 2020.)

Narasimhan said that donations of hydroxychloroquine were given if governments had "appropriate hospital-based protocols or expanded user managed access programs in place to give them access to medicine that potentially could be helpful." He added that Novartis had to run its own trial "to generate gold standard data to determine the benefits or lack of benefits of hydroxychloroquine." (Also see "Novartis CEO Backs Malaria Drug Against COVID-19" - Scrip, 30 Mar, 2020.)

The company is also running Phase III trials to evaluate its JAK 1/2 inhibitor Jakavi (ruxolitinib) and the immunomodulator Ilaris (canakinumab) to treat the cytokine storm that can lead to life-threatening respiratory complications in patients with COVID-19. Narasimhan said that "we have to be humble with respect to any time we try to repurpose drugs in this kind of setting and we’ve seen with the early interleukin-6 data this will be a challenge," referring to the recent setback to Sanofi and Regeneron Pharmaceuticals Inc.'s hopes for positioning the rheumatoid arthritis Kevzara (sarilumab) for COVID-19.  (Also see "Sanofi/Regeneron Refocus Kevzara COVID-19 Trial On Critical Patients, Showing Value Of A Proper Trial" - Scrip, 27 Apr, 2020.)

Nonetheless, he said "it’s critical that we focus now on generating double-blind randomized, controlled, adequately-powered studies to really figure out which of these interventions could help patients." Narasimhan added that the company is supporting 32 investigator-initiated trial proposals involving other drugs in its portfolio such as the immunology blockbuster Cosentyx (secukinumab), cancer therapy Gleevec (imatinib), blood pressure lowerer Diovan (valsartan) and Xolair (omalizumab), marketed for severe allergic asthma and chronic spontaneous urticaria.

Narasimhan concluded by saying that from an internal standpoint, the Novartis Institutes for BioMedical Research (NIBR) has launched its own drug discovery efforts to try to find direct antivirals in collaboration with a number of groups, including one at the University of California, Berkeley.

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