Drugmakers are racing to scoop up patient health records and strike deals with technology companies as big data analytics start to unlock a trove of information about how medicines perform in the real world.
Studying such real-world evidence offers manufacturers a powerful tool to prove the value of their drugs – something Roche aims to leverage, for example, with last month’s $2 billion purchase of Flatiron Health. Real-world evidence involves collecting data outside traditional randomized clinical trials, the current gold standard for judging medicines, and interest in the field is ballooning.
Half of the world’s 1,800 clinical studies involving real-world or real-life data since 2006 have been started in the last three years, with a record 300 last year, according to a Reuters analysis of the U.S. National Institutes of Health’s clinicaltrials.gov website.
Hot areas for such studies include cancer, heart disease, and respiratory disorders.
The ability to capture the experience of real-world patients, who represent a wider sample of society than the relatively narrow selection enrolled into traditional trials, is increasingly used as medicine becomes more personalized.
However, it also opens a new front in the debate about corporate access to personal data at a time when tech giants Apple, Amazon and Google’s parent Alphabet are seeking to carve out a healthcare niche.
Some campaigners and academics worry such data will be used primarily as a commercial tool by drugmakers and may intrude upon patients’ privacy.
Drugmakers Into The Picture
Learning from the experience of millions of patients provides granularity and is especially important in a disease like cancer, where doctors want to know if there is a greater benefit from using a certain drug in patients with highly specific tumor characteristics.
In the case of the Flatiron deal, Roche is acquiring a firm working with 265 U.S. community cancer clinics and six major academic research centers, making it a leading curator of oncology evidence. Roche, which already owns 12.6 percent of Flatiron, will pay $1.9 billion for the rest.
But interest in such real-world data goes far beyond cancer.
All the world’s major drug companies now have departments focused on the use of real-world data across multiple diseases and several have completed scientific studies using the information to delve into key areas addressed by their drugs.
They include diabetes studies by AstraZeneca and Sanofi, joint research by Pfizer and Bristol-Myers Squibb into stroke prevention, and a Takeda Pharmaceutical project in bowel disease.
U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb believes the more widespread use of real-world evidence (RWE) could cut drug development costs and help doctors make better medical choices. The European Medicines Agency, too, is studying ways to use RWE in its decision making.
Whose Data Is It Anyway?
But the growth of real-world evidence also raises questions about data access and patient privacy, as Britain’s National Health Service (NHS) has found to its cost.
An ambitious scheme to pool anonymized NHS patient data for both academic and commercial use had to be scrapped in 2016 after protests from both patients and doctors.
And last year a British hospital trust was rapped by the Information Commissioner’s Office for misusing data after it passed on personal information of around 1.6 million patients to artificial-intelligence firm Google DeepMind.
Some academics also worry RWE studies could be susceptible to “data dredging”, where multiple analyses are conducted until one gives the hoped-for result.
AstraZeneca’s head of innovative medicines Mene Pangalos, whose company has struck several deals with tech start-ups and patient groups to gather real-world data, acknowledges ensuring privacy and scientific rigor is a challenge.