Genetic Engineering & Biotechnology News

DEC 2017

Genetic Engineering & Biotechnology News (GEN) is the world's most widely read biotech publication. It provides the R&D community with critical information on the tools, technologies, and trends that drive the biotech industry.

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Genetic Engineering & Biotechnology News | | DECEMBER 2017 | 7 "I really enjoy the kinds of things he's putting out there," says Dr. Prasad, referring to Dr. Gellad's tweets. "He can engage in dialogue with people on either side of the issue, and do so in a very constructive dia- logue. He doesn't alienate people. He never uses an ad hominem attack." Although well-mannered on Twitter, Dr. Gellad has not been sheltered from attacks on his character. "When you talk a lot about pricing on Twitter, inevitably you're going to get into conversations with one side or the other that feels very strongly about these issues," Dr. Gel- lad says. He rattles off a few attacks thrown at him: He wants children to die. He doesn't care about developing cures for rare diseases. He thinks spending money on drugs for people who have genetic conditions is not worth it, that the money should be spent elsewhere. None of the various accusations are true, he says, "and that rhetoric doesn't help the conversation." When verbally lashed on Twitter, Dr. Gel- lad says he doesn't take it personally. He says it gives you a sense of how strongly people feel about certain issues. He recalls only one instance in which he decided to block someone on Twitter. He explains, "It wasn't productive conversation. It was just yelling falsehoods all the time." "Truth Seeker" Dr. Gellad explains that the whole point of health services research is to identify topics about the healthcare system that people might not know about and then use the research to make decisions about how the healthcare sys- tem should work. Several years ago, he did exactly that. Boldly, he asked, is it a conflict of interest for people running academic medical centers to also run pharmaceutical companies as directors on their boards? "It's an issue that hadn't been addressed in any research," he recalls. The point wasn't to say yes or no, he says, but to raise the question. He coauthored two studies on this topic, one in 2014 and the other in 2015. "Those two pieces were really interesting to write. They were really eye-opening." "We're still working on some of that work, but again, those kinds of papers do not get you funded. They do not get you elected to the Institute of Medicine. They do not get policy change necessarily. They get everyone mad at you," he says. The underlying goal of all of his research is to find ways to make prescription drug use more rational, he says. He explains that even if you can't get the price of drugs down, you can be rational in what you prescribe, when you prescribe, and to whom you prescribe. In the aforementioned NEJM perspective, Dr. Gellad brought an uncomfortable ques- tion to the forefront of people's mind in his discussion of FDA's Accelerated Approval of expensive prescription drugs for rare diseas- es. The reason this was of interest to Dr. Gel- lad was because by nature of accelerated ap- proval, drugs traveling through an expedited pathway often have less evidence (at the trial level) of clinical efficacy than do drugs ap- proved through the traditional pathway. Yet, drugs following an accelerated pathway are increasingly carrying high price tags. "The question is, at what level should ev- eryone else pay for that?" he asks rhetorical- ly. "Obviously, it's a different issue if this is you or your family member versus if you're a taxpayer or policy maker." Close colleague Everette James, J.D., Di- rector of the University of Pittsburgh's Health Policy Institute, has been working with Dr. Gellad for the past six years. He describes Dr. Gellad as a "truth seeker." He says there is a "small handful of clinicians" who have the passion to do the research Dr. Gellad does. Cutting through the Noise When asked what he hopes to accom- plish, Dr. Gellad pauses. "That's a hard one," he says thoughtfully. "It's a conversation I have in my head all the time because it's hard to figure out what the right impact is. It's a little bit unrealistic to say you're going to solve the problem, at least in pricing." He hopes, to "cut through the noise" and help the public understand the reality of the situation, rather than the talking points. That's what academics are supposed to do, he says— provide perspective and an unbiased opinion to the public. "I've been at the university a long time, and every so often there's someone that comes along and you know they're destined for great things," says Dr. Good. "The sky is the limit [for Dr. Gellad]. He really is very talented, and he's driven and interested in be- ing an important voice. … I could utilize cells from the same donor over a long time period? … immune cells could be modified non-virally in large scale ? … I beat my boss at tennis tonight, will he get mad at me? What if... 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