Singapore a magnet for new drug trials
Big pharmaceutical firms drawn to high medical standards here

EFFORTS to draw drug companies here to conduct trials for new medicines are paying off with a record 286 trials started last year.

Since 2004, the Health Sciences Authority (HSA) has approved 200 or more new trials every year involving 2,000 to 3,000 people altogether.

One in three of last year's record haul of trials was for cancer treatment reflecting the focus of big pharmaceutical research in recent years.

Others included drugs for heart, eye, gut and brain problems.

Doctors initiate just a quarter of trials here, with drug companies behind the rest.

"The companies need the findings of the trials to be accepted by health authorities in the United States and in Europe, where patients' buying power makes the US$1 billion (S$ 1.4 billion) spent in developing a new drug worthwhile.

Professor Soo Khee Chee, head of the National Cancer Centre (NCC) says that drug companies are increasingly drawn to Singapore because of the high standards of medical practice, technological expertise, and government support, which mean that trials can be conducted with speed and efficiency.

Quoting an industry axiom, Prof Soo says that it costs a drug company US$1 million for each day's delay in reporting results and receiving approval from the regulators.

Singapore's growing reputation in the field helped convince Quintiles, a company dedicated to conducting clinical trials with 23,000 employees around the world, to open its new regional headquarters at the Science Park last month. It is double the size of its previous facility.

Dr Anand Tharmaratnam who heads clinical development for Quintiles in the Asia-Pacific region expects the company to double the 250 employees it has here within the next five to 10 years, to meet the growing demand for its services.

Dr Jerry Chng, Bayer Schering Pharma's medical director here, said the number of clinical trials his company does here has roughly doubled each year, from just two in 2006 to 14 this year. It has already seven lined up for next year.

The reason, he said, is that "Singapore offers excellent possibilities."

GlaxoSmithKline, which has been conducting trials here for more than a decade has committed to about 2 million worth of on-going trials here primarily in vaccines and cancer.

Every year thousands of patients take part in trials because it gives them new hope when all other options have failed, say doctors participating in such trials which most public hospitals do.

One such patient who signed up is a middle-aged man suffering from a form of blood cancer.

He could not tolerate Glivec, the primary drug for such illness and reacted badly to the second line drug as well, which he took for nine months.

But a new leukaemia drug was being tested and his doctor got him into the trial.

"He is now responding well to the new drug and feeling much more upbeat", said a cancer centre spokesman.

This same trial might also have saved the life of a trainee doctor from India. Suffering from a form of leukaemia, in 2005 he was given less than two years to live.

His doctor contacted Singapore General Hospital, where the trial was being conducted to ask if the patient could be included.

Today, the 29-year-old is living a normal life and preparing for his final medical exams.

Professor Soo said people who take part in trials almost always do better than those who do not participate.

There could be many reasons for this, including their psychological make-up, he said, since people willing to be part of a trial tend to be more "gung ho", with more fighting spirit.

The better outcome could also be be cause they are more closely monitored which is a requirement of trials.

Finally, the new treatment or drug could directly contribute to their survival.

Aside from giving them access to experimental drugs taking part in trials, gives patients treatment options they might not otherwise be able to afford as they do not need to pay for their medication.

Dr Ton Han Chong, head of medical oncology at NCC, said all liver cancer patients in trials are given a new drug called sorafenib - which is expensive and only marginally beneficial for most.

At $5,000 a month it gives most patients two to three months longer to live. But it is able to shrink the cancer tumour in a lucky 3 per cent of patients.

While the treatment's cost is seen as far outweighing its benefits, it is nevertheless the only new liver cancer drug that has been produced in the past three decades, said Dr Toh.

"So we do a lot of trials with sorafenib," he said.