Team:Uppsala/PolicyPractices MicrobialDesigns

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document.getElementById("tab3").innerHTML = '<h2>Clinical Trials & Regulations</h2><p>Before a medical product can be launched on the market, it has to undergo several tests and get approval from various national and international boards. With this in mind, we tried to incorporate these regulations in our business idea by consulting the Swedish filliate of the pharmaceutical company Roche, which deals almost exclusively with getting their medical products approved for usage in Sweden. The following text is the information, given by them, on how to get a product approved.</p><h2>Studies to be conducted</h2><p>The first step of getting a medical product approved is to thoroughly study its effects, both positive and negative.  In the following list, we show the different studies that need to be carried out , listed in a chronological order.<br><br>Preclinical Studies: Made before the clinical studies and contains mostly animal testing, performed  on as wide a range of animals as possible. Preclinical studies are made to make sure it is worth going forwards with  clinical studies.<br><br>Clinical Trials:  The expenditure of the clinical studies as well as the agencies that examine our product, are paid solely by the company itself. The success rates for clinical studies are extremely low. If the study is performed in Sweden, all phases and experiments need to be approved by a number of agencies (ethical board, pharmaceutical board,  etc).<br><br>Phase 1: Performed on healthy people to calculate possible dosage and to see different effects. A small test group with about 10-20 people (the number of people used in this phase depends on the type of disease studied). Phase 1 usually gives swift results.<br><br>Phase 2:  Performed on sick patients to see if there is  actually any real positive effect. This involves around one hundred patients, and takes about two years.<br><br>Phase 3: A study on the medicine’s effect compared to  a control-group, which can be another medicine or a “Placebo pill”. Usually a double-blind study (Neither the doctor nor the patient knows who receives the actual medicine and who got the control).  This involves around one thousand patients  over a  3 year monitoring period.  It is the most expensive phase during the clinical trials. Companies need approval from government agencies to be allowed to continue into Phase 3 studies. Only a handful of medicines pass the Phase 3.<br><br>(Phase 4: Carried out  at hospitals after the medicine has been approved in order to assure  that nothing unexpected occurs. This involves around  two thousand patients)<br><br>The costs for these studies amount to  incredible sums, especially Phase 3. Since they are also highly time-consuming on top of their vast price tag, our small company would not be able to get the product past these clinical trials. Not being able to get past the trials means we would never be able to sell our product, which means we would need to find another way of getting our product onto the market. Therefore, we will have to get a company that can  afford the trials to do them for us, probably by selling the idea to them in one of the earlier stages.</p><h2>Getting approved</h2><p>All the data from these trials are  included in a “product resume” (spc-text) which is sent to a larger agency for approval, either the  EMA in Europe or the  FDA in USA. Approval from a region’s agency is necessary in order to get permission to sell the product in that particular region. The  EMA take about a year to examine all the data. How to produce the product needs to be a part of the resume. Another text is also sent along with the resume for patients to be able to read up on the medicine.<br>During EMA’s examination there is usually a lot of communication between the agency and the company to make sure the resume looks the way they want it to. While some countries approve studies carried out in other regions (Sweden included), other countries approve only the  studies performed in said country. The FDA sometimes approve medicines they consider promising and thus let them pass certain phases quicker. Compared to the EMA, the FDA have a greater history of approving biological medicines.<br>If the same medicine has the potential to be used in treating other  diseases, the studies have to be redone from phase 2. The EMA and läkemedelsverket (Swedish medical agency), both look at “Side effect vs gain” and how sick patients get from said disease as factors when they make their decisions.<br><br>Getting anything associated with genetic manipulation approved in Europe is extremely difficult. Since the FDA generally approve biological medicines, USA would probably be a better first market for our medicine as it is far more likely to get approved there.</p><h2>Regulations specific to Sweden</h2><p>After being approved by the EMA, the medicines should also be approved by the Swedish agencies in order to enable sale and usage. This process is however both complicated and expensive, and the steps taken depend on the market of the medicine, which could be pharmacies or hospitals.<br><br>Medicines sold at pharmacies needs to be approved by the TLV (Swedish agency for teeth and medicine) and the first thing they will decide is, whether the  medicine will be paid for by the government or the individual. If the government is being benefitted by the person, then it will bear all the expense for the treatment and the medication. However, if the person cannot give back to the society, he/she would have to bear their own expense for the medication. This means that if the target group for the medicine is young people, who in their future will be able to pay tax, the medicine will be categorised as free.<br><br>Medicines distributed at hospitals are also examined by the TLV but the final decision taken for the approval is later made at other instances. The TLV takes 60 days to examine a medicine during which they first examine a medicine’s  cost versus efficiency. The pharmaceutical company  have to tell them at what cost they are  planning to sell the medicine. If they want to change the cost, they will have to send in another application for approval. Companies usually have to market to hospitals and doctors to increase the chances of getting it approved and used in Sweden.<br><br>Because of its many agencies and rules Sweden has a really complicated market to get into. It also means that other parts of the world would be better places for us to launch our product especially since in Sweden, even after getting your medicine through trials and getting all the approvals required, you still might not be allowed to sell it because of other swedish agencies.</p><h2>Summary</h2><p>The costs involved in conducting the preclinical and clinical studies are large. They take a long, long time to pass. Therefore, our company’s only option would be to sell the idea early. Even if we have passed the trials in Europe, Sweden in particular would be difficult, to get an approval because of their regulations and systems, as well as getting into their market. Biological medicines usually have tougher rules, but FDA have proved more likely to approve their studies. Therefore the United States would provide a more attractive and potentially better market for our product. The fact still remains though that our company, as well as all other smaller companies, will have to in someway sell the idea in an earlier stage because of long and expensive clinical trials.</p>';
document.getElementById("tab3").innerHTML = '<h2>Clinical Trials & Regulations</h2><p>Before a medical product can be launched on the market, it has to undergo several tests and get approval from various national and international boards. With this in mind, we tried to incorporate these regulations in our business idea by consulting the Swedish filliate of the pharmaceutical company Roche, which deals almost exclusively with getting their medical products approved for usage in Sweden. The following text is the information, given by them, on how to get a product approved.</p><h2>Studies to be conducted</h2><p>The first step of getting a medical product approved is to thoroughly study its effects, both positive and negative.  In the following list, we show the different studies that need to be carried out , listed in a chronological order.<br><br>Preclinical Studies: Made before the clinical studies and contains mostly animal testing, performed  on as wide a range of animals as possible. Preclinical studies are made to make sure it is worth going forwards with  clinical studies.<br><br>Clinical Trials:  The expenditure of the clinical studies as well as the agencies that examine our product, are paid solely by the company itself. The success rates for clinical studies are extremely low. If the study is performed in Sweden, all phases and experiments need to be approved by a number of agencies (ethical board, pharmaceutical board,  etc).<br><br>Phase 1: Performed on healthy people to calculate possible dosage and to see different effects. A small test group with about 10-20 people (the number of people used in this phase depends on the type of disease studied). Phase 1 usually gives swift results.<br><br>Phase 2:  Performed on sick patients to see if there is  actually any real positive effect. This involves around one hundred patients, and takes about two years.<br><br>Phase 3: A study on the medicine’s effect compared to  a control-group, which can be another medicine or a “Placebo pill”. Usually a double-blind study (Neither the doctor nor the patient knows who receives the actual medicine and who got the control).  This involves around one thousand patients  over a  3 year monitoring period.  It is the most expensive phase during the clinical trials. Companies need approval from government agencies to be allowed to continue into Phase 3 studies. Only a handful of medicines pass the Phase 3.<br><br>(Phase 4: Carried out  at hospitals after the medicine has been approved in order to assure  that nothing unexpected occurs. This involves around  two thousand patients)<br><br>The costs for these studies amount to  incredible sums, especially Phase 3. Since they are also highly time-consuming on top of their vast price tag, our small company would not be able to get the product past these clinical trials. Not being able to get past the trials means we would never be able to sell our product, which means we would need to find another way of getting our product onto the market. Therefore, we will have to get a company that can  afford the trials to do them for us, probably by selling the idea to them in one of the earlier stages.</p><h2>Getting approved</h2><p>All the data from these trials are  included in a “product resume” (spc-text) which is sent to a larger agency for approval, either the  EMA in Europe or the  FDA in USA. Approval from a region’s agency is necessary in order to get permission to sell the product in that particular region. The  EMA take about a year to examine all the data. How to produce the product needs to be a part of the resume. Another text is also sent along with the resume for patients to be able to read up on the medicine.<br>During EMA’s examination there is usually a lot of communication between the agency and the company to make sure the resume looks the way they want it to. While some countries approve studies carried out in other regions (Sweden included), other countries approve only the  studies performed in said country. The FDA sometimes approve medicines they consider promising and thus let them pass certain phases quicker. Compared to the EMA, the FDA have a greater history of approving biological medicines.<br>If the same medicine has the potential to be used in treating other  diseases, the studies have to be redone from phase 2. The EMA and läkemedelsverket (Swedish medical agency), both look at “Side effect vs gain” and how sick patients get from said disease as factors when they make their decisions.<br><br>Getting anything associated with genetic manipulation approved in Europe is extremely difficult. Since the FDA generally approve biological medicines, USA would probably be a better first market for our medicine as it is far more likely to get approved there.</p><h2>Regulations specific to Sweden</h2><p>After being approved by the EMA, the medicines should also be approved by the Swedish agencies in order to enable sale and usage. This process is however both complicated and expensive, and the steps taken depend on the market of the medicine, which could be pharmacies or hospitals.<br><br>Medicines sold at pharmacies needs to be approved by the TLV (Swedish agency for teeth and medicine) and the first thing they will decide is, whether the  medicine will be paid for by the government or the individual. If the government is being benefitted by the person, then it will bear all the expense for the treatment and the medication. However, if the person cannot give back to the society, he/she would have to bear their own expense for the medication. This means that if the target group for the medicine is young people, who in their future will be able to pay tax, the medicine will be categorised as free.<br><br>Medicines distributed at hospitals are also examined by the TLV but the final decision taken for the approval is later made at other instances. The TLV takes 60 days to examine a medicine during which they first examine a medicine’s  cost versus efficiency. The pharmaceutical company  have to tell them at what cost they are  planning to sell the medicine. If they want to change the cost, they will have to send in another application for approval. Companies usually have to market to hospitals and doctors to increase the chances of getting it approved and used in Sweden.<br><br>Because of its many agencies and rules Sweden has a really complicated market to get into. It also means that other parts of the world would be better places for us to launch our product especially since in Sweden, even after getting your medicine through trials and getting all the approvals required, you still might not be allowed to sell it because of other swedish agencies.</p><h2>Summary</h2><p>The costs involved in conducting the preclinical and clinical studies are large. They take a long, long time to pass. Therefore, our company’s only option would be to sell the idea early. Even if we have passed the trials in Europe, Sweden in particular would be difficult, to get an approval because of their regulations and systems, as well as getting into their market. Biological medicines usually have tougher rules, but FDA have proved more likely to approve their studies. Therefore the United States would provide a more attractive and potentially better market for our product. The fact still remains though that our company, as well as all other smaller companies, will have to in someway sell the idea in an earlier stage because of long and expensive clinical trials.</p>';
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document.getElementById("tab4").innerHTML = '<h2>Product properties</h2><p>The unique characteristics of our probiotic compared to generic drugs is that our product eliminates the pathogen without using antibiotics. This is a major asset for the future marketing of our product since antibiotic resistance is a well known and severe problem, making treatment of diseases more problematic.<br><br>The product will be easy to distribute as it will be produced as a pill, making it compatible with established drugs in respect to shipping. Both probiotics and antibiotics derives from cultivations of microorganisms grown in large batches. However, in comparison to probiotic drugs, antibiotics need to be extracted and purified from such cultivations. Thus the production of probiotic will be easier and also hopefully cheaper in comparison to antibiotic production.</p><h2>Target customers and positioning strategy</h2><p>Initially, to establish our product, we intended to target the Swedish market simply because of the convenience of location. However, according to our laws and regulation research, it’s difficult to get approval from appropriate authorities for such a product. It was further concluded that a better choice of location for establishment is the United States of America, where it’s easier to get companies authorized.<br><br>Target customers are people infected by the pathogen (Yersinia enterocolitica). To reach our customers we would approach hospitals and pharmaceutical companies and promote our product. By highlighting the threat of antibiotic resistance we believe that our product will be sought. Thus we will be able to establish a market which will be of major importance for the future success of the product.<br><br>The widespread of Y.enterocolitica is relatively low and seem to be most frequent in northern Europe and as an example, the disease affects about 500 - 800 people per year in Sweden[1, 2]. Further, most infections are uncomplicated with most cases resolving themselves without further need of treatment. Hence it’s likely that the profit will be low if selling our product in the northern Europe. However we believe that our product will function as a stepping stone in the future development of pathogen killing probiotics, which hopefully can reduce the usage of antibiotics. Hence we believe that the logical regions, for marketing our product, are those which have problems with antibiotic resistance. Regions such as the United States, the western and southern parts of Europe have been identified as having high occurrence of antibiotic resistance. Thus these regions will be our main target for marketing our product [4].</p><h2>Size of the total market</h2><p>As described previously, the market is not particularly large as the infection rate is low and only those with a compromised immune system, such as elderly people or infants, will be needing treatment. Thus making it difficult to advance our product on the relatively small market.<br><br>If antibiotic resistance emerges to a level where many bacteria will be resistant, people will be forced to step out of their comfort zones and hopefully embrace this new technology. If we can evolve our technology into targeting pathogens that poses a greater threat than Y.enterocolitica we believe the market will expand at a fast rate.</p><h2>Promotions strategy (Commercial)</h2><p>There are many different ways when it comes to advertising a new product. When attracting customers you want to make sure to capture their attention in a memorable way. Another important aspect is the ability to reach as many people as possible. Hence we decided to make an animated infomercial. The goal of the infomercial was to show a schematic description of our modified probiotic and how it attacks the pathogen in the intestinal region. We determined that this would be a convenient and easy way to both describe and promote our product.<br><br>A lot of focus would be aimed towards providing the commercial to the hospitals and pharmaceutical companies. It is also highly important to combine the commercial with lectures to be able to thoroughly educate about our product and its focus on preventing antibiotic resistance.</p><h2>Summary</h2><p>As mentioned earlier, the market for treating Y.enterocolitica does not look promising, due to its low pathogenicity. However, if we manage to develop the idea of targeting other pathogens, we can be sure it will expand into a larger and more advantageous market. If we can promote the probiotica properly, it stands a fair chance of competing against antibiotics and therefore preventing the increase of antibiotic resistance. In the long run, this will hopefully decrease the threat against future medical treatments, saving millions of lives.</p>';
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