The relative absence of blockbuster M&A within medtech in 2018, compared with recent years, does not mean that consolidation of the industry – and of providers and payers – will not continue apace in 2019 and beyond. In fact, it is written – if not in the stars then possibly in digital coding – that there will be fewer and bigger entities at the top end of the ecosystem of medtech stakeholders. And rising demand will be met more and more by digital tools and functionalities.

Glenmark’s nebulized, long-acting muscarinic antagonist for COPD has hit the Indian market. Delivered via a novel mesh nebulizer, it is seen as likely catering to a relatively small patient group.

AbbVie/Pharmacyclics executives Danelle James and Mohamed Zaki, in an interview at ASH, discussed Imbruvica's worth in chemo-free settings and noted additional value that could be created with shorter durations of treatment in combination regimens.

Sanofi and Gilead moved down in the rankings of Scrip's top 100 pharmaceutical companies, based on 2017 pharma sales, while Johnson & Johnson, GSK and AbbVie moved up. Shire joined the top 20 just as it is about to be consumed by Takeda.

Novo Nordisk' obesity pipeline consists of projects addressing both appetite reduction and energy expenditure, with GLP-1 semaglutide topping the list, its CSO says in an interview with Scrip.

Scrip's latest rankings of the top 100 revenue earners in the medical technology industry, published in Outlook 2019, show the groups leading the global market tightening their grip further in 2017. This was partly a function of providers choosing to partner more and more with fewer suppliers who can offer a wider provision of services. But it was steady as she goes for most of the multinational medtechs, with some major exceptions, and there will be more M&A reflected in next year's rankings, based on 2018 revenues.

It was inevitable that Brexit would be the key theme of an interview with Danish Medicines Agency head Thomas Senderovitz earlier this year. The senior European regulator oversees one of the agencies that has taken on new staff to help deal with the impact, in drug regulatory terms, of the vote by the UK in June 2016 to leave the European Union. Senderovitz also chairs the management group of the EU Heads of Medicines Agencies network.

The PD-L1 inhibitor's label excludes NSCLC patients with EGFR or ALK mutations, which could have been an advantage, but the indication largely reflects the registrational IMpower150 clinical trial's population.

Payers are increasingly likely to implement new strategies to manage price negotiations for immuno-oncology combinations, as competition  heats up among the drug class. Mechanisms allowing for the negotiation of different prices for combination therapies do not exist at present, but payers insist that new tools must emerge.

Emerging Company Profile: CoA Therapeutics plans to start a Phase I study of a CoA modulator in the rare, genetic disorder PKAN during the first quarter of 2020.

In "very top-line" Phase IIb data, the magnitude of the treatment effect for valbenazine in children with Tourette syndrome was weaker than expected, and its loss from active development means there will be only a handful of candidates under evaluation for the disorder.

Novartis executives highlighted their stars from its refined pipeline during the company’s first R&D day since Vas Narasimhan took the helm and after a cull that reduced the firm’s development portfolio by 20%.