Klaus Schiller was born in Vienna in 1927 to Walter, a gynaecologist, and Berta, the daughter of an industrialist. Following the Anschluss in 1938, his comfortable childhood was interrupted by enforced emigration and he was sent, with his sister, Verena, to England. Within a few days and with hardly a word of English, he found himself at boarding school in Bishop’s Stortford. He always denied that this uprooting was traumatic and agreed with his friend, the late Professor Peter Scheuer, that “the best thing that ever happened to us was to come to England.” Klaus’s parents and grandparents soon followed and he was sent to Clifton College. In 1945 he gained an Exhibition to read medicine at Queen’s College, Oxford a city that was important to him throughout his life. In 1948, he won a scholarship to the London Hospital, completing his clinical training in December 1951. He was appointed to two house officer posts at the London, and served two years national service, mostly as a medical specialist. After a clutch of junior positions elsewhere, he returned to the London as a registrar. He was appointed senior registrar at the Radcliffe Infirmary in 1962 and in 1966 received his doctorate. Eager to become a consultant, he spent a happy year at the Massachusetts General Hospital. Returning to Oxford, Dr Schiller worked with his mentor and lifelong friend Dr Sidney Truelove. They undertook an in-depth survey of haematemesis and melaena, and the risky abdominal surgical interventions that were undertaken as a result.
Decision Resources: 68% of gastroenterologists select Remicade for Crohn’s treatment
Physicians’ favorable opinion of Remicade’s efficacy for treating moderate to severe Crohn’s disease and the drug’s higher price compared with Crohn’s disease therapies for which generic versions are available, such as prednisone and azathioprine, contribute to Remicade’s status as the current sales leader in this market. Decision Resources’ analysis of the Crohn’s disease drug market reveals that surveyed physicians who regard Remicade as the most efficacious therapy were most satisfied with the drug’s efficacy in induction of remission and response and its impact on quality of life. However, they were least satisfied with Remicade’s effect on maintenance of remission, corticosteroid-free remission, and response, presumably because of patients’ tendency to lose response to the drug over time. In contrast to surveyed gastroenterologists, the majority (60 percent) of surveyed managed care organizations’ (MCOs) pharmacy directors selected Abbott/Eisai’s Humira (adalimumab) as the most efficacious therapy for Crohn’s disease. Surveyed payers who selected Humira as the most efficacious therapy were most satisfied with the drug’s induction and maintenance of remission and response. The findings also reveal that surveyed gastroenterologists who selected Humira as most efficacious were most satisfied with its ability to improve patients’ quality of life. “Although only 23 percent of surveyed gastroenterologists chose Humira as the most efficacious therapy for Crohn’s disease, these physicians expressed a high level of satisfaction with Humira’s impact on quality of life and its effect on maintenance of remission, which will likely contribute to Humira’s increased use in the maintenance setting,” said Decision Resources Analyst MaryEllen Klusacek, Ph.D. “Considering all assessed efficacy end points, surveyed gastroenterologists were least satisfied with Humira’s effect on mucosal healing and fistula closure.” The findings also reveal that the Crohn’s disease drug market will experience modest growth over the next decade, increasing from approximately $3.2 billion in 2009 to $4.2 billion in 2019 in the United States, France, Germany, Italy, Spain, the United Kingdom and Japan. This moderate growth rate will mask dramatic changes as market growth from newer and emerging biological agents outpaces the decline in sales of older, established agents, which will face increasing generics competition and declining use. Tumor necrosis factor-alpha (TNF-alpha) inhibitors, namely Remicade and Humira, dominated the market in 2009, capturing nearly 77 percent of major-market sales. Additionally, several therapies with novel mechanisms of action are expected to launch for Crohn’s disease beginning in 2013, including Millennium Pharmaceuticals’ vedolizumab, Centocor Ortho Biotech/Janssen-Cilag’s Stelara (ustekinumab) and GlaxoSmithKline/ChemoCentryx’s GSK-1605786 (formerly CCX-282B or Traficet-EN). However, none of these agents will rival the efficacy or market share of the TNF-alpha inhibitors. Source: Decision Resources, Inc.