- Associated Press - Monday, April 25, 2011

WASHINGTON (AP) - Every other week, 7-year-old twins Addison and Cassidy Hempel have an experimental medicine injected into their spines in hopes of battling a rare, fatal disease.

And it’s their mom who made that possible.

From her home in Reno, Nev., Chris Hempel persuaded scientists to share their research and managed to get the government to sign off on her daughters’ unusual experiment. Hempel says getting help to fight a rare disease shouldn’t be so hard.

But it’s a huge challenge to generate drug company interest in the expensive testing of medicines for diseases so rare _ like her girls’ Niemann-Pick Type C _ that the market is only a few hundred or few thousand people a year.

There are treatments for just 200 of the roughly 7,000 rare diseases, illnesses that affect fewer than 200,000 people, often far, far fewer. Yet add those diseases together, and more than 20 million Americans have one.

Now a movement is beginning to spur more rare-disease treatments: The National Institutes of Health this fall will open a center to speed genetic discoveries into usable therapies, doing some of the riskiest early-stage research in hopes companies then will step in.

A new International Rare Diseases Research Consortium is pushing for at least 200 more treatments by 2020, in part by pooling the work of far-flung scientists and families.

Rather than starting from scratch, the Food and Drug Administration is pointing the way for manufacturers to “repurpose” old drugs for new use against rare diseases, publishing a list of those deemed particularly promising.

And bipartisan legislation recently introduced in the Senate, called the Creating Hope Act, would offer drug makers another financial incentive _ a voucher promising fast FDA evaluation of their next blockbuster drug in return for developing a therapy for a rare or neglected disease that disproportionately affects children. It’s unclear what the prospects for passage are.

“We have to give drug companies a reason to go into this market,” says Nancy Goodman of Kids v Cancer, a group pushing the legislation. Her son Jacob died at age 10 from a type of brain cancer that has no good treatment.

“My kids may not be curable, but they are treatable,” adds Hempel, the Nevada mom. “Who’s going to take this over?”

Pharmaceutical giants are starting to show some new interest in rare diseases, traditionally a niche market for small biotech companies. The practical reason: Blockbusters are drying up, says Dr. Ed Mascioli of Pfizer Inc., the world’s largest drug company.

“The industry as a whole has a pipeline problem. It’s increasingly difficult to develop drugs for common diseases,” says Mascioli. He heads a separate research unit that Pfizer opened last year to search for medications for certain distinctively gene-based rare diseases, such as muscular dystrophy and hereditary emphysema.

Some other companies, including Novartis AG and GlaxoSmithKline PLC, also have begun rare-disease programs.

But NIH Director Dr. Francis Collins says all the activity also reflects a larger promise. “Getting a home run with a rare disease sometimes points you in a direction that will be beneficial for common diseases,” he told The Associated Press.

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