What if we nationalized the drug industry? Just turned all of us into national research institutes, a public utility of the sort beloved by Martha Angell: like the post office, but with Erlenmeyer flasks?
I think something would be missing, and you might be surprised to hear what it is. It's fear. Oh, and greed, too - mustn't forget greed. Those two are the main movers of capitalism, which is why, aesthetically, the whole system drives some people nuts. Wouldn't it be nicer to let some finer feelings run things for a while? Well, who knows, because we're not going to find out as long as we're the species we are. Attempts to substitute allegedly higher-octane fuels haven't worked out as planned, to put it delicately.
Not that I have anything against altruism. I like the fact that the work I do could eventually help desperate people. But clinical success is so far away, off in the hazy distance, that it would be easy just to roll along at a comfortable pace. It looks about as close as it did last week, so what's the difference? But that doesn't cut it. To really keep things moving along in the drug industry, we need what every other industry needs, namely, the feeling of someone else's breath on our necks. Believe it, every time someone in my business makes a big discovery, the next thing they do is start wondering if someone else hasn't just done the same thing a week before at another company. Scooped! Aargh!
It happens. I've seen several photo finishes in my research career, and the order can be worth tens or hundreds of millions of dollars. The times are posted on the first page of the patent filings, which is where you can see the earliest priority date. (In the US, the date at the bottom of the lab notebook page is important, too.) Every day we haven't filed on a new drug series is a day that we wonder if someone else will, and the jitters continue even after the patent's been submitted. You won't see the applications publish for many months, and that lag time could be when you find out that someone beat you. The longer it takes to find out, the worse it feels when it happens.
So we race each other in the clinic, all the way through, trying to figure out what everyone else is up to, and then we fight it out in the market. And it's a mess! It's inefficient and it's wasteful! But the hellacious part is, it's the best way that anyone's found to do it. We chase the reward of a successful drug, and we fear failure - losing out to another company, or worse, losing out to hordes of swarming lawyers. What else would make us jump as high, what else would make us run as fast?