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January 3, 2005
. . .Nor Am I Out of It
I jumped the gun a bit with my year-end piece yesterday, in which I got my hand-wringing out of the way for now. The most casual observer can see that the drug industry is in something of a fix. What I'm asking now is for ideas on how to get ourselves out of it.
In the short term, I think we're just going to have to reef in the sails and hold on tight. On the new drug front, what's in our clinical pipelines now is what's in 'em, and we're not going to change that soon in any way that's going to help. On the political front, I don't have any faith at all in PhRMA (the industry trade association)'s ability to slide us out of this jam, and in fact, I worry that they'll end up making it worse.
Solutions will have to come in the longer term. I can think of a lot of things the drug industry needs - better clinical sucess rates, for example. Anything's better than the roughly 85% failure rate we have now. For that, we need a better understanding of basic biology, mechanisms of efficacy and toxicity. That's where most of the failures are coming from these days, from the hard parts.
But the most important thing we need, as far as I can see, is more drugs that people really need. I'm not talking about the lifestyle enhancement stuff here. People buy those products - sometimes - but they don't respect them, and they're not willing to do any favors for the people who make them. I mean the big tough ones - Alzheimer's, intractable cancers, diabetes, major depression. These are very hard areas to work in, and we don't always have a good idea of what we're doing. But we're going to need good products for conditions like these to remind people of what the drug industry can do.
And we're going to have to resist the temptation to hype the incremental advances that we make in these areas. Headlines about a Wonder Cancer Drug don't do anyone any good when the WCD turns out to help about 5% of its initially targeted patient population. Crazy hype about stem cells might move some IPO stock, but we all know that it's going to take many years of ridiculously hard work - and many bonfires of venture capital - to realize their potential. If we keep jumping up and down, jabbering about the great stuff that's coming real soon now, everyone's going to tune us out. Some have already.
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