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January 3, 2005
. . .Nor Am I Out of It
Posted by Derek
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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1. M. Simon on January 13, 2005 7:26 AM writes...
Well the industry could also use a lot more honesty and a lot less rent seeking.
The Brown Acid - Quality Control in A Free Market
http://powerandcontrol.blogspot.com/2005/01/brown-acid-quality-control-in-free.html
Let me give you the heart of the post:
It turns out that anxiety disorders are the most common mental health problem in the United States. They are worth $46 billion a year to the pharmaceutical industry. You don't suppose this fact has any thing to do with the pharmaceutical industries being in the forefront of the Drug Free America campaign do you? Of course not. They are just trying to keep you from being addicted to natural products at the cost of 1/10th of a cent per dose when they are more than willing to sell you an FDA and doctor approved, pharmacy sold product that will do the job for a dollar a dose. They have only your best interests at heart. Just ask their accountants.
There is no doubt that we need an honest robust drug industry. They may through their research have the keys to extending life and reducing suffering. Without honest profits they can not do the research that keeps the pipeline for new medicines full. What is lacking is honest profits. In fact the FDA was invented by the Federal Government to keep the drug companies honest. It hasn't worked out that way. It seems that every Federal regulatory agency eventually gets taken over by the very people it is intended to regulate. See the history of the ICC (The Interstate Commerce Commission) which is fortunately no longer a factor in regulating transportation rates. The same needs to be done to the FDA. What is needed is a private watchdog like UL (for electrical equipment) which came into being around the same time as the FDA. They also regulate a market. The market for electrical equipment. It has worked out rather well with no laws needed and no Federal Regulatory Bureau subject to political pressure. Funny thing is that the UL is a creature beholden to insurance c-ompanies.
The free market in action.
--==--
BTW for what it is worth I'm a capitalist.
What we have in the drug industry is corporate socialism.
Funny how this has gone practically un-noticed. Except when the occasional scandal shines a light.
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