About this Author
DBL%20Hendrix%20small.png College chemistry, 1983

Derek Lowe The 2002 Model

Dbl%20new%20portrait%20B%26W.png After 10 years of blogging. . .

Derek Lowe, an Arkansan by birth, got his BA from Hendrix College and his PhD in organic chemistry from Duke before spending time in Germany on a Humboldt Fellowship on his post-doc. He's worked for several major pharmaceutical companies since 1989 on drug discovery projects against schizophrenia, Alzheimer's, diabetes, osteoporosis and other diseases. To contact Derek email him directly: Twitter: Dereklowe

Chemistry and Drug Data: Drugbank
Chempedia Lab
Synthetic Pages
Organic Chemistry Portal
Not Voodoo

Chemistry and Pharma Blogs:
Org Prep Daily
The Haystack
A New Merck, Reviewed
Liberal Arts Chemistry
Electron Pusher
All Things Metathesis
C&E News Blogs
Chemiotics II
Chemical Space
Noel O'Blog
In Vivo Blog
Terra Sigilatta
BBSRC/Douglas Kell
Realizations in Biostatistics
ChemSpider Blog
Organic Chem - Education & Industry
Pharma Strategy Blog
No Name No Slogan
Practical Fragments
The Curious Wavefunction
Natural Product Man
Fragment Literature
Chemistry World Blog
Synthetic Nature
Chemistry Blog
Synthesizing Ideas
Eye on FDA
Chemical Forums
Symyx Blog
Sceptical Chymist
Lamentations on Chemistry
Computational Organic Chemistry
Mining Drugs
Henry Rzepa

Science Blogs and News:
Bad Science
The Loom
Uncertain Principles
Fierce Biotech
Blogs for Industry
Omics! Omics!
Young Female Scientist
Notional Slurry
Nobel Intent
SciTech Daily
Science Blog
Gene Expression (I)
Gene Expression (II)
Adventures in Ethics and Science
Transterrestrial Musings
Slashdot Science
Cosmic Variance
Biology News Net

Medical Blogs
DB's Medical Rants
Science-Based Medicine
Respectful Insolence
Diabetes Mine

Economics and Business
Marginal Revolution
The Volokh Conspiracy
Knowledge Problem

Politics / Current Events
Virginia Postrel
Belmont Club
Mickey Kaus

Belles Lettres
Uncouth Reflections
Arts and Letters Daily
In the Pipeline: Don't miss Derek Lowe's excellent commentary on drug discovery and the pharma industry in general at In the Pipeline

In the Pipeline

« What We Are Pleased to Call State of the Art | Main | Glassware Geek »

January 25, 2005

The Novartis Way

Email This Entry

Posted by Derek

Last week, the Wall Street Journal ran an article (if you have a subscription, it's here)on the Novartis research center in Cambridge (the MA one) and its director, Mark Fishman. I wrote a couple of blog posts back when the place was first starting up, which I'll have to unearth at some point and compare to reality. So far, that reality looks a bit different from the way that the rest of Novartis (and much of the rest of the drug industry) are doing things.

The article makes much of the emphasis on genetic causes of disease that Fishman has spoken of, which is only natural, since he's known as a force behind the decipherment of the zebrafish genome. (If you're not in the biomedical sciences, you may wonder what the big deal is about zebrafish. Actually, they're one of the most heavily studied creatures in developmental biology, sort of a fruit fly with fins.)

That genomic strategy is probably going to be either a big winner or a big loser, but it's too soon to say which. He has several others which fall into that category, too. From the article:

"Dr. Fishman also is changing how Novartis selects diseases to study. Traditionally, it and other big companies have decided by calculating the size of the potential market. Dr. Fishman thinks Novartis has a better chance of increasing sales and curing people if it goes after illnesses whose genetic makeup it has the best chance of deciphering, and diseases for which few treatments are available. In some cases, that has meant studying illnesses that affect relatively few people, such as multiple sclerosis.

Most drugs today are tested on large groups of patients suffering from a common illness. But Dr. Fishman believes that many diseases, such as hypertension and diabetes, can be divided into subgroups. So Novartis has begun conducting more specific drug trials in smaller groups of patients, which Dr. Fishman says has the added benefit of saving money and time."

That first one is sort of the Gleevec story writ large, but I've said several times that Gleevec's status as a billion-dollar orphan drug says more about the state of the oncology market than it does about the compound. In general, drugs are going to sell in proportion to the size of their market. (Now, you can underestimate that size or overestimate it, of course - this is far from being a science. Pfizer underestimated Viagra's potential at first, and Pfizer's competitors seem to have turned around and then overestimated the exact same market.) I worry that some of these decipherable genomic targets will be for diseases that affect very few people. The resulting drug will end up with quite a price tag. But, still, Novartis is a Swiss company, and I assume that the Swiss have thought this through.

And as for the smaller trials, that's indeed where the industry would like to go. But there's a shortage of biomarkers (so far) for being sure that you're dividing up your patients into the right groups of responders and non-responders. Validating a new genetic marker could, in some cases, be just as expensive as developing a drug. And if you pick the wrong one, as one of my commentators once pointed out, you could find yourself testing your drug against a group that's actually worse than random chance would have given you.

I don't want to give the impression that Fishman's ideas won't work. They're good ones, and worth trying. I think, though, that some other drug companies may be just as glad that someone else's money is trying them out first. But perhaps Novartis will eventually have their revenge.

Comments (2) + TrackBacks (0) | Category: Drug Development


1. anon on January 26, 2005 7:37 PM writes...

There certainly seems to be a lot of skepticism in the industry about Novartis putting an academic in charge of the Cambridge site (which is now their "worldwide research headquarters"). FWIW, when I interviewed there in 2003, it struck me as a pretty academic place with flies, fish and who know what other model organisms that one doesn't usually see at a big pharma running around.

From what I've heard, there also seems to be some problems integrating the various groups. The Swiss look down their noses at the folks from NJ, and they both look down their noses at the ex-Millennium crowd (a big crowd!).

I've also heard that the recent deal with Infinity Pharmaceuticals was essentially a penalty assessed on Fishman for announcing that they didn't need to do deals with small biotechs, which went against the publicly stated company line.

It will be interesting to see what comes out of there over the next 5 years.

Permalink to Comment

2. steve on January 26, 2005 8:27 PM writes...

This post illustrates exactly why having a competitive pharma industry is a lot better than a centralized research bureaucracy (for those commenters on past posts who've argued that we don't need pharma research). A diversity of research approaches is likely to be better than a monoculture, and there is enough competitive pressure to force some of the riskier ideas to be pursued (although the theoretical economic literature suggests that the degree of diversity is unlikely to be "optimal"--using a standard of optimality that probably can't be measured in the real world).

Permalink to Comment


Email this entry to:

Your email address:

Message (optional):

The Last Post
The GSK Layoffs Continue, By Proxy
The Move is Nigh
Another Alzheimer's IPO
Cutbacks at C&E News
Sanofi Pays to Get Back Into Oncology
An Irresponsible Statement About Curing Cancer
Oliver Sacks on Turning Back to Chemistry