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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

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January 5, 2006

Ugly, But Effective

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Posted by Derek

There are plenty of links around the blog world to the "Dangerous Ideas" symposium, and much of it makes for good reading. But there are some clinkers. I was going to take some time to disassemble this one from biologist Paul Ewald, but that effort has already been made for me.

Put briefly, Ewald is a believer in the more extravagant reaches of the "New Germ Theory", the idea that many more diseases than we now think are actually caused by infectious agents. But he also seems to believe that even if vaccines were possible for things like cardiovacular disease that no drug company would develop them. Y'know, so we could keep selling our regular drugs instead of curing diseases. But it never seems to occur to people who advance ideas like this that such a vaccine would make an overwhelming amount of money, and that we'd be very interested in it indeed. Think about how much people are willing to pay for, say, medication to lower their cholesterol or keep their blood pressure down. Think how much people pay yearly for insulin or for asthma medication - whole companies are founded on these kinds of franchises, even with fierce competition between drugs.

Now imagine how much people would pay to never have to do that again. Quite a bit, I'd guess, since you no longer have the disease and no longer have to take any drugs for it. And here's the real kicker: the company that comes up with this wonder cure would scoop up the revenue from the entire therapeutic area, because there would be nothing that could compete. No, I think that we'd be quite intrigued.

Now, I have to say that such treatments probably aren't going to turn out to be possible in most cases. I like a lot of the New Germ Theory stuff, but I'm not sure if it can be pushed this far - although I'd love to be proven wrong about that. But the best way to make sure that they don't happen is to remove that gigantic incentive. Any company that makes a serious try at something like this will be taking a very large, very expensive risk, and if they know that there's a patent seizure waiting at the end of it they may decide that the money is better spent elsewhere. It would get done, eventually, but the fastest way - if there is a way at all - is to let profit-minded companies scramble for it.

Comments (17) + TrackBacks (1) | Category: Drug Prices


1. Jeff Bonwick on January 6, 2006 1:53 AM writes...


I pity the company that invents a truly effective broad-spectrum vaccine for cancer. It would take less than 24 hours for Ted Kennedy to be pounding his lectern, accusing them of "withholding" treatment from the poor (by their evil, greedy corporate scheme of charging money for the product).

The more effective the drug is, the more tempting it becomes as a target for nationalization. Of course we'll never call it that. No, we'll just do mass "reimportation" from some country that was allowed to make the stuff off patent due to a UN resolution in the name of social justice for the oppressed.

Sorry, this whole topic really flips my bits.

I utterly despise politicians who bash drug companies. You guys make miracles. If we don't also let you make money, the miracles will cease.

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2. Smallpharma on January 6, 2006 6:31 AM writes...

There is a company, Protherics, a british biotech
working on a Angiotensin vaccine for hypertension

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3. NJbiologist on January 6, 2006 7:30 AM writes...

The corporate conspiracy argument is pretty frustrating when it comes at you at, say, a dinner party. The counterarguments that I've tried are 1) the incentives for being first to market with a vaccine (or cure) would be tremendous; and 2) supplanting existing therapy isn't an issue if you don't market an existing therapy of your own. I suspect Protherics doesn't have any ACE inhibitors, for an example. Unfortunately, I haven't made much headway with the people I've talked to about this..

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4. Petros on January 6, 2006 8:42 AM writes...

This raises an interesting point and I suspect pharma is in a lose/lose position on this, someone will have a go regardless.

I'm just waiting for the mud to start flying around when the critics spot Celgene's pricing policy for its newly approved lenalidomide. The reported price for this simple synthetic is higher than that of many recombinant products.

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5. Timothy on January 6, 2006 10:06 AM writes...

What, the market delivers things faster and more effectively with less waste than government?!?!? I'm SHOCKED!

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6. Demosthenes by day on January 6, 2006 10:32 AM writes...

This version of the conspiracy argument that goes "Corporations don't want to see better versions of fill in the blank" has always been a curious argument, to me. I agree with Derek that in this very capatalistic society that the money to be made in any of these advances far, far outweighs any secret hidden motive to not develop something.
Just as advised in any good conspiracy theory to "follow the money". The same idea applies here in that any company is going to "follow the money" to try and make much, much more

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7. tom bartlett on January 6, 2006 10:52 AM writes...

There may be more diseases traceable to germs than we know. Time will tell. As for companies trying to avoid vaccinating people against such conditions, this is nonsense. MRK is launching a vaccine for ovarian cancer soon that works by immunizing against Human Pappilloma virus, the primary cause of OC (thus the pap smear). Predictably, the kooky Right is against it because HPV can be transmitted by sex and we all know, they think sex is bad. Of course, HPV can also be transmitted by toilet seats.....

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8. Sigivald on January 6, 2006 1:57 PM writes...

To be clear, Tom, even the Kooky Right (as opposed to the everyday right) doesn't think sex is bad.

They think having sex outside of marriage is bad.

(The everyday right thinks, as near as I can tell, that having lots of sex, especially unprotected, with random people is foolish and probably bad. But then nearly everyone over 25 or so that isn't on the Kooky Left (or just plain Kooky) thinks that...)

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9. jim on January 6, 2006 2:10 PM writes...

Just to be clear, Sigivald,
The Kooky Right thinks it's better for young women to die horrible deaths than to have sex outside of marriage. And there is no connection between being lefty and having random, unprotected sex, despite what the aforementioned K.R. may think.

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10. fub on January 6, 2006 3:10 PM writes...

Thanks for distinguishing the "new germ theory" component from the "pharma conspiracy".

While the "new germ theory" has the merit of falsifiability by experiment in any particular case, the "pharma conspiracy" is just another generation of those unfalsifiable beliefs known as urban legends.

When I was a kid, the popular manifestation was the "200 mile per gallon carbeurator", or the Pogue carbeurator which big auto manufacturers or big oil companies had purchased, purloined, or otherwise spirited away to oppress the public.

Before that it was the "100 year light bulb".

For a thorough examination of this species of urban legend, see

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11. tom bartlett on January 6, 2006 3:48 PM writes...

the 100 year light bulb may indeed be right around the corner, if they can ever get a decent white out of LED's......

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12. Kendall on January 7, 2006 1:36 AM writes...

Hey Derek...,

William Kendall Cannon here; Remember Ms. Katherine Furnatter? I've written you earlier. C'mon & contact me, if you please. I'd bet you're my age now. Sorry for off-post.


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13. Daniel Newby on January 7, 2006 5:00 AM writes...

I don't buy Ewald's theory, but not because of any fancy macroeconomics. Just look at the biology.

Vaccines require booster shots. Even if there are no patents and the profit margin is only 1%, it's a steady guaranteed 1%, year after year, forever, on a gross billions of dollars a year. In other words, retail sales heaven.

Moreover, you cannot just go dosing the entire population to the gills with hundreds of the most active innoculants you can find. That would give an appalling rate of autoimmune disease. Each innoculant in each booster shot will need to be customized for the recipient, based on their current blood antibody levels (and maybe even skin antibody levels). That will require automation of fluorescence microarray scanners on a massive scale, requiring a huge new industry to support it, as well as automated innoculant mixers.

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14. gmm on January 7, 2006 6:35 PM writes...

hpv can be transmitted by toilet seats??? That from tom bartlett. nice- another reason to wait until i get home and travel with bleach cloths- lol sort of. if you are completely serious then why the hell does no-one tell US- the little people who are apparently clueless- that there are inherent risks in using the public potties? i swear to GOD that that makes me absolutely sick to my stomach. sick and wrong, sick and wrong........

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15. BE on January 7, 2006 9:32 PM writes...

A report the other day linked cerebral palsy with in utero herpes virus. One by one...

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16. Nitpicker on January 8, 2006 12:34 PM writes...

Tom Bartlet,
Typo there. Ovarian Cancer is not linked to HPV nor does pap smears detect it. What you are thinking of is Cervical Cancer.

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17. Tara Smith on January 11, 2006 3:02 PM writes...

Y'know, it's too bad that Ewald has to say all this extra stuff that gives the whole "infectious causes of chronic disease" research area--which happens to be a big interest of mine--a bad name. He did the same thing with the evolution of virulence, taking it too far and making grand sweeping proclamations that can't really be backed up. Makes people think he's a crank, and therefore the ideas he supports are similarly wacko.

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Listed below are links to weblogs that reference Ugly, But Effective:

Dangerous ideas in science from Kristofer's computational biology blog
Very cool article, What is your dangerous idea?, in the Edge. The history of science is replete with discoveries that were considered socially, morally, or emotionally dangerous in their time; the Copernican and Darwinian revolutions are the most obv... [Read More]

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