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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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« Hits, Misses, and Some More Misses | Main | Taranabant in Trouble? »

March 10, 2008

Fill Out Your Pharma Brackets

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Posted by Derek

A reader called my attention to this alarming but weirdly fascinating graphic over at the Wall Street Journal's Health Blog. It's a March tournament bracket for the drug industry, but the winning team takes over the loser. Of course, the thing that makes it so spooky is that all the second-round matchups they show are fairly plausible (and have, in fact, all been rumored at one time or another).

The whole thing is prompted by some investment banks calling for Pfizer to do some big deal to shore up their numbers, which is just the sort of thing you'd expect a bunch of investment bankers to come up with. Business is slow these days, you know, and a big ol' deal would be just what the doctor ordered.

If you work through the whole thing, you end up with. . .well, you end up with Pfizer most of the time. It's like one of those pool sheets where you find yourself putting money on a team you don't really care for. The comments to the post are worth reading, too - my favorite line might be "Problem with Pfizer is that they haven’t the foggiest idea about what they are doing. . ."

Comments (17) + TrackBacks (0) | Category:


1. Don B. on March 11, 2008 8:04 AM writes...

What can be expected from a company run by a "hamburger lawyer"?

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2. MolecModeler on March 11, 2008 9:20 AM writes...

Pfizer is going to lose 80-90% of their 13b/year lipitor revenue when it goes off patent. If it has nothing in late stage clinical trials that will get on market around that time, they are in deep doo-doo.

As far as I know, they have nothing.

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3. sroy on March 11, 2008 2:01 PM writes...

Merck learns that it is not special and system pharmacology is real (again).


Melinda Peer, 03.10.08, 7:00 PM ET

Merck Drug's Not Worth The Weight

Merck’s experimental obesity drug, taranabant, is the latest pound-shedding pill to be weighed down by disturbing side effects.

On Monday, Leerink Swann analyst Aileen Salares said Merck (nyse: MRK - news - people )’s intended commercial dosage of two milligrams did not produce the intended 5% weight loss in Phase III human trials, the final round of testing required by the U.S. Food and Drug Administration.

The most effective – and highest tested – four milligram dose achieved the desired weight loss but more than doubled instances of psychiatric side effects than a placebo. Even the two milligram dose proved problematic: nearly twice as many patients taking it removed themselves from the trial, compared with the placebo, citing suicidal thoughts and neurological effects, Salares said.


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4. sroy on March 11, 2008 2:20 PM writes...

On a related note-

If you wanted to loose a few pounds would you take-

1] a dopamine/NA reuptake inhibitor (bupropion, methylphenidate)- fairly safe, no adverse effect on mood or sexual function. Some people get excessive anxiety with bupropion.

2] Drugs that block fat absorption (Orlistat) and give you "treatment effects" and fat soluble vitamin malabsorption.

3] Drugs that block cannabinoid receptors (Rimonabant, Taranabant) and give you depression, anxiety and more.

4] Non-specific Serotonin enhancer (Fenfluramine) and get some heart valve problems.

Remember they all cause around the same weight loss (%) in human trials.

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5. MolecModeler on March 11, 2008 3:04 PM writes...

Or, instead of taking drugs, you could:

a) eat healthier
b) eat less
c) exercise

Amazing concepts to be sure.

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6. Brooks Moses on March 11, 2008 9:01 PM writes...

MolecModeler: To be sure.

Too bad that, for a lot of people, those factors simply don't produce weight loss.

And, for a lot of people for whom they might work, eating "healthier" is difficult-to-impossible because of allergies, eating less merely means being malnourished with no health or weight-loss benefits, and exercise is impossible due to other health conditions.

I don't think most candidates for weight loss medications would be candidates if these "simple" solutions were actually working for them.

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7. sroy on March 11, 2008 9:57 PM writes...

I think the problems are-

1] How do we define obesity? (BMI vs WHR)- BMI is a worthless way of quantifying obesity, WHR (waist hip ratio)is not perfect but a much better index of the kind of obesity that hurts your health.

2] Knowing what we know now, how can anyone suggest that caloric restriction and fat intake reduction can help obesity. If anything they will make things worser in the long term -rebound/ adaptive effects.

3] If dietary changes (More protein + fats and less carbs) do not work optimally, which is is the least risky therapeutic option? Which drugs have the best therapeutic profile (least side effects)?

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8. Shane on March 12, 2008 12:16 AM writes...

Derek- Are you preparing an upcoming entry on Pfizer suing the New England Journal of Medicine to get access to confidential reviewer responses? This feels like a big issue.....

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9. Jose on March 12, 2008 12:29 AM writes...

Brooks Moses- I have to say I do not agree in the least. Nutritional calories do not, and cannot, violate the laws of thermodynamics. If calories in are >> than calories utilized, you get obesity. Becoming more active and eating few calories = weight loss, period. The social/economic factors that may make that difficult are an entirely different discussion.

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10. sroy on March 12, 2008 1:53 AM writes...

Hi Jose,

Thermodynamics is inconsequential in hunger/ weight control, the more important thing is post prandial satiety. The body can regulate its own weight very well, as long as you eat what the human body evolved for - namely a fairly meat + fruit rich diet. For most of history humans were hunter-gatherers- ate a fair amount of meat (mostly small game) + fish/ seafood + fruits + vegetables/tubers. The average stone age hunter gatherer ate between 1/2 pound - 1 pound of meat per day. There is a reason skeletons of stone age human beings are as tall and well built as us. Agriculture (and a predominantly vegetarian diet) cut down human health and longevity until we started industrial agiculture + animal farming on a large scale in the last 80-60 years.

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11. LNT on March 12, 2008 5:29 AM writes...

Derek -- I'll second Shane's comment. I'd love to get your take on the NEJM/Pfizer situation...

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12. SBC123 on March 12, 2008 6:49 AM writes...

Obesity was not such a big problem 50 years ago suggesting life style change could be helpful.

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13. MTK on March 12, 2008 7:11 AM writes...


Can I ask a favor, please?

Could you try to stop hijacking posts? I realize that it happens every now and then within this blog, but you do it all the time. Most of us read Derek's blog because it has a good balance of business, science, media, grad school type posts. When you hijack posts to go off on whatever you go off on, it screws up that balance. This post, for example, was about a WSJ graphic and you've turned into a weight-loss column.

I'm trying to be nice, really I am. But I have to admit, it's darn annoying. You obviously have a lot to say, so as someone suggested start your own blog (once again, I mean that in a nice way). This is Derek's blog.

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14. Derek Lowe on March 12, 2008 8:11 AM writes...

Yep, the NEJM/Pfizer story is tomorrow's post. There's a lot of news this week, it seems. . .

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15. eugene on March 12, 2008 8:21 AM writes...

sroy, eating less can cause meaningful weight loss, as this uplifting story shows. Maybe an overweight researcher from a company that was taken over and destroyed by foolish Pfizer management as par the course, could use this method to save some cash (since you want to work in pharma ;) ):

Sorry for the hijack... Derek does have lots of weight loss posts. I sometimes comment on a two year old post. Look in the archives.

P.S. The original story is in the Spiegel, but I just can't beat the partisan hacks at the 'World Socialist Website' for a better take on it.

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16. Jose on March 12, 2008 12:10 PM writes...

Sorry to feed the (well-intentioned?) trolls, but this certainly is in the running for funniest post of the decade.

10. sroy on March 12, 2008 1:53 AM writes...

Hi Jose,

Thermodynamics is inconsequential in hunger/ weight control [snip]

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17. WEL on August 14, 2008 11:24 AM writes...


I had eye surgery and in the post-op pack was MAXIDEX(dexamethasone) drops by ALCON LABS.

Two days later I was BLIND

Use Google and enter EPOCRATES MAXIDEX to verify

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