Monday, April 18, 2011

Why Pharma's New Drug Pipeline is Dry

Back over again to the Health Care Renewal blog, this time from Dr. Scot Silverstein: Dr. Silverstein calls our attention to a post on another blog titled "What Is Really Killing Pharma," by Anthony Nicholls, well worth reading in full: Dr. Silverstein, whose work we have admired in the past, is HCR's main IT critic, and so he chooses to focus on those aspects of Nicholls's critique that especially relate to misuses of IT in the drug industry, and that carry lessons for misuse of IT in medical care. This is indeed worthwhile, but the general lessons Nicholls offers are perhaps of more interest to readers of this blog. In short, Nicholls passes the This Must Be True test with flying colors, by meeting the central criterion, Agrees with My Existing Prejudices. He proposes that Pharma has failed in its recent efforts to increase reasearch output of useful new molecules, based on its model that claims that drug discovery can be "commoditized, industrialized, and ramped up" in response to marketing demands. This imodel is flawed since drug discovery is an "art" because "an embarrassingly large fraction of drug discovery involves serendipity--while you're looking for one thing, you find another." The main target of Nicholls's rant is upper management in the drug industry, which, he claims, because they misunderstand the fundamental nature of drug discovery, manage only to get in the way of their scientists, when they are not cutting costs by laying off the most talented scientists in the company--basically the "Dilbert" comic strip writ large. And this in turn, Nicholls says, is what you'd expect when an industry whose CEOs were once drawn from the upper ranks of research chemists now hires marketers and lawyers. And this finally allows me once more to preach my sermon, that if the pharmaceutical industry ever really took us pharmascolds seriously and tried to reform itself so as to eliminate the ethical problems at the interface with the medical profession--which would require eliminating many of the excesses that arise from allowing the marketing tail to wag the scientific dog--the resulting benefit would not solely reside with enhanced professional ethics in medicine. The industry itself would actually be a better place, and better poised to make major new drug discoveries, if those reforms could be implemented.

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