The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it

Alex Telford · 23 Dec 2023 · atelfo.github.io ↗

9 korrents from this piece

Alex Telford did not write this page.

Every claim below was made in this piece, quoted word for word and numbered in the order the piece makes them, so you can read it there rather than take our word for it. The sentence above each quote is our reading of the claim, not their wording. Each quote was checked against a stored copy of the page at build time; where the two differ, the quote is the fact.

Our reading
A drug discovery scientist starting today will probably retire without ever having worked on a drug that reached the market.

Their wordsSuch prolificacy is unlikely to be repeated any time soon; if current trends hold, a drug discovery scientist starting their career today is likely to retire without ever having worked on a single drug that makes it to market.

Interesting
Our reading
Pharmaceutical R&D productivity has fallen for decades: far more money spent per drug, with no matching improvement in the odds a candidate reaches the market.

Their wordsThe cost to discover and develop a drug today is orders of magnitude higher than in the 1950s. Despite this, the probability that a drug entering clinical trials will eventually reach the market has hardly improved in the intervening years.

Interesting
Our reading
The pharmaceutical productivity crisis has no single villain: nearly every part of discovery and development got gradually harder and more expensive at once.

Their wordsIn reality, the productivity crisis in the pharmaceutical industry is the culmination of decades of just about every aspect of drug discovery and development getting gradually harder and more expensive.

Interesting
Our reading
No amount of animal testing can guarantee a drug is safe in humans, so human volunteers must carry some irreducible risk for medicine to advance.

Their wordsBiology is unpredictable, especially when the immune system is involved, and there is no guarantee that a drug that appears safe in animals will be safe in humans.

Interesting
Our reading
Regulatory and social tolerance for drug risk falls over time, and the ratchet is almost never loosened.

Their wordsit seems to be broadly true that regulatory and societal tolerance for risk declines with time

Interesting
Our reading
Clinical trials cost what they do because they are complex, bureaucratic and reliant on highly skilled labour.

Their wordsClinical trials are expensive because they are complex, bureaucratic, and reliant on highly skilled labour.

Interesting
Our reading
The hard part of drug discovery is knowing what to make - which target is worth drugging - not designing the molecule.

Their wordsThe most significant factor preventing us from taking better molecules into clinical trials is not our ability to design arbitrary molecules, but our (lack of) understanding of underlying disease biology. In other words, we often know how to make something, but not what to make.

Interesting
Our reading
Deep learning is not yet ready for the task that would actually add value in drug development: predicting safety and efficacy in humans.

Their wordsit will take time for deep learning systems and training data to mature enough to be useful for the truly value-adding task of predicting safety and efficacy in humans

Interesting
Our reading
How long a trial takes decides which diseases get drugs at all, because capital flows to the indications whose endpoints can be measured quickly.

Their wordsBecause patents have fixed term lengths, with small extensions to compensate for the year or so when the drug is under regulatory review, drug developers are incentivized to go after conditions where clinical trials can be completed quickly, all else being equal.

Interesting