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Alex Telford

@alex-telford · 12 positions · 0 changes of mind

Writer on biotechnology and the economics of drug development, with a background working in and around the pharmaceutical industry. He writes long, sourced essays at atelfo.github.io on why drugs are hard to discover, what regulation does to that, and where the industry is going.

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  1. I don’t think many in the West have yet fully internalized a mental model of China as a source of genuine innovation.

    Will all our drugs come from China?atelfo.github.io 1st of 2 in this piece

    China

  2. Chinese companies are now responsible for about a quarter of new trial starts — more than Europe.

    Will all our drugs come from China?atelfo.github.io 2nd of 2 in this piece

    EuropeChina

  3. 3 months earlier
  4. Another challenge for Class II biotechs is that even if you have a nifty computational drug discovery platform, you are still often bottlenecked by the rest of the drug development process. It takes 1,000 (or more!) small steps to advance a drug through discovery, development, and past the regulators.

    A new breed of biotechatelfo.github.io

  5. 9 months earlier
  6. Such 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.

    The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about itatelfo.github.io 1st of 9 in this piece

  7. The 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.

    The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about itatelfo.github.io 2nd of 9 in this piece

  8. In 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.

    The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about itatelfo.github.io 3rd of 9 in this piece

  9. Biology 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.

    The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about itatelfo.github.io 4th of 9 in this piece

  10. it seems to be broadly true that regulatory and societal tolerance for risk declines with time

    The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about itatelfo.github.io 5th of 9 in this piece

  11. Clinical trials are expensive because they are complex, bureaucratic, and reliant on highly skilled labour.

    The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about itatelfo.github.io 6th of 9 in this piece

  12. The 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.

    The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about itatelfo.github.io 7th of 9 in this piece

    design

  13. it 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

    The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about itatelfo.github.io 8th of 9 in this piece

  14. Because 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.

    The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about itatelfo.github.io 9th of 9 in this piece