Agree that the author's extrapolations of the problems of medicine to science are cringe-worthy. The focus on medicine though makes me think it was just a bad editorial decision for the headline.
That said, I think he is correct in his critique of medicine/pharma. The cost of drug development has gone astronomically high these past decades, with billion dollar pipelines to account for the cost of failure.
The pharma drug development model has not really evolved beyond a lottery system of testing random compounds to treat diseases, and going back/forth until the right permutation of a compound is found. This might have worked before for initial "easy" diseases (that had easy drug targets, or single gene mutations), but the problems we face now (Alzheimers, Cancer) are too complex for our lottery-based drug development system.
I would disagree that the pharma drug development model hasn't evolved. There are many recent advances that have helped improve drug development (human cells used in pre-clinical screening, more advanced clinical trial design, etc).
What I think has really changed is the cost of failure. The best example I can think of is the discovery of benzodiazepines (the drug class that includes Valium). The first benzodiazepine (chlordiazepoxide, Librium) was discovered in 1957 (we're talking, the FIRST set of pre-clinical tests) and it was on the market in 1960. 3 years from the first tests to market.
Nowadays, you'd be lucky to get to market in 15 years. A great example is Qutenza. The product is nothing more than a patch that contains a very high level of capsaicin (the stuff that makes peppers hot). When you apply it to the skin, it can reduce the pain that sticks around after an attack of shingles. I can't think of a product with fewer safety issues, yet it took 10 YEARS for the company to get FDA approval.
This is due to a combination of increased FDA scrutiny around safety along with a high standard for efficacy (i.e. we don't care if your drug reduces cholesterol, we want you to prove it reduces heart attacks). So in the past, when a smaller, shorter trial was sufficient for FDA approval, you could take a promising drug all the way to the FDA without a lot of expense. Not so anymore.
Comments
Agree that the author's extrapolations of the problems of medicine to science are cringe-worthy. The focus on medicine though makes me think it was just a bad editorial decision for the headline.
That said, I think he is correct in his critique of medicine/pharma. The cost of drug development has gone astronomically high these past decades, with billion dollar pipelines to account for the cost of failure.
The pharma drug development model has not really evolved beyond a lottery system of testing random compounds to treat diseases, and going back/forth until the right permutation of a compound is found. This might have worked before for initial "easy" diseases (that had easy drug targets, or single gene mutations), but the problems we face now (Alzheimers, Cancer) are too complex for our lottery-based drug development system.
I would disagree that the pharma drug development model hasn't evolved. There are many recent advances that have helped improve drug development (human cells used in pre-clinical screening, more advanced clinical trial design, etc).
What I think has really changed is the cost of failure. The best example I can think of is the discovery of benzodiazepines (the drug class that includes Valium). The first benzodiazepine (chlordiazepoxide, Librium) was discovered in 1957 (we're talking, the FIRST set of pre-clinical tests) and it was on the market in 1960. 3 years from the first tests to market.
Nowadays, you'd be lucky to get to market in 15 years. A great example is Qutenza. The product is nothing more than a patch that contains a very high level of capsaicin (the stuff that makes peppers hot). When you apply it to the skin, it can reduce the pain that sticks around after an attack of shingles. I can't think of a product with fewer safety issues, yet it took 10 YEARS for the company to get FDA approval.
This is due to a combination of increased FDA scrutiny around safety along with a high standard for efficacy (i.e. we don't care if your drug reduces cholesterol, we want you to prove it reduces heart attacks). So in the past, when a smaller, shorter trial was sufficient for FDA approval, you could take a promising drug all the way to the FDA without a lot of expense. Not so anymore.