Where has all the innovation gone?

In the midst of recent high-profile R&D failures that have sent the major drug companies scrambling to purchase biotech firms to replenish their cobweb-filled pipelines, I stop and ask myself, “Where has all the innovation gone?” After all, American citizens are the ones who pay ridiculously inflated prices in order to give incentive for Big Pharma to produce innovative drugs. We are essentially bearing the R&D burden for the entire world, right?

I found a pretty good answer to my question on Merrill Goozner’s blog:

The industry’s claim rests on a simple proposition. Without high prices, research and development will be cut back. For the millions of Americans suffering from cancer, heart disease, Alzheimer’s, and (fill in the blank with your most feared disease here), the fervently-hoped-for miracles that are just over the horizon will not emerge from industry’s labs.

It’s a compelling story, and total hogwash, as a new report from the Government Accountability Office released by leading Congressional Democrats today shows. Rather that replicating the Tufts Center for Drug Development methodology that generates the industry’s much ballyhooed “cost per drug” number, the GAO investigators interviewed dozens of experts in an effort to explain why medical innovation is lagging.

Okay, so why hasn’t more money for the drug industry led to more innovative drugs? The most important reason, the report said, was that “the complexity of the diseases to be addressed have increased.” In other words, the low-hanging fruit of the drug revolution has been picked. The diseases that an aging population needs to address are diseases that have defied man’s ingenuity for decades — no, centuries. Is more money the answer? Or must we await a better understanding of the underlying mechanisms?

I think it is the latter. Yet, between 1983 and 1998 there was a 22 percent decline in the number of physician-scientists working on these questions, the report noted. Physicians willing to test new drugs in their patients are a dime a dozen, and industry has hired plenty of them. But “lengthy training and relatively lower compensation for physicians who are scientists” has undercut our society’s ability to do the hard work that might one day lead to real innovation.

The second major reason for lagging innovation in the drug industry most innovative drugs “do not offer the same revenue-generating potential as blockbuster drugs,” which frequently must be tested on thousands of patients because they offer only marginal health benefits — like cholesterol-lowering drugs, for instance. Moreover, once one company comes up with a blockbuster, then the rest of the industry follows suit with their own versions, the so-called “me-too” drugs.

Sadly, Gooz nails it.

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