Getting the drugs we need

A drug company executive and university professor tackle the cost, safety and future of pharmaceuticals

Bill Snyder
Published: July, 2005

Steven M. Paul, M.D., president of Lilly Research Laboratories, and long-time Vanderbilt pharmacologist Alastair J.J. Wood, M.B., Ch.B., trade opinions about the challenges facing the nation’s pharmaceutical industry. Their points of agreement—and disagreement—may surprise you.

Wood, a former candidate for FDA commissioner, is a managing director of Symphony Capital LLC, a biopharmaceutical investment firm in New York City. Paul is former scientific director and chief of the clinical neuroscience branch at the National Institute of Mental Health. They were interviewed by Lens editor Bill Snyder in 2005.

There is concern that fewer novel drugs appear to be coming to market. What’s causing this, and what can be done to solve the problem?

Photo Courtesy of Steven Paul, M.D.
PAUL—(For) virtually every disease or cluster of diseases that we are working on right now, the science is incredibly rich. The number of novel, potentially disease-modifying drug targets that have been discovered as a result of the revolutionary advances in biomedical research over the past two decades is truly remarkable.

(But) if you look at the costs to discover and develop a new drug, from the inception of a discovery project to its launch into the marketplace, we now believe that the number as of 2005 is well over $1 billion. It’s been rising almost exponentially over the last 20 years ...

The cost of discovering and developing a new medicine, of course, includes all of the compounds that never make it through the various phases of discovery and development—indeed the attrition rate for drug discovery and development has actually increased somewhat over the past few years despite the incredible science we have at our disposal.

We’ve got on the one hand this enormous scientific and medical opportunity that we must take advantage of, and on the other hand this enormous challenge of cost.

One of my major concerns is that with all of the political and economic issues that the industry is now facing, we could literally “throw the baby out with the bath water.” We might literally need to re-invent a new industry. My worst fear is that the pharmaceutical industry may go the way of the steel industry or the automobile industry or, God forbid, the airline industry.

This would be most unfortunate.

WOOD—Whatever that number is, I don’t think that’s sustainable into the future, at least to develop the kind of high-risk drugs that we need ...

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