Professor Tamas Bartfai
The Scripps Research Institute, La Jolla, CA, USA
Pharmaceutical industry spends ca 15 % of its income on research, the highest portion of income in any industry and the product development time is ca 10 years and the capital needed per approved drug is ca 1.2 bUSD, also the development of drugs is the most regulated human activity. The largest expenditures in drug development are made by private pharmaceutical companies and they focus on the largest markets which are still USA and Europe although the Chinese and Indian middle class numbers now 400 mUSD or more people thus the companies chose to work on rare diseases - oncology, diabetes and cardiovascular diseases. At the same time most large companies stopped research in pain and stopped efforts to develop new antipsychotics, and drugs to slow progression or to stop Alzheimer’s disease and almost none is investing in malaria medicine despite of the disease affecting the largest number of people albeit living in low income countries.
The reasons have to do with the companies need for relatively safe projects which result in approvable and high cost drugs and do not have 3- or 4-year long clinical trials as e.g. in case of Alzheimer’s disease. Also scientists have their serious responsibility. One of the reasons for popularity of oncology as therapeutic area is our understanding of the cellular and molecular mechanisms of different cancers, and thus of the wealth of molecular drug targets that were discovered. We have no similar understanding of schizophrenia, or neuropathic pain. As a result, pain research has been mostly stopped because of the lack of good molecular targets and of reliable, translatable models, so the last 9 pain drugs that failed in the clinical trials were all working in the preclinical models, meaning that these models are useless. Governments who pay for most of the basic research, and indirectly also for the medicines, can affect this development.
Cf. : Future of Drug Development by Bartfai and Lees, Elsevier, 2013, English, Mandarin, Japanese at Amazon.com