Big pharma has taken a new course over the past few years. In the past, most useful drugs originated in some kind of living organism – penicillin, quinine, insulin, etc etc. Nowadays, big pharmaceutical companies use combinatorial chemistry and computer modeling. Merck has sold off its biological-products research arm. This new approach, combined with doubled spending on drug R&D, has been a resounding failure. The rate of development of fundamentally new drugs – ‘new molecular entities’ – is running about 40% of that seen in the 1970s. Since big pharma makes its money from drugs that are still on patent, this slowed innovation is a real threat to their bottom line.
You get more complicated molecules from biological products, molecules that have been optimized by billions of years of evolution. Sometimes they do what you want or need.
Big pharma’s criticisms of natural products: these more complicated molecules can be can be hard to produce, or extract, or synthesize. They worry about patentability. They worry that the organism will suddenly be declared an endangered species (which has happened exactly once) … Of course, they ought to worry more about going broke, but hardly anything is as unstoppable as a bad idea whose time has come.
I have spoken to libertarians who explain that our exorbitantly expensive and inefficient medical system must naturally drive rapid medical innovation. Except that it hasn’t. And that if it doesn’t, it’s because of onerous FDA requirements. Except that it isn’t.
I can’t say that big pharma has entirely refused to respond to this crisis. They’ve found that even if their current approaches to drug development aren’t performing very well, making up shit still works. Many drug companies have a long history, and 100 years ago they had to make shit up, because there were probably only three genuinely effective drugs in the entire pharmacopeia. I have a copy of the 1899 Merck Manual: it’s a hoot. Even when they get caught and have to pay a few billion in fines or court settlements, they generally make out. They may kill 40,000 people when things go wrong – but hardly anybody really cares. Right now caring about that sort of thing isn’t fashionable.
I think that this is an instance of a more general trend: often a modern, advanced approach shows up, and it persists long after it’s been shown to be a miserable failure. You can see some of the reasons why: the people trained in the new technique would lose out if it were abandoned. Hard to imagine combinatorial chemists rooting around in a garbage can looking for moldy fruit.