Drug discoveries
BMJ 2001; 322 doi: https://doi.org/10.1136/sbmj.010213 (Published 01 February 2001) Cite this as: BMJ 2001;322:010213
- Daniel Sado
New drugs appear on the market all the time. One of the challenges facing us, as doctors to be, is to try to evaluate how good a new drug is likely to be. To attempt to critically appraise a new drug, it is important to understand the different stages that the drug has had to go through to reach the market.
Hippocrates prescribes a willow (salicin) for pain relief, and the journey towards the ubiquitous Aspirin is begun
Cost effectiveness
When considering whether to undertake a drug discovery programme, the first thought of any drug company is, “Will the drug be of economical benefit to us?” The cost of developing and testing a new drug can be as much as £125m. Discovery programmes suffer high failure rates and it is often difficult for drug companies to predict whether the new treatment will be commercially valuable when it hits the market. These uncertainties mean that drug companies will often undertake drug discovery programmes only if there will be a big market for the drug in developed countries. This is why there is not much interest in developing antimalarial treatments. Malaria is prevalent only in developing countries, and many of the countries that would benefit from new drugs would not be able to afford them. On the other hand, conditions such as hypertension and asthma are regularly targeted for new drugs because they are chronic and prevalent in developed countries.
Identifying a drug target
The next question is, “What might be a suitable drug target?" This will often require a good physiological, pathophysiological, biochemical, or even genetic understanding of the disease. The commonest sites to target a drug at are enzymes or receptors. An example of this is the recently licensed drug clopidogrel, which is an antiplatelet aggregation …
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