Getting new drugs to market: how individuals could do this without leaving their desksBMJ 2006; 333 doi: https://doi.org/10.1136/bmj.39055.610764.47 (Published 21 December 2006) Cite this as: BMJ 2006;333:1315
All rapid responses
Professor Collier’s inspiring paper is timely, true, and on target
Despite massive investments, new drug discovery and development is in
decline (2). And prices for new drugs keep on going up. Since most, if not
all, new drug ideas originate in universities (3), one wonders why
academic scientists have not taken the lead ? And, in doing so, make novel
medicines affordable and accessible to all (4). Physicians are best
positioned to recognize unmet need. But why does thinking and action stop
here? Since innovation can de-stabilize the establishment, could new ideas
be feared as generating rejection and ridicule? and further, as a career-
There is nothing new under the sun. Ideas and products related to
medicinal potential are everywhere; what we call discovery and development
is the isolation, identification, characterization, and evaluation of a
defined entity in diseased states – connecting the relevant dots.
Development is not difficult, nor expensive. First assess whether
something is better than nothing, then compare whether more is better than
less, and finally infer whether overall benefit exceeds harm. The chemical
composition of the medicinal entity is invariant; the approved product
label makes the drug, and the patent makes the price. In this context,
medicines are “information products”, and this construct may allow for
individuals to get new drugs to market without leaving their desks.
But they have to work – the task as Professor Collier has noted, is
multi-disciplinary and this necessitates teamwork and discipline. And
herein lies the rub - it is easier to make a dozen cats walk in a straight
line than to make three professors agree to a plan of action. And at 9.30
am, industry scientists are half way through their experiments, while
university folks are barely through their first coffee and the sports
page. But maybe I am being a little rude? After all, is not serendipity
the name of this game?
Collier's proposal has been validated. Professors Wald and Law at the
Wolfson Institute of Preventive Medicine, Barts and the London, and Queen
Mary's School of Medicine and Dentistry, University of London, proceeded
along the information route and developed the Polypill, a strategy that
has the potential to reduce cardiovascular disease by more than 80% (5).
And recently, Professors Shaunak and Brocchini at Imperial College, and
the University of London have initiated development for the first medicine
for Hepatitis C (6).
We reap what we sow – our educational system is geared to conformity,
and we are evaluated by memory, not critical thinking. Inspired by the
contributions to this issue of the BMJ, we propose a novel examination:
answers are provided and students are graded by questions raised or
falsifiable hypotheses constructed.
To conclude, we disagree with Tony Delamothe (7). A single issue of a
single medical journal can do it - point a direction, and make an impact !
1. Collier J. Getting new drugs to market: how individuals could do
this without leaving their desks. BMJ 2006; 333:1315-1317.
2. US Government Accountability Office. New Drug Development.
Science, Business, and Intellectual Property issues cited as hampering
drug development Efforts. GAO-07-49. November 2006
3. Fernandes M, Miska, D. Beyond Bayh-Dole and the Lambert Review: An
Initial Product Development and Transaction Model for the Interface
Between Universities and Business. Biotechnology and Genetic Engineering
Reviews. 2004; 21: 249-276.
4. Leaf C. The Law of Unintended Consequences. FORTUNE September 19,
5. Wald NJ, Law MR. A strategy to reduce cardiovascular disease by
more than 80%. BMJ 2003; 326: 1419-23.
6. Bosely S. Scientists find way to slash cost of drugs. Indian-
backed approach could aid poor nations and cut NHS bills. The Guardian,
January 2, 2007
7. Delamothe T. Get inspired, again. BMJ 2006; 333.
Competing interests: No competing interests