“Because We’re Stupid, Not Evil”

Ashutosh Jogalekar explains that the high price of drugs isn’t entirely due to corporate greed:

Often you will hear people talking about why drugs are expensive: it’s the greedy pharmaceutical companies, the patent system, the government, capitalism itself. All these factors contribute to increasing the price of a drug, but one very important factor often gets entirely overlooked: Drugs are expensive because the science of drug discovery is hard. And it’s just getting harder. In fact purely on a scientific level, taking a drug all the way from initial discovery to market is considered harder than putting a man on the moon, and there’s more than a shred of truth to this contention.

In this series of posts I will try to highlight some of the purely scientific challenges inherent in the discovery of new medicines. I am hoping that this will make laymen appreciate a little better why the cost of drugs doesn’t have everything to do with profit and power and much to do with scientific ignorance and difficulty; as one leading scientist I know quips, “Drugs are not expensive because we are evil, they are expensive because we are stupid.”

I could actually end this post right here by stating one simple, predominant reason why the science of drug discovery is so tortuous: it’s because biology is complex. The second reason is because we are dealing with a classic multiple variable optimization problem, except that the variables to be optimized again pertain to a very poorly understood, complex and unpredictable system.

In a later post, he focuses on the difficulty of finding new drugs:

Almost every single time, irrespective of the starting source, a promising newly discovered molecule is what’s called a hit. A hit is to a drug what a freshly minted West Point graduate is to a four-star general. It is weak and unpolished in its interactions with biological system and it can often be too toxic. It may be poorly absorbed or it may hang around in the body for much too long. It may be impossible to press it into a pill and it may be impossible to simply get it into cells in the first place. Namely, it may have a lot of potential but very few real credentials. With some effort a hit may be turned into a lead which is a better version of a hit but still inadequate. Turning a hit or lead into a drug occupies the mind of the best scientists in academia and industry and even after decades of efforts there is no general formula which will achieve this. But not for lack of trying.