I just wanted to add my $0.02 on drug discovery in pharma companies. I won’t dispute the 3/4 of drugs are “me too” s that Dr. Angell cites. But I think you have to ask why?
My take on it is that discovering drugs is not easy! You can bet that every major pharma company is researching the hell out of trying to find breakthrough products in onclology, AIDS, ALzheimer’s, etc. But if it were easy, we’d already have it.
It a pretty well known phenomenon that the pharma pipeline has been drying up. Again, my take on it is, over the last 30 years the majority of the chemical targets have been identified and pretty well researched. It’s a natural progression of diminishing returns. We’ve sort of caught up to the leading edge of science, and any incremental discoveries are ‘harder’ in a sense.
Which brings us to biotech. IMHO biotech today is probably about where chemical drug discovery was 30-40 years ago. We’ve seen the first fruits of biologic medicines, and we’re waitng for the boom. But as another poster mentioned above, biotech science costs a lot more than the lone scientist and his test tubes did 40 years ago.
Of course, none of that means our current patent system is optimal. One interesting idea I’ve heard kicked around is the governemnt should make upfront payment to pharma companies upon approval of a drug. Me-too drug, small payment, scientific breakthrough gets a huge payment. Drug companies recoup their investment with profit, and the government can distribute the drug as they see fit, theoretically implying that everyone who needs it gets it.
disclaimer: I work in pharma, but I am not a scientist.