Jennifer Fisher Wilson
Potential Financial Conflicts of Interest: None disclosed.
Fisher Wilson J.; Alterations in Processes and Priorities Needed for New Drug Development. Ann Intern Med. 2006;145:793-796. doi: 10.7326/0003-4819-145-10-200611210-00024
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Published: Ann Intern Med. 2006;145(10):793-796.
During the 1990s, the U.S. drug industry launched one big new drug after another—the list included statins, proton-pump inhibitors, antidepressants, osteoporosis therapies, and nonsedating antihistamines. Pharmaceutical companies predicted that the number of new drugs would continue to grow in the years to come, a prediction supported by the investment of more than $100 billion in drug research and development by the National Institutes of Health (NIH), public institutions, and private companies. Furthermore, scientific advances related to combinatorial chemistry, genomics, and proteomics promised to make drug discovery and development more efficient.
Unfortunately, instead of prospering, drug development has stalled. The U.S. Food and Drug Administration receives significantly fewer applications from the drug industry than they did in the mid- to late-1990s, and regulatory sources say the number of new drugs approved by the FDA is at an all-time low. Drug companies are reporting a higher failure rate of candidates in clinical development, as new drug development technologies have failed to deliver on their potential. In the past decade or so, average development costs have tripled to an estimated $860 million per drug, while typical development times have increased to 15 years.
Kenneth A Hoekstra
Western States Chiropractic College
November 22, 2006
Our failure to provide drugs to developing countries
In Jennifer Wilson's article titled Alterations in Processes and Priorities Needed for New Drug Development, the author describes some of the failures of the pharmaceutical companies in drug discovery, development and distribution (1). All aspects of industrialized nations (i.e. medical, economic, business, political) have taken two steps backwards for each and every step forward in the promotion of drug discovery and/or distribution for developing countries (2-4). While it can be argued that pharmaceutical companies may have no special obligation to third world countries and drug discovery and distribution (5, 6), a greater obligation to do no harm, and promote and extend the fundamental rights and values that we (i.e. industrialized nations) cherish supersedes such philosophical thought. To this date, developed countries have failed (3).
1. Wilson JF. 2006. Alterations in Processes and Priorities Needed for New Drug Development. Ann Intern Med 145: 793-796.
2. Nyigo VA, Malebo HM. 2005. Drug discovery and developments in developing countries: bottlenecks and way forward.Tanzan Health Res Bull., 7(3):154-8.
3. O'dowd A. Doha Declaration has failed to deliver cheap drugs to developing countries, Oxfam says. 2006. BMJ, 333(7577): 1036.
4. Silversides A. Canada falters on promise of AIDS drugs for Africa. 2006. CMAJ, 175(7):726.
5. Lee Chang P.2006. Who's in the business of saving lives? J Med Philos. 31(5):465-82.
6. Ashcroft RE. 2005.Access to essential medicines: a Hobbesian social contract approach. Developing World Bioeth. 5(2):121-41.
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