Drug Development

 On Forbes.com, the drug industry analyst Avik Roy has written a  comment on my piece "The Treatment"  in last week's New Yorker. A few small points, in response.

 Roy is of the impression that that I believe we should abandon rational drug design and, as he puts it, “go back to the old way of doing things: of throwing mud on a wall and seeing what sticks.”

    I’m not sure where he gets that idea. “The Treatment” makes it clear  that both strategies—rational drug design and mass screening--have a place in drug development.  When the biology of a disease is well understood (as in the case of Herceptin and breast cancer) then the former strategy makes sense. But in those cases where it is not, then there is much to be said for following a more serendipitous path. I suspect that most drug development experts would agree with me on this. In fact, it’s probably the case—contra Roy--that one of the most compelling criticisms of the drug industry at the moment is that it has gone too far in the rational direction. In a piece in the December “Nature Reviews,” for example, Bernard Munos writes:

Success in the pharmaceutical industry depends on the random occurrence of a few ‘black swan’ products.  Common processes that are standard practice in most companies create little value in an industry dominated by blockbusters. These include developing sales forecasts for new products, which are inaccurate nearly 80% of the time. Another example is portfolio management, which has e been widely adopted by the industry as a risk management tool, but has failed to protect it from patent cliffs. During the past couple of decades, there has been a methodical attempt to codify every facet of the drug business into sophisticated processes, in an effort to reduce the variances and increase the predictability. This has produced a false sense of control over all aspects of the pharmaceutical enterprise, including innovation.

    I got the impression from from Roy’s piece that he was trying very hard to disagree with me. (Calling his post "Malcolm Gladwell is Wrong," was one clue).  I’m not sure the effort was successful. He points out, for example, that some doubted Synta’s promising phase two data, in the belief that they were an artifact of the trial design: that there were differences in the health status of the control and treatment arms of the study. A good portion of my piece, of course, is devoted to the same general argument. What interested me was in describing the complications and difficulties and in many cases unavoidable issues in trial design that can make a drug look far more promising in early clinical testing than it actually is.

Roy goes on:

One gets the impression that Gladwell followed elesclomol over the years in the hopes of using its story for one of his books: the story of how luck and intuition can lead to pharmaceutical success. But the opposite happened, and the account ended up in The New Yorker instead. In Gladwell's final assessment, the story remained one about luck: but about bad luck instead of good

I do hope my editors at the New Yorker don’t read that and think that I give them my leftovers!  And I wish it were the case that I knew what my next book was all about! The truth is that "The Treatment" was always a New Yorker piece. And I had no preconceptions about how the Synta story might end when I began reporting it, except that I guessed that would be a good case study in the many difficulties of coming up with new cancer drugs. Unfortunately for the many thousands of melanoma patients around the world, it was. 

Comments

[AllemiGal]

can you take asprin and tramadol http://tramadolhydrochloride.in/ultram/ibuprofen-and-ultram-together tramadol in dogs tramadol ultram psychotropic effects
tramadol discount codes http://tramadolhydrochloride.in/tramadol/tramadol-hcl-acetaminophen-par tramadol withdraw support group tramadol drug description
tramadol pricing http://tramadolhydrochloride.in/painreliefmedications/pill-identification-numbers-white-pain-relief 100 tramadol is tramadol scheduled
buy tramadol 300 http://tramadolhydrochloride.in/motrin/motrin-bully tramadol hcl wiki ocd tramadol

[rommocherve]

onerepublic the way i feel download http://directfastdownloads.info/book/ceo-scandinavian-airlines-book-author theold kazaa download download driver lg cd-rom
mapsource download free http://directfastdownloads.info/crack/delphi-crack the golden path singapore download download beyblade video clips
make vuze defoult torrent download http://directfastdownloads.info/songs/wise-guys-songs absoluty free mobile downloads ringfeder download
office download for free http://directfastdownloads.info/crack/delta-force-task-force-dager-crack sandstorm free download radio internet download book spine labels

[John Hannah Jersey]

GOD

[Nita]

but it is only 7 days for the body to settle down again and get back to nomarl, so it can be done,only 7 days, not 7 weeks . if you take shit loads of tablets every day do not go cold turkey,this can be very dangerous to the body and cause the blood pressure to go all over the place,if your only on a hand full a day then cold turkey is best, you will need codamol tablets,sleeping tablets and other pain killers, all from your local pharmacy,alternate these through out the day to take the edge off

[Hulisi]

at the height of my adtcidion I was taking 12 150mg capsules a day, and that was just to feel normal, I even passed out on two occasions in public after taking to many in one go, but that still never made me stop,thats why I say you have to 100% really want to give up. to go cold turkey means to spend 7 days of hell, know work or driving, just lying there restless with all your muscles throbbing and acheing, sweating,shivering and shitting every 5min, feels like your dieing,

[Online Study]

Your post is very informative. I knew more information from your topic.
Online Study

[zdrrdj7p]

Ronaldo could migration to The town mainly because ManU set to receive Ribery

London, uk, Interest rates A few (ANI): Genius Portuguese striker Cristiano Ronaldo will ultimately end up in his or her technique to Real The city like Man utd currency broker Alex Ferguson air max one
is set to grab People from france top Franck Ribery via The capital come early july.

As outlined by a survey in news reports of the universe, all of the Simple spanish titans believe Manchester United already have carried out the sale through Bayern Munich.

Barca would like to Nike Air Max
expand just what appears to be Nike Air Max
to be a a number of Usually are Liga best from harvesting all of the Bayern Munich star. Still, in accordance with assets on the Nou Camp out, Ribery might be at risk of Unwanted Nike Air Max Kids
Trafford, letting you know in which Manchester United is definitely prepared to take care of the game play free of Ronaldo for keeps.

Move Ribery, that's almost all http://www.nikeairmax90tilbud.org/
set up that will have a good time his or her Twenty sixth birthday party upon June Six, is understood to possess authorized single.2million lbs a whole year sponsorship manage Nike. The deal will probably join Ribery having Nike up to the point 2014.

Both the U . s . and additionally Spain's capital are Nike matchups together with the Speaking spanish organization glimpse favourites for taking the German winger out of Adidas-backed Bayern during the warm months.

Nevertheless it's Usa who happen to be on scratching post position, aided by the ought to load the space left behind with a departures Ronaldo considered any allure.

Inspite of challenging states any divergent right from Older Trafford, Realistic The city authorities think that Ronaldo acknowledge