Skip to Content

Gosh, Fellows, There’s a Better Way

I wrote a few months ago about the Drugs for Neglected Diseases Initiative (DNDI) and how some people have pointed to its low costs as a new model for drug discovery. I wasn’t convinced. Now there’s a long article at Nature News (update: link fixed) about the DNDI and how its low costs could be a new model for drug discovery. I’m not convinced.

As pointed out in that previous post, the initiative, for the most part, is repurposing drugs that were discovered and at least partially developed by someone else, using someone else’s time, money, expertise and infrastructure. That makes perfect sense – they’re trying, after all, to get to a human therapeutic in the shortest amount of time and without spending huge amounts of money. But it doesn’t mean that everyone else can do it that way. The article itself says that the DNDI claims that these in-kind contributions account for only 10 to 20% of its expenses, but I find that hard to work out, and would like to see the numbers to verify that figure. It’s not easy, for example, to account for the savings of (in the case of fexnidazole) knowing to look at nitroimidazoles because plenty of people have already looked at them as similar drugs, or to assign a dollar value to “having a big set of proprietary antiinfective screening compounds made available to us when we didn’t have any”.

That’s not a made-up example. My post last December went into the history of most of the compounds that this current article talks about, but there’s another one to mention: SCYX-7158 for sleeping sickness. Here’s a recent article on the project, which looks to be going well so far. But where did this one come from? Well, that four-letter code, which the Nature article doesn’t explain, refers to an actual small drug company called Scynexis. Here’s an article from a year earlier on the screening efforts that led to the discovery of the lead molecule, and you’ll notice that the authors are both academic researchers as well as people from Scynexis (a contract research company in North Carolina) and from another company, Anacor (in Palo Alto). It was, in fact, a screening library from Anacor of proprietary boron-containing compounds that led to the hit, and the compound is also known as AN5568.

How did Anacor come to have a big set of such compounds? Why, they raised money from investors to synthesize, purify, curate and screen them, because they were going to make money by selling the resulting drugs to patients. They in fact signed a deal with GSK (for money) for one of their compounds as an antibiotic candidate, which after several years ran into some problems in the clinic, as new compounds often do. Anacor, though, had several other compounds in its development pipeline, and was, in fact, acquired by Pfizer in June – for money, needless to say, $5.2 billion dollars of the stuff. Scynexis, for its part, is able to do what it does because they charge their own clients money for their services, although their work for the DNDI seems to have been largely or entirely pro bono.

I keep emphasizing all that money stuff because of comments like these from Bernard Pécoul of DNDI:

“I hope we provide lessons that can be used by others,” says Pécoul. But companies won’t simply adopt the DNDi’s methods, because they do not generate profit. The investors who keep firms alive are concerned with the bottom line. Pécoul says that a transformation would require government involvement and a reorganization of the development process. It would need a system to prioritize what treatments are needed and which companies and organizations could collaborate; and it would require forethought about how the final products would reach those in need. It means shifting away from profit-based incentives to things such as prizes and government funding. Today’s profit-driven approach is not only expensive, Pécoul says, it fails huge swathes of the population.

Ah, “a system”, one that would “require forethought”. There we go. Wiser heads than ours will work that sort of thing out, no doubt at some sort of central planning bureau, where far-seeing administrators will pick the “companies” – quaint term – that will be assigned to work on the projects. All will be well – or all would be well, if those pesky investors, concerned with the bottom line, would just get out of the way.What I think that Pécoul is missing is that the DNDI’s methods exist because of those investors. These methods presuppose that other people have already put their money into things that the DNDI can use. Every single drug that the initiative is developing – and they’re all worthwhile – piggybacks on other people’s quest for profit. I hate to be so crass about it, but there’s no way around that fact. Other people bought the concrete and rebar, other people were paid to pour the stuff into forms and lay the flooring, use of the resulting stairs was donated to the DNDI, and its director claims to have found a cheaper way to get to the second floor. And he’s up there wagging his finger at those of us who are still hauling around the construction equipment.

Now, market failures exist, and tropical diseases are definitely one of them. I think that the DNDI is a worthwhile thing and that they’re doing good in the world. I would donate some of my own efforts to their work if the opportunity arose. But that donation would be made because I could afford it, just as the donations from the rest of the drug industry are being made because we can afford to do so, which is because we make money and have used this money to discover an awful lot about human drug research. I very much hope that the DNDI gets its compounds to those who need them – but to pretend that they’re showing us the way beyond the grubby profit motive is just mistaken.

 

 

55 comments on “Gosh, Fellows, There’s a Better Way”

  1. Calvin says:

    DNDi has some great people working there but it’s a terrible organization to work with. They believe that their way, if the only way. They are the Pfizer of the PDP world. Having reviewed many of their grants they certainly are cheaper than big Pharma but they are little different to biotech. This article is a load of bs. However, the real “game” here is the role of MSF in the background. They are the major driver behind DNDi and drive their politics. Now while MSF do some amazing work they truly believe that for profit Pharma companies are evil and bad and should be banned. DNDi are also raising their renewal funds from their big investors like Gates etc so naturally they are going to report how fabulous they are and great value for money. So, Dr Lowe I believe you are spot on here. The sweet smell of BS is thick in the air.

  2. anonymous coward says:

    A lot of the open information (open source/access) models depend on someone else to build or pay the infrastructure. If you’re a computer person, you can write code in your spare time, but you need to make money somehow (and ideally, make money refining your coding skills so that you can get better at it). The models work for what their users want, as long as there are sufficient ways to fund the infrastructure the models require (a way for the people to provide for themselves, the networks needed to work, etc.). The problem with the person from DNDI (and maybe with the parent organization and its parents) is that he assumes that the infrastructure just appeared or decides to ignore where it came from and therefore concludes that their model will work better because it didn’t require the money to build the infrastructure. It came from somewhere, no?

    Until we achieve heaven or some equivalent, things that are useful require resources to make them. People want to be able to do what they want, and that requires resources for them too. Until people stop wanting control and things for themselves and the people they care about, models assuming that useful things don’t require resources to be made don’t work. That doesn’t mean their isn’t room for altruism, just that there has to be enough resources to be given. Models requiring people to be permanently altruistic are likely to fail, badly and bloodily.

  3. Chimica says:

    I am a fan of do-good organizations, such as DNDi. However, the ignorance of their arrogance is hard to fathom. Are they really so clueless about drug R&D?

  4. The Engineer in the Basement says:

    Sounds like one more example, to quote President Obama, of ” Somebody invested in roads and bridges. ….. you didn’t build that.”

    I wish the DNDI guys all the best, along with everyone else searching to help those with any disease, but lets not get religious on how we go about it. Same is true in any sector of research, lets just make progress boys and girls.

  5. RM says:

    The link is currently broken. Try http://dx.doi.org/10.1038/536388a instead.

  6. CMCguy says:

    Please spare me “government can do it better” meme. While granted occasionally government entities have played a solid role if drug discovery and development, paclitaxel is an example, the majority of projects would never go far without support and repair provided by industry types. I trust I am work as really is frustrating that NIH seems to have altered the mission to encourage and perform more basic science to a transitional/application focus whose damage probably will become evident in the next decade with a dearth of new ideas/biological knowledge on how to treat diseases.

  7. Rule (of 5) Breaker says:

    So, drug discovery can be done cheaply when you don’t have to pay for materials or labor? That is some cutting-edge, innovative thinking. I think when Pécoul uses the word “collaborate” he means give stuff away for free like it doesn’t cost anything to begin with. How dare my company try to turn a profit. The nerve I have to want a paycheck to support my family!

    The problem with his model is it goes back to the old days of management putting up any garbage compound to collect their bonus without regard to clinical success. Remove competition and that is what we will get. Put up compounds, collect your prize or government check and move on. Currently, competition will at least punish companies that cannot succeed in the clinic (via their stock price of course). Not a perfect system, but better than PharmaCommunism. Anybody else cringe at the thought of government involvement in the development process?

    1. Peter S. Shenkin says:

      Your last sentence is a non-sequitur.

      Just as the DNDI initiative relies on a huge investment by industry, industry in turn relies on a huge investment in basic biological and chemical research, mainly carried out in academic labs and funded by government, and not just the U. S. government.

      So government is already involved and has been for a very long time. Without that government involvement, the pharmaceutical industry as we know it would not exist.

      1. Rule (of 5) Breaker says:

        The involvement I was referring to was decision-making type involvement – something the government always performs poorly at. Certainly government injects money into the system by the route you described, but let’s not go nuts. To say the industry would not exist is ridiculous. Biopharma does just as much basic science as academia. The only reason it does not appear so is that we don’t publish most of it (at least not for long periods of time) for competitive reasons. Also, let’s not forget (depending on which studies you look at) that 80%+ of “drug targets” discovered in academic labs cannot be validated by industry.

        1. anonymous coward says:

          1) If information isn’t published though, then it doesn’t really exist – it can’t be incorporated into the body of knowledge, and when the people who have it leave the field or die, it won’t exist anymore. Thus, the basic research investment of biotech/pharma isn’t as big, because most of it is ephemeral, and proprietary (else it wouldn’t be so ephemeral).

          I don’t think I was saying that business is responsible for everything, but if you claim to have a system that does what you want and is stable, you need to be aware of where its inputs come from and outputs go (e.g., it’s not self-sustaining if you depend on lots of other people’s work) and it needs to assume that people are what they are and don’t have to be something else (that we cease being selfish, which will happen when we cease having selves). Your proposal needs to pass a sniff test before you take it out in public.

      2. CMCguy says:

        PSS perhaps R5B was reacting the same way as I did to the statement ” a transformation would require government involvement and a reorganization of the development process” which does IMO propose government as the central player in later stages of drugs. This goes well beyond vital role of contributing to basic science and support of infrastructure that pharma does tap into to build on discovery and conduct clinical trials as part of the process. As government has started to move away from more foundational elements to application orientations there likely will be a sacrifice of key knowledge explorations and I do not think they can do it efficiently and less costly.

  8. Lou Wainwright says:

    Hey neighbor. Your debts are paid cuz you don’t pay for labor.

  9. While there are plenty of things governments do better than private enterprise, the problem of allocating resources optimally isn’t one of them. This problem is, it turns out, astronomically complex (in a computational sense). An “economy” can be viewed as a gigantic analog computer which computes a good, although not perfect, solution to the resource allocation problem.

    Allocating resources for pharma is a smaller problem than doing an entire economy, but my gut reaction is that it’s still Too Large for central planning to work.

    1. CH says:

      “While there are plenty of things governments do better than private enterprise, the problem of allocating resources optimally isn’t one of them.”

      Based on the comments on many other posts on this blog, most commenters would say this isn’t a particular strength of the Pharma industry either. It’s amazing how the persistent opinion is Pharma management is incompetent; yet, on the other hand, the persistent opinion is nobody can do it better. Both cannot be right.

      1. Possibly the problem is simply intractable.

      2. Phil says:

        That it has to be either (a) current Pharma management or (b) the government is a false dichotomy.

        I think the persistent opinion is that Pharma would operate best by remaining a private, for-profit enterprise run by managers with better incentive systems, decision tools, and backbone to stand up to nearsighted investors who would gladly mortgage the future for a little more profit today.

    2. xplo says:

      Markets aren’t particularly good at resource optimization either. True, by distributing all those nasty calculations among the population you accomplish a lot of heavy lifting – but the population is made up of notoriously poor estimators of value.

      But never mind that now. Decisions about pharma aren’t really made by a market per se; they’re made by an ever-shrinking pool of wealthy investors and pharma executives whose incentives are not tied to the market in any close way. How is that any different from central planning, really? Except that the wealthy investors and pharma execs aren’t even ostensibly bound to act in anyone’s interest but their own, whereas a public central planner would have at least an obligation on paper to serve the general public.

  10. Chemist Turned Banker says:

    To paraphrase Margaret Thatcher, the problem with these new drug discovery approaches is that you eventually run out of other people’s money….

    1. Anonymous coward says:

      Problem is, that looks like current pharma, as well – they’re busy hoping that some else will give them drugs (for free or cheap) that they can sell for lots of money while they pillage (most of) their investors.

  11. Mark Murcko says:

    One interesting angle on this thread is the fact that, so far, “drug discovery X prizes” haven’t really caught on, for many good reasons. This tells us, I think, something useful about the complexity of drug discovery versus other prize-worth projects such as a 100mpg car or a re-usable space vehicle.

    1. Xplo says:

      I believe Derek has remarked on this before; what it tells us is that drug discovery (or any kind of scientific breakthrough, really) is distinctly different from an engineering problem where the science is already generally understood and it’s just a question of who will build a well-characterized thingy faster or cheaper.

  12. Barry says:

    Pécoul’s accounting is suspect, at best and his hostility to market-driven Drug Discovery is known. But–while discarding most of the article–we should still entertain the question; Is male pattern baldness more important than e.g. tuberculosis? Market-drive Drug Discovery has achieved great things. But the particular case of Penicillin had (required? can’t know) government involvement. And it’s not alone. In the 21st century, we’re aware that we need new antibiotics, but there’s no prospect profit in that search if the FDA will reserve a new agent only for the most resistant cases (to delay the emergence of resistance) but pirate (in India? China?) will swiftly put the compound out into unregulated markets.
    I don’t pretend that any other system that has been proposed could do as well what our market-driven Drug Discovery system has done. But neither to I pretend that our system is working for all disease areas.

    1. bioc says:

      “Is male pattern baldness more important than e.g. tuberculosis?”
      I feel compelled to note that one of our (American) presidential candidates would say “A thousand times yes!”

      1. fajensen says:

        Probably Both would!

        We have narrowed the field of worthy contenders for one of the hardest and maybe most important jobs there is down to two geriatrics who – considering the medication they both must be taking – are basically cyborgs, parts of their endocrine systems being located within the likes of Hoechst or Bayer, and running off JIT supply lines. Scary!

        I prefer to get my Dino Combat Footage by watching “Godzilla vs Mothra” rather than presidential elections.

  13. Jeff says:

    I’m in the biotech industry, and have been a donor to DNDi for years, and have helped them a little with them on a few projects. I think the comments have been taken out of context by the article perhaps. I don’t know Pecoul himself, but the everyone I have spoken to at DNDi understands how expensive and difficult drug develop is. They don’t pretend to have a better model for general drug development as a whole, they only stress how the system is broken for developing drugs for rare/tropical diseases. They believe is government rewards and grants to bridge the funding divide in this area. I think they are right on target there. Without the financial incentive of marketing in 1st world countries, little to no work would be done on new drugs for many diseases which only exist in rural 3rd world areas.

    They are also very aware that most of what they do is reformulation of older drugs, or proving the dose and efficacy of drugs people know/suspect are efficacious. They view this as the low hanging fruit for their mission. Their dream is to move to truly novel discovery, but they understand this is many years and orders of magnitude in funding away from happening for them.

    Derek, as a long time fan I’m stunned you’ve now repeatedly spent time going after a good group like this, when there are so many terrible charities and fake health people you could concentrate on.

    1. johnnyboy says:

      I don’t think Derek is “going after” anyone in his post, just reacting to Pecoul’s rather misguided statements – I reacted the same way when I read the news item this morning. No one is doubting that DNDI does good, useful work, but it’s a shame that its director feels he has to politicize their work by making statements that are rather ignorant of where their drugs actually come from. But Pecoul is a public health/epidemiology specialist who has spent most of his career with MSF and not one minute in drug discovery, so I guess you have to expect that sort of thing.

    2. Peter S. Shenkin says:

      Hey, Jeff,

      In Derek’s defense, it didn’t appear to me that he was “going after” DNDI at all. He even said that he’d contribute personal time to DNDI if the opportunity arose. What he did “go after” was Pécoul’s implication that DNDI had a new, low-cost route to new drugs. In fact, DNDI survives largely by the good graces, and yes, charitable impulses, of the drug industry, which has already spent the money to lay the foundation for DNDI’s work. You appear to recognize this, and I don’t see disagreement with Derek’s points in your posting.

    3. Nick K says:

      Pecoul’s assertion is ignorant and insulting. MSF is an extremely “progressive”, right-on organization, and this probably explains his ideological bias.

  14. steve says:

    All of biotechnology is because of government-sponsored spending. Recombinant DNA came out of Boyer’s lab, from government grants. Monoclonal antibodies came from Milstein, whose lab was funded by the UK government. The arrogance goes both ways – those, like Pecoul, who don’t acknowledge the role of private industry spending for their ability to develop pre-existing chemical entities, and others, such as some of the writers on this blog, that refuse to acknowledge the important role played by government spending. A more scientific approach would be to eschew ideology (“government is bad”) and try to see how best to synergize the efforts of government, private industry (large and small) and nonprofits.

  15. peter kenny says:

    While we do need to be open to alternative approaches to drug discovery, those advocating those approaches need to go easy on the hype and propaganda. The sanctimonious, holier-than-thou attitudes of some ‘open advocates’ does tend to undermine their advocacy. Some of the ‘we’re going to disrupt drug discovery by putting apps on phones’ does have more than whiff f snake oil to it. I believe that applying the term ‘open source’ to drug discovery suggests a lack of an understanding of both/either drug discovery and/or creation of software. I make this point not to put down attempts to make drug discovery more open and collaborative but to make the point that the using the term ‘source’ will cause many to take the initiatives less seriously. I believe it was Derek who coined the term ‘Andy Grove fallacy’. Why not just ‘open drug discovery’?

  16. 104goodbuddy says:

    I can certainly appreciate the indignation at the apparently clueless tone of this article and lack of consideration for the expensive resources behind each of these molecules. Wagging a finger at the folks who donated/discounted the starting materials doesn’t sound great. But I don’t think a careful calculus of R&D costs is what in important here. The point is that this organization can use molecules the private sector already has to make medicines for the poorest in the world, and do so on a modest budget. How much are donors going to ante up if they are assuming an idea-to-market cost of $1.5 billion for a single indication? If this piece convinces someone that their contribution is actually going to get medicines to those in need, then let them write 10 more condescending Nature articles for all I care.

    1. anonymous coward says:

      As a tool to do that, DNDI is good. As a lever to assume that drugs can be developed from scratch using those methods (and thus they should cost less and be more available), it is likely bad (because drugs almost certainly can’t be developed that way in general). I don’t think anyone wants to to discourage people from funding drugs for people who aren’t getting them, but it’s probably a bad idea for people to think that all drugs can be developed in the way DNDI is using, which seems to be what their person is saying.

  17. steve says:

    One issue is that pharma has grown so big by accretion that it needs blockbuster drugs or it’s not worth it for them to develop. There are lots of perfectly good drugs that address unmet medical needs that are sitting on pharma shelves undeveloped because of business considerations. Groups like DNDI are worthwhile if they can prior some of these compounds away and get them on the market so those who need them can access them. Government could play a role as well. NCATS, for example, has a program to repurpose existing drugs. If pharma would open up their shelves for those kinds of programs then it would be an example of the pharma/government/nonprofit synergy I mentioned earlier.

    1. Derek Lowe says:

      I keep hearing this, but to tell you the truth, I don’t think that I know of any in my own experience. Companies tend to try to deal these out to someone so that they can at least make something off of them. Having them sit on the shelf, if they’re all the way to “perfectly good drug” stage, is (or would be) ridiculously wasteful. Now, I’ve seen companies try several times to get something to the market for one indication or another, and I’ve seen them bungle the attempts to strike deals with other companies, but “perfectly good drugs that address unmet medical needs” sitting on the shelves? Haven’t seen it.

      1. steve says:

        I’ve been party to several discussions with large pharmas about this. Some of them are trying to figure out mechanisms for outlicensing existing compounds for two reasons: (1) because they think it’s morally imperative and (2) because at least they’d get some positive publicity out of it. However, in at least two cases it’s gotten bogged down in business and legal. Note that when I say perfectly good drugs, these haven’t gone all the way through clinical testing. I probably should have said perfectly good candidate drugs – i.e., they look great in preclinical or early Ph1 but a business decision was made to not take them further because the market wasn’t large enough or because there was a switch in priority.

        1. ab says:

          Ummmmm, saying “There are lots of perfectly good drugs that address unmet medical needs that are sitting on pharma shelves undeveloped because of business considerations” when what you really mean is, “Perfectly good pre-clinical candidates” is way beyond disingenuous. Come on. The entire being of many companies fits in the space between those two statements.

      2. Barry says:

        the closest thing to a “perfectly good drug sitting on the shelf” that comes to mind is Gleevec. Demonstrated good affinity, good Pharmacokinetics, good Pharmacodynamics, but against BcrAbl and PDGFr, which Novartis decided were not/no longer interesting targets. But no smaller company stepped up to buy/develop Gleevec. Novartis was strong-armed into doing that itself by Pazdur of the FDA.

        1. wlm says:

          That’s a fascinating story. Is there any documentation of it in the public domain?

  18. Mike B. says:

    I know this is not pertinent to this entry, but I was wondering what kind of amusing responses the followers of this blog would provide (as well as Derek) on the finding that so much literature out there is wrong simply because of the way a program like Excel works:

    http://genomebiology.biomedcentral.com/articles/10.1186/s13059-016-1044-7

    1. Lars says:

      It worries me slightly (as a computer scientist) that the researchers say they did not use Excel itself for data conversion, but rather this ssconvert thing. They do say they verified their findings manually, but not whether they actually used Excel. The XLS file format was not public information until recently, and it and the Office formats in general are known to be… fickle, so cases like these are not necessarily consistent across different applications and versions. Now, my primary OS is Linux and I would probably have used many of the same tools if it was me, but it does seem improper to blame Excel if they don’t use it for verification at least.

      1. Anonymous Researcher snaw says:

        Lots of people have been warning about Excel’s habit of automatically guessing the semantics of text strings, such as thinking certain gene symbols are calendar dates, for over a decade, But the issue continues to corrupt genomic data. For some HGNC gene symbols, it is possible to reverse the error once detected. For instance, if there’s a numerical value in a Gene Name field corresponding to September 1st of any year, then almost certainly it’s this HGNC record because no other gene symbol turns into September 1st:
        HGNC:2879 SEPT1 septin 1

        But these two HGNC records are more troublesome in this regard because Excel turns both of them into the same date: March 1st:
        HGNC:26189 MARC1 mitochondrial amidoxime reducing component 1
        HGNC:26077 MARCH1 membrane associated ring-CH-type finger 1

        If Microsoft cared, they could make one very simple change that would help a lot: before automatically making such conversions, have a dialog box pop up “some of these strings look like calendar dates. Convert them? Yes No.”

        1. Lars says:

          But everyone is emulating them now…

    2. wlm says:

      I continue to be amazed at the willingness of technically competent people to use spreadsheets for heavy analytical lifting. Sure, they’re convenient, and the graphing facilities are nice. But it seems like a recipe for unintentional data corruption even aside from Excel’s eagerness to “help.”

  19. Anonymous Researcher snaw says:

    People outside the open source software world may not realize how much code is contributed to such projects by coders at profitable companies on their employers’ time. Partly this is for altruistic reasons: people inside the company appreciate how much their work has benefited from open source code so when they think an internal tool might be useful to others they ask management for permission to “give back” by releasing the code. Managers approve such requests in large part because they think donating some internal code is a cheap way of improving their reputation in the technical community.

    But much of the open source code released by companies is written as part of their competitive strategy. For instance much of Linux comes from companies that wish to weaken the control of MS and Apple over the industry.

  20. Anon says:

    This model is like going through the drug development garbage bag for stuff that can be recycled. Then why not go through an actual household garbage bag looking for drugs? I mean that’s what we’ll be doing anyway once the industry implodes and we’re all living on the street.

  21. drsnowboard says:

    OK, so you object to the tone. Their claims (filtered through a journalist) are evangelical and likely to be overblown. But you can’t deny Big Pharma wastes / buries a lot of preclinical compounds and programmes because of lack of efficacy in the target indication , lack of institutional will, plain arse covering fear (boron compounds are bad, COX-2 inhibitors are bad, anilines are bad etc)
    If they can turn over some stones by taking mechanisms that are ‘discredited’ for the diseases of the developed world and re-purpose them due to good science into parasitic diseases or acute infectious disease, then I think being snippy about their high horse is just trying to climb on your own elephant? And don’t tell me all the compounds that have been in man have been tried against all possible indications within pharma, because we just quote the awfully narrow and feudal portfolio management that we’ve all experienced….

    1. Barry says:

      compounds that have failed in one indication in Big Pharma remain in their archives of small molecules. Their close congeners will go through every HTS campaign ever after (actual clinical candidates probably not, but they can be summoned/assayed if/when a congener hits). In that sense, nothing is ever fully buried. But to get to market requires the will to devote the resources. If that decision is left to the Business Development people, they’ll prioritize Alopecia/baldness or ED/impotence over Tuberculosis or leishmaniasis because the former afflict people who can pay and the latter mostly afflict people who cannot. This is a failing (in my estimate) of relying on the magic of the Free Market to allocate resources.
      The other great failing is antibiotics. Everyone agrees we need new ones, but it’s not clear that you could ever make back the R&D costs if the FDA only grants the indication for third-line cases that have already failed all other available treatments.

  22. Non Whinger says:

    Perhaps if people spent less time whinging on this page and got on with doing some work the world would be in better place with respect to drugs for important diseases like those DNDi is working on. Certainly many of you have not discovered a drug and seem to just drool over Derek’s every post as if it were the word of some holy diety. Time to shape up and get back to work. Apps might or might not change drug discovery but they have reshaped many industries (Uber etc. anyone). Remaining open to new business models like the one DNDi uses may be the only way to more treatments on for neglected and tropical diseases. Yes the article in Nature was over-hyped. Move on. It is Nature, that’s what they do.

    1. metaphysician says:

      So, do you have an actual substantive response to any of the numerous actually-detailed reasons why this suggestion is nonsense? Or are you, like many, simply following the aphorism of “Anything is easy as long as someone else has to do it”?

  23. Emjeff says:

    The idea of government “prizes”, where the government hands some company cash and/or an exclusive license to market some drug, make me want to both laugh and vomit. With all of the evidence in the news lately that influence can be bought at the highest levels, anyone who believes that a system like this would work well is living in a dream world.

    1. Derek Lowe says:

      Then you probably have a rough time with the patent system and with FDA approval, I’d reckon. . .

Comments are closed.