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Academia (vs. Industry)

Rep. Ocasio-Cortez and Where Drugs Come From

There have been several hearings in Washington on the drug industry and drug prices, and there are going to be more. Drug pricing is a large and messy issue, for sure, and all I’ll say about it today is to ask everyone to read Jack Scannell on it before expressing an opinion. I’m not going into pricing in this post at all – I have another issue. One exchange in particular from the House hearing is going around (several people have sent me the clip already), and I wanted to address it because it’s not so much about drug pricing as where drugs come from. And that is a subject I can speak to, and one where there fact/opinion ratio is perhaps a bit more favorable.

The reason this clip is being shared so much is, of course, because it features Alexandra Ocasio-Cortez. She’s questioning Aaron Kesselheim of Harvard, and I have transcribed the exchange below:

AOC: “Would it be correct, Dr. Kesselheim, to characterize the NIH money that is being used in development and research as an early investment? So the public is acting as an early investor in the production of these drugs. Is the public receiving any sort of direct return on that investment from the highly profitable drugs that are developed from that research?”

AK: “No, in most cases there is – when those products are eventually handed off to a for-profit company, there aren’t licensing deals that bring money back into the coffers of the NIH. That usually doesn’t happen.”

AOC: “So the public is acting as an early investor, putting tons of money in the development of drugs that then become privatized, and then they receive no return on the investment that they have made.”

AK: “Right”

So we’re going to do this again. I have written numerous times here about the NIH’s role in drug discovery (and that of academic science in general). And I have written many times about the persistent idea that pretty much all drugs are discovered either at the NIH or with NIH funds, whereupon Big Pharma comes in, scoops them up for beads and trinkets, comes up with a catchy name and goes off to reap the big tall stacks of cash. I would say that the exchange above reflects this view, albeit with a bit less vivid detail.

It’s wrong. I know that this picture of the drug-discovery process is just irresistible catnip to some people, but it’s wrong. Here’s why, and here‘s why, and here’s why, and here’s why, and here‘s why again. I’m not saying that there are no drugs that have been born in academic labs, of course – there certainly have been (for a look at one, try Lyrica/pregabalin). But as one of those links details (in an analysis of the 1998-2007 period), such drugs are definitely a minority. This fall I will (I hope) celebrate my 30th year of doing drug discovery research, and never once have I worked on a project where the chemical matter came from an academic lab. You can, in fact, buy entire books that teach academic labs what drug development is really like.

Identifying an interesting protein or cellular pathway, which is what academia does very well, is not inventing a drug. And even on those occasions when an academic lab has identified new chemical matter, a hit in your screening assay is not a drug, either. I’ve gone into detail about the steps in between, but let me just say that I have spent my whole career, one way or another, on just those steps. So when I hear people acting as if none of that exists, that the process is NIH-to-marketed-drug, then I get a bit worked up. (Update: here’s an excellent post on the NIH, basic research, and how to assign credit for it, from Prof. Lisa Ouelette at Stanford).

Another point: you would get the impression from that clip above that the NIH hardly ever realizes any revenue from licensing its own discoveries. But that’s wrong, too. The agency has not been very forthcoming about the terms of those licenses and how they’re awarded (as that link shows), but one of their own administrators has pointed out, and he’s absolutely right, that “Because many, if not most of the technologies developed at the NIH and FDA, are early stage biomedical technologies, the time and development risks to develop a commercial product are high“. Early stage biomedical technologies are like that. Note that he does not seem to know about a lot of market-ready drugs. And concentrating on the highly profitable successes, as mentioned in the exchange w/Dr. Kesselheim, glosses over who gets to participate in the far more numerous failures, some of which are rather expensive themselves.

Rep. Ocasio-Cortez: it is absolutely your job to participate in hearings like the above, to question those appearing at them, and to look into such issues. But it’s also your job to know as much about these issues as you can. Right now, your knowledge of where drugs come from appears to be seriously inadequate. To be fair, you’re definitely not alone in that, but there’s no reason not to learn more. Unless you, like many of your colleagues on both sides of the aisle, are mostly interested in generating zippy sound bites and looking dynamic for the next round of fund-raising and the next election. In which case, carry on. But that would be sad.

175 comments on “Rep. Ocasio-Cortez and Where Drugs Come From”

  1. JBstein says:

    I haven’t gone through all the links, but there is one important piece of the puzzle missing: the famous spin- off/out coming from academic labs. It’s mainly them using a bit of private capital doing the baby steps of lead generation. The swooping Pharma Industry comes in later, often buying these start-ups for an horrendous amount of money based on the famous due diligence. So the ones really profiting of the grant money are the founders of these spin-offs. They used public funding to develop a business idea, when it works nicely they earn big, otherwise they just publish the stuff …

    1. Academic says:

      Dude, **** off. It cracks me up that people like you are perfectly fine with the LPs of a VC firm making a killing, but the second the scientists (you know, THE FOLKS WHO ACTUALLY TURN RESEARCH DOLLARS INTO IDEAS AND DATA) make a buck, the pearl clutching begins. God forbid we actually reward the true innovators who make peanuts for a salary anyway.

      1. pv=nrt says:

        Academics do some good work in target discovery and validation, but not anywhere near as much as they think they do. Discovery in big pharma has to repeat everything, because about 80% of the time, the published result doesn’t hold up. I suspect this is the result of no job security among grad students and post docs, because we can almost always reproduce data from Japan, where asst profs generate the data. (And we can always reproduce published data from other big pharmas, always.)

        Also, I think the risk for profs is lower. They have tenure and will always have their salaries, even if the start up dies off. And, their salaries aren’t much lower than industry salaries these days.

        1. Adonis says:

          This is spot on. My main objection to the growing trend of academic drug discovery. So long as grant money keeps coming, it is irrelevant if compounds would actually make it as drugs, or assays can be reproduced. Detachment from reality that can be seen in academic labs is sometimes astounding.

        2. Academic says:

          The only company testing new biology is Genentech. The rest of you sorry lot are tailing off our discoveries. Innovation deserves to be rewarded. You get paid to be told what to do as an industry grunt. We get paid crap to figure out what is actually impactful. Most academics fail, it is a brutal and grueling career. It is only fair that very occasionally the good guys come out ahead. We don’t need the sniping from the ninnies and the jock-sniffers on this board and elsewhere.

          As to your point about tenure, most positions are soft-money with only partial salary support. If you have tenure but the grants dry up, it is unlikely you’ll have a job much longer. Also, most of us have some sense of self-respect not to stay at a place after we failed.

          1. anon says:

            To be frankly honest, biology as itself has very low entry barrier ( hence the proliferation of biological scientists). Most people in biology thrived due to luck and right timing in the right lab, not their brilliance. Unlike computer programing in which a simple test can tell one’s competence, everyone I met in biology can spin a good story. In reality, more than 80% people in biology lack the basic logic reasoning skill ( knowing facts is not the equivalent of knowledge and solving problem) and they can not pass the rigorous logics in computer programing. I guess we know where the smartest people go.

          2. anon says:

            Unfortunately, new discoveries in Biology belong to public knowledge which can not be patented. Discoveries can not follow a time-line, which is a bane for the managers in the corporate world. Most Ph.D. scientists in pharm and biotech are aspired to become managers who are paid more and do not have to do the grunt work, as known as a popular people person. The real bench work( where discovery and innovation originate) are delegated to technicians who are more process orientated but ill prepared in scientific knowledge. The separation of scientific knowledge and scientific practice on bench caused the lack of innovation in Drug discovery. It is a culture decay that is difficult to reverse.

          3. bootsy says:

            I didn’t realize Genentech employed trolls. Score one for diversity.

          4. Anonymous says:

            Academic wrote: “The only company testing new biology is Genentech.” — “During litigation in which UCSF sued Genentech for infringement of their human growth hormone (HGF) patents, Seeburg admitted that he took DNA samples from his former lab at UCSF while he was working at Genentech. He also admitted that the paper describing his HGF work at Genentech falsely described the origin of the materials. In an out of court settlement, Genentech agreed to pay UCSF $200 million.” (Sourced from footnote x in PDF linked in my handle.)

            In addition, City of Hope received over $300 million from Genentech from a lawsuit alleging that Genentech “failed to pay the Duarte-based cancer hospital royalties on [insulin and] nearly two dozen other drugs, including the hepatitis B vaccine, that stemmed from City of Hope research.” (Genentech sub-licensed the CoH licenses to a Genentech subsidiary so they could hide the actual profits! As I recall, Merck did something like that, too.)

          5. Orv says:

            Re anon:

            Frankly, entry tests don’t really work in computer science fields either. Yes, you can find out if someone can write quicksort from memory, or explain how TCP/IP sequence numbers work, or identify if an algorithm is O(n^2). But it turns out the ability of someone to regurgitate stuff they memorized in class, without references, while people stare at them, is not all that well correlated to how good a programmer they are.

            A while back Google went through their copious hiring data to determine how well their hiring process worked. They found it didn’t. There was no correlation between how highly interviewers rated a candidate and how long they lasted at the company.

            No one knows how to do hiring for knowledge jobs. It’s a mess.

          6. David says:

            If you can show me the “simple test” that can show programming competence, our industry would love to hear about it?

            Your analogy is pretty closely aligned with the very narrative you’re criticising about academics making the discoveries and drug companies doing the trivial work of QC/safety and scale-up.

        3. Lenox says:

          This is spot on! The reason for Eroom’s law (extrapolated the end of the drug industry, no new medicines, suffering wins):
          (1) the pay and conditions in a science “career” are now so bad that clever people, by definition, want nothing to do with it.
          (2) people are now having to make stuff up, falsify etc. to try and hang onto a job in science when results go against them or take longer than their 1-2 year postdoc to deliver. yes. it isn’t what they set out to do, but their children need to eat, and they are forced to make a survival decision.
          The literature is now becoming spammed with crap. New work relies on old. But if the old is crap, how can we move forward? this is a massive emerging problem, indeed, a drive to Eroom’s Law. it is fixable by fixing point (1) above. Have less scientists if needs be. but make sure they are the very smartest of their generation and support them well. Doesn’t have to be pop star wages. but liveable, enough to have a family etc. with a bit of security thrown in. i.e. basically like it was before, which funnily enough is back when Eroom’s law wasn’t a thing.

        4. Amihan Ocampo says:

          I’m a lay person on this subject of drug discovery, Dr. Lowe, but I am a tax payer so your criticism to AOCs line of questioning made me read several of your links that were intended to debunk the conclusion that she drew. Wasn’t her conclusion that the Public is an early investor in drug discovery directly affirmed by an expert witness from Harvard, Aaron Kesselheim, MD, JD, MPH? It is interesting how he didn’t come under your critical gaze. Your choice to characterize Ms. Ocasio-Cortez as being willfully uninformed does not square with her being informed by the credible testimony of Dr. Kesselheim. At least be consistent to extend your critique to Dr. Kesselheim. Otherwise your argument is weak. His bio is here btw: http://bioethics.hms.harvard.edu/person/faculty-members/aaron-kesselheim

          1. Mike Haenisch says:

            I’d say you have a fair point that the cv of the ‘expert witness’ would imply that AOC is at least trying to expand her understanding of drug discovery by asking questions of someone who – again, based on his resume – should be able to broaden her perspective. What really stuck me in watching the clip was how someone with that many relevant degrees could be so darn wrong! What’s this guy’s deal that he gives a one-word answer and won’t even mention overall public health benefits or licensing deals that bring money into universities as (indirect) return on investment?

          2. Tatianna says:

            Thanks for the link Amihan,
            After reading Dr. Kesselheim’s bio. my only question is:
            Exactly which drugs has he played a major role in the discovery, development, clinical trials and FDA approval of for human use.
            Not being a brainiac i may have missed that but i didn’t see em listed in his bio, or in his publications list. Did ya look at that? The publication list i means. He must get payed for those right?

      2. ivory tower says:

        LOL. Are you !@#$ing serious? Only 1% of academia actually makes “new” discoveries. The other 99% is just an extension/application of the work done by 1%. Stop wasting my tax dollars on your intellectual masturbation and sense of entitlement.

      3. loupgarous says:

        JBStein was answering the question Rep. Ocasio-Cortez asked of the witness – who benefits from NIH research? And the most common recent answer is “The researchers with IP rights to the drug, and their VC partners, if and when their start-ups are bought by Big Pharma”.

        Big Pharma coughs up all that money despite the 1:10 chance of gaining a marketable drug or family of drugs from it for the same reason modern gold miners buy mineral rights in some isolated armpit of creation so they can dig huge holes in the ground and sift through the dirt – it’s where the gold is.

        But if Alexandria Ocasio-Cortez wants NIH and the Federal Government to participate in the revenue stream arising from NIH-sponsored drug research, she and Congress have at least two logical and moral alternatives:
        – have Congress insist that NIH gain a share of IP arising from NIH-sponsored work (researchers’ logical counter-move so far has been to make start-ups earlier and earlier in the research process to avoid having to share IP with universities hosting their research, and Ms. AO-C conveniently forgets that universities drink deeply of Federal funding from overhead and by grabbing IP from researchers whenever possible), or
        – FULLY participate in drug development, which means absorbing the costs for that 90-odd percent of drug candidates which fail to gain FDA approval, as well as carving off a slice of drug company benefits.

        I’ll be cynical here and predicts that the latter alternative will tend not to work because Congress tends to drastically increase the costs of any service they provide, and “privatization” (see “Amtrak” and “the Postal Service”) results in even more disparity between what Congress spends on providing a service and its cost in the free market (UPS vs. USPS, for example – if USPS couldn’t rely on Congressional bailouts, it’d have gone bankrupt several times by now).

        Congress only is able to provide services like cheap mail and not-so-cheap passenger rail transport because it’s the only venture capitalist who pays people with guns and powers of arrest to raise capital. AOC wants drug discovery to, somehow, be added to that list of money sinks.

        1. x says:

          “Congress tends to drastically increase the costs of any service they provide, and “privatization” (see “Amtrak” and “the Postal Service”) results in even more disparity between what Congress spends on providing a service and its cost in the free market (UPS vs. USPS, for example – if USPS couldn’t rely on Congressional bailouts, it’d have gone bankrupt several times by now).”

          USPS is self-sufficient – aside from the ridiculous Congressional mandate to fully fund pensions 75 years out, which no company does, and was obviously an attack on USPS.

          1. Anonymous says:

            x wrote “USPS is self-sufficient …” – The USPS has been operating at a loss for many years (2018 deficit ~$6 B). It is not just the mandated pensions. They are mandated by Congress to provide a variety of services at very low costs that most private carriers would never even consider. I’m no expert, but I think they are still required to deliver daily mail to customers in the most remote locations for the same 55 cents as in a large urban center and to deliver mail to your mailbox 6 days per week. I used to think that China Post (that let’s you buy a 50 cent item from China with Free Shipping) was subsidized by the Chinese government to help Chinese businesses sell to the US; it turns out that China Post is subsidized by the USPS under a US law intended to help developing nations. If I buy that same 50 cent item from a US company it’s more likely to be $2.50 or more and the S&H is typically $4 – $10. Please don’t think me unpatriotic, but I prefer to spend 50 cents for a 10 cent item rather than $10 for a 10 cent item.

    2. Wavefunction says:

      Well, the founders of these spinoffs also plug in a lot of that money into the own research, but more importantly, the university gets 70% of the profits from the royalties.

      1. JBstein says:

        My point, so money comes back to state, via Universities, taxes, wages, funding more research & education … not exactly a circle, but somehow having an momentum. That doesn’t solve the issue of high-priced drugs though, but it’s certainly not a drain-hole for public funding.

    3. You're not wrong, but... says:

      If we engage with the sentiment of the remarks, and not just focus on the misconceptions:

      Maybe the Bayh-Dole Act went too far. Before the NIH, NSF, etc. completely controlled IP that came from grants and researchers had less incentive to make valuable things. Now, a few scientists/states and private orgs like NU (Lyrica) and the Broad (Cas9) makes buckets off the patents.

      Maybe the government should get a larger cut of that: 33% or 50%. Then government officials and lawmakers could take that money to the taxpayers and say, “here’s your return on the investment.”

  2. Brian says:

    Thank you but, most people don’t care about the truth.

  3. Joe says:

    I dont know why people give folks like Bach, Kasselheim the platform to put out some of the nonsense they spew. Gotta love guys like Aaron who are “policy experts” but never worked in pharma or FDA, but then they go say just absolutely ridiculous crap like this.

  4. MTK says:

    Leaving aside the actual fact of where most drugs originate, even in those minority of cases where they do come directly from an NIH funded lab, the public does get a return. A pretty good return at that in the form of a newly available therapy.

    1. Athaic says:

      I think one of AOC point is that this new therapy comes with a horrendous bill not many taxpayers can afford. At least, in the US.
      Plenty of other countries have healthcare systems in place which allow people access at these new therapies without them needing to mortgage their house.

      1. loupgarous says:

        AOC conveniently forgets the income taxes Big Pharma companies and their employees and contractors pay.

        Since costs of drug development twenty years ago, when I worked at a Big Pharma firm, were estimated to run $300,000/day per drug development project from beginning (actual drug development in labs) to end (granting of a New Drug Approval), the income tax flow from that expenditure wasn’t negligble, and it probably is less negligible now.

        Does Big Pharma get to write off the ninety percent of those expenditures that end without approval to sell the drug? I don’t know, but even if they do, that just means they don’t pay taxes on the money they pay out when a drug candidate fails to get NDA. Most of that money is still lost capital and it runs into the billions. And if AOC wants a slice of Big Pharma profits for Congress, she should logically advocate for Congress to kick in for part of the drug development process’ costs, which are massively higher than what NIH pays for research that studies disease processes to identify targetable proteins and receptors.

        AOC’s time would be much more productively spent asking why Big Pharma sells drugs overseas for pennies on the dollars Americans pay for them, either directly or through their insurance premiums and taxes spent buying them for the nation’s indigent and retired population.

        1. jim says:

          Income tax from pharma, … and what next from Apple and Google? They are notorious to put all their income in tax heavens to avoid paying taxes.

          1. loupgarous says:

            I was primarily talking about income tax paid by employees and contractors in Big Pharma, but sure, if you have a cite showing that Eli Lilly’s domiciled in (say) Vanuatu for tax purposes, let’s see it.

    2. Sukumar says:

      Not when it is unaffordable. That’s the whole point.

  5. electrochemist says:

    An obvious solution: Let AOC and her ilk create a law that requires NIH to charge $1 trillion dollars for each drug candidate that NIH patents and licenses to a big, bad, evil, nefarious drug company.

    The only impact of such a stupid law would be that in the very rare instance that NIH produces intellectual property that *could* be licensed, no one will take them up on the offer. The drug industry would soldier on with little disruption.

    1. eub says:

      I have a theory that any utterance that incorporates the word “ilk” is far more an expression of emotion than it is a statement about the world.

      (Uses of the Scottish naming formula are excepted.)

    2. Anonymous says:

      “NIH to charge [for] NIH patents and licenses to a big, bad, evil, nefarious drug company.” – That reminds me of the collaboration between Myriad Genetics (the company that licensed the Mormon family history database to search for genetic linkages), another company AND THE NIH to track down and ID the BRCA genes.

      Myriad filed a patent (patentS?) but failed to include the names of the NIH collaborators as inventors because that would have required that some of any future profits be bled into the public coffers. That sounds “big, bad, evil, nefarious” if you ask me. (I’d throw in other negatives, as well.)

      The NIH got wind of what was happening and immediately filed their own patents. This turned out to be a powerful laxative to Myriad who then negotiated a new deal with the NIH. Myriad made money from testing for BRCA; the high cost of the test outraged the public; Myriad enforced their patents against anyone who ran the assay using their own custom kits.

      “Beware the sin of hubris.” Myriad’s claims to the BRCA genes were eventually overthrown by the Supreme Court of the US. (They still make money from other stuff in their patents.)

  6. Marcello says:

    I have been at the inception and funerals of a couple startups and I have to say Alexandra-Ocasio Cortez has a point. I am not going to rant how the semi-slave system of grad-students and postdocs are used by the PIs, as the representatives of a NIH as an early investor. I am in medicine now hoping to actually help actual people.

  7. Gollum says:

    Very disappointing. The questions Ocasio-Cortez raises are fair game, but there’s not going to be informed policy by having debate on this subject in a vacuum. Certainly not if the lone expert happens to think that the private sector does not do independent (and expensive) research or that everything coming out of academic labs is reproducible and low-hanging fruit, ready for development (regardless of intellectual property issues).

    On the flip side, how many academic labs (publications) have benefited from pharma/biotech drug discovery programs that effectively end up generating high-quality tool compounds for academia, once those programs have translated to the clinic, or more likely, crashed and burned. I also wonder what Kesselheim would have to say about his many fellow academics having their cake and eating it too – NIH funding, multiple start-ups, multiple scientific boards.

  8. Cialisized says:

    Derek, great to bring this up. She (AOC) obviously is getting much too simplified info from “experts”. On the other hand, it is very true that the NIH *is* an early investor, as AOC points out. NIH puts in $$ that establishes the biological *basis* for most pharmaceuticals, but does not fund development of the compounds themselves. So the early investor part is indeed correct.

    Take it to the extreme: Say NIH puts in zero dollars. Most new drug research would be hobbled if not dead in a few years. So I think it is obvious that the early investment by NIH has been a key and necessary piece of the pharma industry’s success. The complex part is how to reward this. As MTK points out, the new therapies will benefit all citizens. is that enough or not? Or should all drugs just have a small royalty paid to the govt. as a matter of general practice? (0.1%, 0.01%) Debate among yourselves.

    1. b says:

      The government also paves roads. Does that mean every business that uses them should pay a small royalty to the government for their use as a matter of general practice?

      Technologies developed with DARPA funding include the internet, GPS, robotics. Every business that uses those technologies should pay in?

      The point of funding scientific discovery, and infrastructure in general, is that it provides a net-positive for society as a whole. This leads to economic development, which leads to tax revenue. There’s your royalty being paid.

      1. bs says:

        yes it’s called taxation and it works?

      2. Allan Olley says:

        It seems like that might be Ocasio-Cortez point that the NIH is indeed providing great value and deserves funding to be maintained or increased, it seems like she might be laying the ground work to counter those who might propose slashing NIH funding and saying the private sector would do better…

      3. Sukumar says:

        On roads: we do; they’re called tolls.

      4. x says:

        “The government also paves roads. Does that mean every business that uses them should pay a small royalty to the government for their use as a matter of general practice?”

        Yes?

        I mean, if this country is as relentlessly and absolutely capitalist as our rich, corrupt, neoliberal elected officials keep insisting, then absolutely yes. Otherwise you’d get – what do they call it – socialism for the rich?

        In truth, if pharma is going to pretend that it does all the real work and takes all the real risk, maybe we should stop funding NIH altogether. Since, you know, they contribute nothing that matters. Let us know what you think of that proposal.

        “The point of funding scientific discovery, and infrastructure in general, is that it provides a net-positive for society as a whole. This leads to economic development, which leads to tax revenue. There’s your royalty being paid.”

        The federal government doesn’t actually need tax revenue as long as it’s using funny money; the only thing taxes serve to do is cool off inflation.

        Now, scientific advancement is great and all, but why are we funding advancement if the only result is discovering therapies so expensive that the public gets little benefit from them?

        1. Derek Lowe says:

          Your tax/inflation connection, aka “Modern Monetary Theory”, is not exactly mainstream economics. But this may not be the best venue to thrash that out.

          1. x says:

            Probably not the best venue for a lot of this discussion, and yet, here it is… in any case, when mainstream economics is finally willing to admit we’re off the gold standard and have been for years, and that banks don’t go to the vault every time they make a loan, let us know.

      5. David says:

        I think it should be EXACTLY like roads, police forces, courts, military, representation in government, public records, etc. The public should benefit. And be able to affordably and appropriately access such services. Not cost a third (ish) of minimum wage per month for insurance that makes a prescription for a week’s medicine cost half a day’s wage.

        1. b says:

          Ok, so the NIH funds some research, and we find that receptor X may have some link to disease Y. Now… benefit! I’ll wait.
          The general infrastructure allows society to benefit by means of providing a foundation on which to build. Roads, military, police forces, etc. are not an end product in themselves. They do not generate revenue, they allow revenue to be generated by others. There’s quite a large disconnect between “I can get from here to there safely and fairly certain that a bomb won’t come crashing down on my head” and “here’s an iPhone, $1000 please”.

    2. loupgarous says:

      In the case of NIH-funded research, the “calf” doesn’t follow the “cow” all the way to successful marketing of a drug which depends on that research, necessarily. Congress, even if it seized sole ownership of IP arising from that research, would be profiting not from drug development in general, but the income from sale of important concepts from NIH-funded research to Big Pharma. That’s the biggest their slice of that pie can theoretically get. But good luck pushing that through the current Supreme Court.

      Now, Congress could actually get involved in purchasing start-ups marketing NIH-funded research. That could allow Congress to morally and legally get a larger slice of the pie by supplying venture capital for development of marketable knowledge into drug candidates, and selling those rights to Big Pharma.

      If AOC wants to not only recoup sunk NIH costs but realize a profit from them, that might be a legal way to do it (I’m neither an attorney, nor to I play one on TV).

      This would be a good time for the Congressional Research Service to write up a document on the economics of drug development for degreed economists in Congress who want to comment on that subject without creating more fodder for their critics on Twitter. So far, all they’re doing is providing Aaron Sorkin with material for another fantasy series about the Federal government.

  9. bs says:

    ‘big red wet lips’

    You can do better than this.

    1. Derek Lowe says:

      Just trashed that comment – over the line.

  10. AT says:

    Uncle Al, I think you meant to post that over at Breitbart. The discussion here is generally more classy. Maybe you should lay off the carbon tet.

  11. Hap says:

    Why couldn’t they have asked someone who knows about drug discovery to give testimony on it? I don’t really want to throw Dr. Lowe to the wolves but he could do it, for example (though his employer might not like that), and there have to be others who know both the big picture of drug discovery and how the sausage gets made.

    Maybe I’m being optimistic, but isn’t the point to get information on a topic (rather, as is also likely, to get information that fits the action you already want to take). Getting good information on a topic is the only way to do something useful about it, something that will last and be good in the long run. If you can’t be honest about what you’re doing, you probably shouldn’t be doing it (one of the theme songs for this Administration).

    1. Gollum says:

      I second the motion – Dr. Lowe goes to Washington.

      1. Derek Lowe says:

        Oh man, can’t I just spend the day eating habanero peppers and washing them down with vinegar or something?

        1. Gollum says:

          Wolves probably aren’t fond of capsaisin. Dose-up before you go to Washington – and thank you for taking one for the team 🙂

        2. jeff says:

          But wouldn’t we get another installment of “Things I’m Glad I Don’t Do” out of it?

  12. Kiss the Chemist says:

    Hap…you win quote of the day…”…how the sausage gets made”

    Laughed so hard I nearly dropped my bacon sandwich!

    PS : Derek for President!!

  13. M says:

    There are not enough of us who both understand the subject – any science-related subject!! – and make the time to communicate, as Dr. Lowe does. A blue unicorn, indeed, and invaluable. Until more of us get better at speaking out, the dialog in the public sphere will be directed by those who make time to communicate, even when their talents lie more in getting themselves heard than in the areas they purport to be expert about.

    Note to self: go home a write a letter to the editor!

  14. M says:

    I second bs. The century for menstruation-related put-downs has passed.

  15. Anonymous says:

    It’s Occasional-Cortex.

    1. Marcel Kincaid says:

      “It’s Occasional-Cortex.”

      A common trait of the right wing is lack of emotional maturity.

      1. chemist says:

        A common trait of the left wing is a lack of sense of humor, and bullying people like Derek who want to have an honest discussion by shaming them as sexists, bigots, racists, etc. If you still consider yourself a Democrat in 2019 there is something seriously wrong with your critical thinking abilities.

        1. Hap says:

          The Republican sense of humor seems to run about sixth grade-bully level (as well as its policies, reasoning, and moral position). The Democrats may have problems, but inability to understand Republican humor is not one of them.

          Current Republican “humor” would have gotten one a few moments behind the woodshed with Dad and a mouth full of soap not so long ago.

          1. chemist says:

            The left got away with relentless bullying of the GOP for decades. Remember how they treated GWB? How about Mitt Romney getting endlessly shamed for a minor gaffe such as “binders full of women?”
            Now the political left is rightly getting ridiculed and smacked in the face, day-in and day-out, by a POTUS with enormous balls who doesn’t just simply apologize to his attackers. I think you just hate getting a taste of your own medicine, you elitist snot. Buckle up because you leftoids are only going to be mocked, ridiculed, and further marginalized for the mess you’ve caused in this country.

          2. Derek Lowe says:

            Enough of this, please. We’re not going to be able to avoid politics in this discussion, but going to a straight partisan rant won’t do any of us any good. I understand the temptation, though.

          3. Hap says:

            Gosh, I don’t remember the “Romney wasn’t born in this country” or the “W had (pick ex-compatriot) whacked” criticism from the Democrats. I guess those examples must have just slipped my mind.

            Your sense of history is of a piece with your party’s sense of honesty.

          4. Hap says:

            I’m off topic and being a nutweasel. Sorry.

          5. Derek Lowe says:

            Happens to all of us these days! I’d rather not have this particular branch of the discussion take off, though, for sure.

          6. Hap says:

            I should have anticipated how cranky I was getting and how far off topic. I don’t want to poop on someone’s stuff.

            I also missed the other “stop this” message. I would have started yelling if it were my kids but that’s hard to do over the internet.

          7. Derek Lowe says:

            No problem – all those messages came from me at about the same time

  16. PhotoDeTox says:

    This is ridiculous. Private Investors bear the financial risk of drug discovery and drug development (and NOT the government!) and those who succeed rightfully make good money. What does the society get? Economic growth, jobs and new treatment options after all. So what’s the problem?

    One could also argue that the internet was invented by scientists funded by governments and now Facebook and Google make the big money! Why is pharma bashing so popular? There would be alternatives!

    1. John Wayne says:

      It is popular because:
      1. People pay for drugs visibly in our health care system, so there is an awareness in the general population. Do people know how much of their health care costs go for insurance, lawyers, and administrative overhead? If people knew, they’d be pissed; it isn’t a line item on your bill.
      2. Pharma has a terrible reputation, so politicians are incentivized to take shots at them
      3. You have to understand a lot before you can grasp the fragile nature of drug discovery (mostly that we don’t know what we’re doing), so few are going to do this
      4. Convincing people that the ‘product’ of the NIH is very low quality and usually doesn’t work out is a tough sell (even if it is true) due to the hype/reality cycle most things go through

      To quote somebody (Churchhill, probably), “democracy is the theory that the common people know what they want, and they deserve to get it good and hard.” Congress, go ahead and finish destroying drug discovery; I will move to the country that doesn’t and sell the cures back to you.

      1. Hap says:

        I think that’s Mencken.

        Things with visible sticker prices tend to attract attention – gas prices aren’t a big part of my spending, but they are a visible measure of prices in general. The list prices of recent drugs are really high ($425K/year, for example), and in lots of cases their cost/benefit equations are hard to solve and hard to swallow if you can solve them.

        The rate of increase for front-line therapies is likely problematic – how much will an Alzheimer’s drug that actually works cost? I don’t think that Congress is likely to solve that problem (not like this) but it seems like there might be a real problem.

        1. John Wayne says:

          Yeah, you are right, it was Mencken.

          As for Alzheimer’s disease …. if you had something that actually worked you could charge pretty much whatever you wanted. At minimum, $50k/year; but I think they could ask for a lot more. If the approved patient population was of any significant size, it could immediately bankrupt every health care system.

          1. Nameless says:

            I don’t think you would need to charge so much to make the next blockbuster. The insurance companies see how many patients they have asking for this wonder drug and cap the payment at a few billion per year. With a million patients the individual cost is really low.

          2. Hap says:

            But I suspect if the insurers limit access there will be crowds of old people and soon-to-be-old people cramming into Congress complaining, and an awful lot of resultant pressure. I think that whoever makes the drug would have some leverage, unless the Hep C saga was repeated (more than one company has a similar drug in similar time).

          3. Nameless says:

            I was thinking about the situation in germany where a single institution (representing the insurance companies with about 90% of the patients) negotiates the price with the pharma company. They know how many patients will take the drug and then they come up with a budget that they are willing to pay.
            Then they divide that budget by the number of patients and the price per treatment course is set. Since the tablet itself will probably be very cheap (in relation to the price of the drug) this is a viable option. Net revenue will be billions so pharma is happy.

      2. eub says:

        I believe the public reputation of health insurance companies would rate lower than pharma companies, which in their turn are lower than Congress in public esteem. It’s not that citizens are in love with their insurance company.

        I do think a large part of it is that people have a feel for that sale price versus marginal production cost, while they don’t see the investment to make the drug exist.

        1. Hap says:

          It’s hard for the companies to know how much they actually spend to get a drug, much less anyone else. The money is going somewhere, though. I’d be cynical and say execs, but that not entirely fair (although being a pharma exec seems like a way to make a good living while not having responsibility for one’s failures because of pharma’s timelines).

          I think there’s probably a general level of frustration about health care. People can go bankrupt to get it (not as much as claimed, but more than almost everyplace else with similar per capita incomes), when they can get it (because hospitals and doctors are more concentrated where the money is), and overall because of that we get worse outcomes for much more money spent (it’s difficult for me to believe that our habits suck that much more than other countries of similar wealth). Hospitals and insurers make drug pricing look transparent and friendly (double-billing?). Drug prices have been increasing rapidly at the same time that the cost per drug developed has been increasing even faster, and gene therapy/immunotherapy/RNA is unlikely to be cheaper (though it may cost less to develop). There seems to be cause for frustration. The current system is not sustainable – if it doesn’t break financially, it will be broken politically.

          AOC seems to get more stupidity imputed to her for the same (or lower) level of political grandstanding (Warren didn’t get it, for example, and she’s been around the block longer in a pharma-heavy state), and it’s not like the questions haven’t been asked repeatedly. Some of it is the frustrations above that people don’t like the answers to, but some questions need better answers and haven’t gotten them It seems unfair to call her names for asking the same questions that others have asked and gotten bad answers (when others of similar position do not – no one calls Steve King anything, for example, even when they should have).

  17. LD says:

    What about Bayh–Dole Act ? Whatever the rights they had before for invention funded by government money was given away to academia or non-profit. I don’t really see how Big Pharma is involved. Look at the CAR T-cell technology for example. Big pharma pays a hefty price. NIH should ask academia for money back

  18. LD says:

    Another comment. I am fresh from academia just joined the ranks of big pharma industry and I can clearly see why Kesselheim said this. There are different views on drug development in industry and academia. In industry the drug is a pill in a box, in academia the target discovery is already a drug and all the rest is just technicalities

    1. NANA says:

      … and it gets even worse when those academics become R&D leaders in industry and still think that way…

      1. cb says:

        Haha Prof Peter Kim from Harvard who created an empty pipeline for Merck 😉

        1. Old Timer says:

          Peter Kim was at MIT before Merck.

      2. a says:

        Prof Patrick Vallance who emptied out the GSK pipeline in order to buy Sirtris. I’d write ‘haha’ too, but I can’t find the humor.

  19. mjs says:

    We need a short course in drug development for politicians who want to make public statements about drug costs. The process, the success rate, the number of steps between a positive response in cultured cells and a drug on the shelf at the local pharmacy, the number of experts — PhD, MD, or equivalent experience — needed to carry out those steps. Text for the course from articles in C&E News and here, including the comment section here to give an idea of the range of opinion.

    1. Cb says:

      Please dont start that course with the sofosbuvir story where Gilead paid 11 billion for the small biotech Pharmasset and consequently had to ask a high price to make profit. Do we call the 11 billion dollars also R&D cost!?

      1. sort_of_knowledgeable says:

        You mention the other 99 small biotech stocks that received lots of funding and then died. The 11 Billion is paying for a lot of failed efforts before the final one succeed.

        1. Cb says:

          OK in this course we take the sofosbuvir example and explain the high cost of creating a real drug (after all, it even cures hepatitis). So the total cost for this drug was about 26.5 billion dollars and includes ca 0.5B for R&D at Pharmasset + 99 failures in biotech= ca 9B + acquisition cost= 11B + general research cost NIH/Univ= ca 5B. So the first 5y on the market you need at least 50 billion dollar sales to pay the cost, to run the big company, to pay the share holders and to do the next acquisition. I am sure they now understand………………….

      2. wbl says:

        How much did surgeons charge for liver transplants?

    2. MCS says:

      If your idea is extended to all of the subjects politicians comment on with zero knowledge, it would keep them busy enough to avoid all sorts of mischief. The alternative is to elect smarter politicians. One is about as likely as the other.

  20. ANonyMouse says:

    Grandstanding by the likes of Alexandria Ocasio-Cortez helps no one. Her level of mis-education and agenda-driven stupid questions is remarkable for someone who attended one of America’s supposed best universities. Ocasio-Cortez majored in international relations and economics at Boston University (ranked #42).

    1. SIlverlake Bodhisattva says:

      In comparison with someone who touts himself as having “gone to” Wharton, but thinks than foreign companies pay tariffs to the US government?

    2. Marcel Kincaid says:

      You’re the one grandstanding here.

  21. anonymous says:

    Isn’t this why Pharma pays lobbyists, so they can identify some credentialed scientist to go up on the stand to oppose this view and slant things to make it seem that drug companies are selfless machines whose only goals are to improve the quality of of lives of patients? Isn’t this the way that the political body has agreed the game will be played?

    I agree that this testimony is misleading, but as far as lies in Washington go, this exercise seems at least somewhat tethered to the truth. I think if anything more anger should be directed towards the “expert”. Politicians are not and will not become experts on drug discovery. Experts called for this topic should be. And cheap shots on public figures (looks, mental capacity, history) don’t make anyone look good

  22. abc says:

    Rather than criticize AOC – who, after all, has been in congress for less than a month, and could (and hopefully will) learn more about how stuff like drug discovery works over time – I think the criticism would be better directed at Kesselheim, who reinforced her misconceptions rather than debunking them. Next time Kesselheim testifies, he needs to have an earpiece, with Derek telling him what to say.

  23. tlp says:

    NIH gives a grant – discovery is made – handed over to pharma – pharma develops a drug – pharma makes profit and pays the income tax – (also people live longer/more productive and also pay more tax) – taxes fund NIH

    What is missing?

    Some quickly googled numbers: NIH budget for 2018 was $34.8 billion, which was about 8% of total spending on drugs in the US.

    1. Medi says:

      Nice. This take, combined with the two comments above (abc and anonymous), seems to be an appropriate reaction. Yes, there is data that shows how it all works. Yes, experts should be experts. No, in this case, he wasn’t.

  24. AcademicMedChem says:

    As a medicinal chemist in academia, I always try to stress the idea that our job is simply to derisk and inform a target as thoroughly and rigorously as possible before the target becomes a focus for industry groups. If we get lucky and our chemical matter turns out to be worth a try at a spin-off, then cool. But that isn’t the goal, and I’m glad it’s not since we do not have the resources to independently and routinely identify promising chemical matter. That is the goal of people like Derek in pharma, where a lot of recourses are spent on early stage chemical matter integrity. We can get pretty good molecules, which is no doubt highly important for learning about a target (e.g. selectivity). But, there’s a significant gap in what we do to get a good, tolerable, selective molecule into a rodent and what pharma does when facing down clinical trials.

    One small caveat, full of nuance, is in the area of neglected (many times tropical/foreign) diseases. Not usually orphan classified, no benefit to *most* Americans, no profit incentives for industry. NIH funded drug discovery in this area is not really an investment for Americans, but absolutely essential for improving health globally. Non-profit orgs are stepping up for the academic-to-clinic hand-off, but small impact overall. Really interesting segment, when viewed financially and with either a macro- or micro-economic tilt.

    1. John Wayne says:

      I agree. If you invented a flat out cure for malaria today, you wouldn’t get rich. When the market won’t motivate folks to do something about suffering, the government should step in.

      1. Chris Singleton says:

        Or leave some of that neglected disease work to non-profits. I have colleagues at the Broad who work in neglected diseases, and they are committed scientists who do excellent work.

  25. Jay says:

    I think it also is worth mentioning that, at least my company, we don’t trust any published data – everything has to be replicated in house before it is trusted and well over half of what we try and replicate either doesn’t work or has a much smaller effect than what we find.

    So, yes, industry does sometimes get some helpful basic research from academia, but it’s also mitigated somewhat by a lot of the time and money we waste trying to validate whatever the new hotness is in Cell or Nature.

    1. MrRogers says:

      My (academic) lab also validates key results, whether they be from industry or academia. We also commonly find results that seem to be overstated, however we also find that as we gain more experience with a technique or system, our results often move closer to those of the original authors. I’ve also found that sending people to the original labs helps in replication. There’s definitely a problem with overstated results, but there’s also a problem with labs lacking the necessary talent or experience to successfully replicate results.

    1. Derek Lowe says:

      Right you are. These folks have long since gained plenty of ability to value their contributions.

    2. Anonymous says:

      Sometime around 1975, Berson and Hayes, working at Harvard (MEEI), discovered that taurine is an essential amino acid for cats. Taurine deficiency leads to retinal degeneration and blindness. I think they worked out an MDR. (If you think that “herding cats” is tough, imagine what “herding blind cats” must be like.) They approached Harvard with the suggestion to patent the discovery but Harvard didn’t see anything in it. Doh! How many millions of cans and bags of cat food were subsequently formulated and sold with added taurine, royalty free? Harvard doesn’t do that anymore. If they could figure out a way, they would probably try to patent air or water. 🙂

      1. eub says:

        That’s an amazing story!

      2. loupgarous says:

        Another undergraduate and I approached Louisiana Tech’s University Research department about our idea to make intra-uterine devices (for contraception) from biocompatible shape-memory alloy, the idea being that engagement of the uterine cervix would be assured at body temperature as the shape-memory coil expanded, and when it came time to remove the coil, cold saline solution would cause the coil to retract from the uterine wall with less risk of damage or pain than retrieving the expanded coil.

        University Reseach told us at a meeting that they asked around and didn’t see any interest in the technology, and told us to run with it if we could get funding. Being undergraduates, and this being long before the Age of Elizabeth Holmes, we didn’t. Five years later, after i’d graduated and gone to work as a medical writer, I read that a team at Emory had gone with it. So it goes….

  26. mallam says:

    I find the singular focus on drug prices to be ridiculous.Especially since some novel medicines, as any diligent reader of this blog will know, transforms how diseases are treated. H2 antagonists did away with surgery for ulcers. HIV drugs have made AIDs a survivable disease. HepC medicines cure the essentially incurable. And more to come. Imagine what successful drugs for neurological diseases could do. Why not look into exaggerated hospital costs? $10 for a generic Tylenol? And it’s a recent phenomenon that it’s expected that MDs should become wealthy while supposedly doing good for their community. Drugs and drug companies are simple, easy targets within a complicated health care system that need reform in terms of access, education as well as cost.

    1. zero says:

      The singular focus on drug prices is because of the humanitarian crises of medical bankruptcy and rationing, which are often a direct result of drug prices.
      In our current system, cutting prices saves lives. That’s a powerful motivating factor and a particularly compelling story when we’re fresh off a federal shutdown and staring down another one shortly.

      I think just about everyone would like to have a better system, one where everyone can afford treatment and manufacturers can still be profitable. Public opinion has swung over to some form of public healthcare; if something like that does not happen soon there will be stop-gap bills that attack Pharma directly to score political points in what is looking to be an absolutely ruthless campaign season. Some people might be helped, but probably not in proportion to the damage done.

      It’s trivially easy to pick on the T*rings of the world and use them as leverage against the rest of the industry. Perhaps if that industry were to support a public option then the PR benefits of saving so many lives would help build some protection against attack bills. Lobbying isn’t going to cut it.

      Comprehensive reform negotiated with all the stakeholders will be difficult, but it’s the only way to stop senseless death without killing innovative businesses through reactionary or punitive terms.

  27. B(i)ased God says:

    I’d caution everyone to check their implicit biases in these situations. Many many MANY politicians have made these same oversimplifications over the years but Ocasio-Cortez definitely receives ire of a different magnitude than her white male predecessors. She will hopefully internalize some more of the nuance of drug discovery as she becomes more seasoned; however, do ask yourself whether you would be nearly as critical if someone like cocaine mitch made the same errors…

    1. Derek Lowe says:

      I would be happy to. In fact, I have called out men and women of all sorts on this exact error over the years – thus my unhappiness at seeing it coming up again.

    2. Anonymous says:

      I’d ask you to park the intersectionality-driven, explicit/implicit-bias-against-AOC b*llsh*t.

      AOC draws ire for a reason: she is exceedingly good at opening her mouth—over and over again—and allowing ill-informed or ill-thought-out or false words spill out. A few examples:

      “She grew up in a working-class household where her mother cleaned homes and everyone pitched in on the family business [her father’s architectural firm, which won $10 million contracts from NYC]” That “working-class” household lived in leafy Yorktown Heights, NY, not the Bronx, all of AOC’s school years.

      “Unemployment is low because everyone has two jobs… Unemployment is low because people are working 60, 70, 80 hours a week and can barely feed their kids.” Washington Post: 100% wrong.

      “What people are starting to see, at least in the occupation of Palestine, is just an increasing crisis of humanitarian condition.” When asked by the interviewer to explain her term “occupation,” AOC replied “I am not the expert on geopolitics on this issue [Israel].”

      “People often say, how are you gonna pay for it? And I find the question so puzzling because, how do you pay for something that’s more affordable? How do you pay for cheaper rent? How do you pay for—you just pay for it.” AOC was referring to Medicare for all, which the Mercatus Center at George Mason University has shown would cost more than $32.6 trillion over 10 years, requiring historic tax hikes.

      “Just last year we gave the military a $700 billion dollar budget increase, which they didn’t even ask for.” False (increase $32B; $700B was exactly what DoD requested).

      “So ICE is required to fill 34,000 beds with detainees every single night and that number has only been increasing since 2009.” ICE is required to *make* ~34k beds available—not to fill them. AOC inversion sort of turns the reality on its head, doesn’t it?

      Stupid is as stupid does. The Constitution allows for Representatives to be as young as 25 years old. AOC may be young and inexperienced, but I’ve seen a whole lot of 25 (and 29) year old much less stupid, and just as “visionary,” as AOC.

      1. Anonymous says:

        Re: “How do you pay for—you just pay for it.” AOC was referring to Medicare for all,” — In the articles I first read about that, I thought I knew what she meant immediately. I don’t know if this is AOC’s explanation, but as I see it: Collectively, we currently spend almost $4T per year on health care. “How do we pay ($4T) for it?” Lots of complicated, convoluted, sometimes inefficient or insufficient ways, including private health insurance plans, sometimes bankrupting out of pocket co-pays, etc., but that $4T is there already. What I heard (NOT her words!) was, “Collect and distribute that exact same $4T per year but do it differently (tax it IN, Medicare-for-All it OUT) and you will SAVE money.” (Using your George Mason numbers $32.6T / 10 = $3.26T, is a savings of around 4 – 3.26 = $740B per year.) Some businesses will no longer have to provide health care benefits but will pay a higher business tax, so it could be a wash for them.

        I also liked her comparative (and combative) rebuttal about things like Space Force: Someone proposes Space Force and no one asks them how are you going to pay for it but you ask me about paying for Medicare-for-All?

        When politicians speak to their base, they can say ANYTHING and get approval. AOC can say to her base, “you just pay for it!” and not have to justify anything about it over the cheers and applause. (Yes, I can easily come up with preposterous proposals and promises from the other side of the aisle, too.) To sway OTHERS to her position(s), she will have to provide stronger, more convincing, validated arguments. I think she will make mistakes and that she will learn.

      2. Marcel Kincaid says:

        ‘I’d ask you to park the intersectionality-driven, explicit/implicit-bias-against-AOC b*llsh*t.”

        The BS is all yours, anonymous right wing mudslinging coward.

  28. anon the II says:

    My sense is that the simpler thing to do is to look at the stock performance of big pharma over the last 20 years. It really kind of sucks. If these guys are gouging us, then where is the money going?

    I know, one injection costs $10,000 and they’re not making money. Kitty vids and search are free and they’re making multi-billions. It’s complicated. You don’t make money the same way these days.

  29. anon3 says:

    My postdoc advisor made a lot of money on a patent. The school got half, he got the other half. All the work was done by postdocs via NIH grants (and none of the postdocs were put on the patent). Its actually pretty reasonable for the NIH to get a cut of that patent money. If the school gets a cut, why shouldn’t the NIH?

    1. easymoney says:

      The NIH does get a cut indirectly . . .it’s called taxes.

    2. Academic says:

      “Doing the work” does not make one an inventor. Now if the students/post-docs co-conceived of the ideas with the professor, they should be inventors and excluding them should invalidate the patent.This is patents 101. From what you presented thus far, it only seems fair the professor got his share. Too bad he didn’t get 100%.

  30. Watson says:

    What we get in return for our investment is job opportunities and initial training for the next generation of scientists.

    People are a resource, and in my mind, that’s one thing that is lost in these discussions.

  31. Anonymous says:

    (There are several people posting as “Anonymous” or “anonymous”. Somehow, sciencemag.org attached an avatar of someone in a red shirt to me based on IP address or something. Another anonymous has a leopard or cheetah avatar.)

    I think I read most of the replies. Some of my points.
    1a. There are multiple sides to every story. Derek linked to the old Pipeline on Lyrica. Silverman’s academic lab made pregabalin and it was active … but for the “wrong” (“rational drug design”) reasons. It was my understanding that the Parke-Davis scientists who figured out the correct pathway and eventually bought into the program. They also tried lots more compounds, probably to get around any composition of matter IP 🙂 but pregabalin was still the best. NIH money produced the basic tech. Private P-D money added to it (and tried to get around it). I know where I want to look for more examples (from both directions) but I don’t have good lit access.
    1b. The entirety of molecular biology came out of NIH funded academic research (Boyer, Cohen, Berg)!! Oh, wait, no it didn’t. There is more than one way to tell the story. PCR came out of Cetus, and so many other breakthroughs came from BOTH sides of the aisle (to use a political analogy).
    1c. HPLC: Private development at Waters, academic research at ETH (Swiss money, not US money). NMR: academic and industrial. “Biacore” is almost genericized (like kleenex for tissue) for Surface Plasmon Resonance. It came out of Swedish academia (Swedish money, not US money) and is now a COMMERCIAL cog in academic AND industrial drug discovery research. Add dozens more examples, as you like.

    2. In recent days, In The Pipeline has mentioned academic AND industry research on (a) Alzheimer’s (b) gene therapy (c) immunotherapy (d) stem cell therapy (e) molecular medicine … (and Alfred Bader and Leo Paquette) … It’s not a two-way street, it’s a clogged highway with everyone going in the same general direction to “find a cure”. Sometimes it’s directed to expanding essential knowledge, sometimes it’s product-as-the-sole-goal directed. (Sometimes it’s running off the road into a ditch, as in recent amyloid results.)

    3. Someone mentioned tenured profs having security and “their salaries aren’t much lower than industry”????? I think that at the top unis (Boston, NYC, San Francisco, San Diego, LA, Big Texas centers [KC Nicolaou’s big move to Rice; others) tenured profs 9-month salaries alone are WAY above industry salaries. And that doesn’t include summer salaries, consulting, etc..

    4. Someone else mentioned the separation of academic and industrial research. It has been mentioned In The Pipeline several times that some profs operate their academic (NIH funded) labs as research arms of their privately funded biotech ventures, probably illegally. Meanwhile, they are also double dipping by getting paid by the biotech for their service on the Board, Advisory Committee, etc.. (I knew of a biotech paying a Prof approx 3x the salary of the PhD research scientists (52×5 = 250+ days per year) for 10 days (max) of consulting per year. They wanted the name on their webpage and other media.)

    5. Someone mentioned that grad students and post-docs do not receive any of the big money. Quite true. In The Pipeline has covered some examples of that, too, such as the student vs uni lawsuits in the Boston area about some IP related to antibiotic research. Historically, it probably goes back to the days of the medieval Guilds. It came to further light with more recent stories of the discovery of insulin (Nobel: Banting and McLeod, Best got screwed) or the discovery of streptomycin (Nobel: Waksman, downplaying the role of Schatz) and others. In the recent Paquette thread, Golob’s singular discovery of the anionic oxy-Cope is known as work of Evans (and more work, years later, by Paquette). Politically, this sort of gets back to AOC and some of her views on the income and wealth gaps. PhDs can go into industry for a few years and find themselves used up, squeezed dry (as Carlo Rubbia used to say about junior physicists), and out on the street.

    The NIH funds lots of basic research and sometimes gets close to an actual product but “final drug product” is NOT their mission. The NIH basic research opens up and spearheads areas of research that private enterprise might not otherwise have touched. But SOME industrial drug research IS very basic or fundamental. (Dare I mention the private Carlsberg Laboratory in Denmark? It was founded in 1875 to do FUNDAMENTAL research to understand biochemistry, yeast, and brewing. (They also provided funding to Niels Bohr!) Bell Labs was established ~1880 to do basic research (on telephony, not drugs or bio). Roche established Roche Institute of Mol Bio which was supposed to be for basic research and independent from Roche meddling. Ciba established the Woodward Res Inst for RBW to play in. And others.)

    I seem to be rambling.) NIH funds a lot of stuff that CAN be considered to be essential to the creation of an FDA approved drug. Industry does a lot of basic research on the way to bringing a drug to market. Is the current system (taxpayers benefiting from taxes on big DrugCo profits, fewer (not lower!) hospital costs to society, better QoL, etc., etc.) enough or should it be modified in some way?

    I seem to have run out of space or I’d express an opinio

  32. Bohdan Oryshkevich, MD, MPH says:

    If one looks at the development of very young soccer players in Europe, the academy that develops the child then teenage player benefits from any subsequent transfer fee from team to team the player may be part of.

    Early discovery has its costs also. So, in the profitable development or sale of a pharmaceutical product there could and should should be some formula for compensating the NIH, the NSF, or even the academic institution for the early development.

    In the development of me too drugs the formula could be more strict.

  33. Sisyphus says:

    Dr. Kesselheim’s answer is not exactly correct. When a company is formed, that company will pay a corporate tax and property tax and the employees will pay income tax as well as property tax. This has the effect of filling the federal, state and local coffers with moneys for schools, roads, services, etc. This is the same reason for every jobs stimulus package that has ever been proposed. If the scientific knowledge discovered with federal moneys is framed as a jobs creation program and not a profiteering company then it might be better understood by AOC. In addtional, Dr. K is not an economist so the question is a bit misguided from the beginning anyway.

    In addition, there are significant non-monetary benefits that result in improved health of the general population and increased standard of living when successful medicines make it to market. It is actually right there in the preamble to the US Constitution (general welfare clause):

    We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, PROMOTE THE GENERAL WELFARE, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

    But I doubt AOC has time for dusty old documents when there are tweets to be sent and Youtube videos to be uploaded!

  34. Levorotatory says:

    At least she is the rare politician with her heart in the right place: trying to help regular folks get the medications they need without going bankrupt, unlike most of the bought-and-paid-for politicians in our best government that money can buy. Think about it.

    1. Sisyphus says:

      There was a guy in a once prosperous Venezuela named Hugo Chavez. Well, one day he decided he wanted to help the poor…

  35. Levorotatory says:

    There was a guy in a once prosperous USA named FDR. Well, one day he decided he wanted to help the poor…rules, regulations, laws, and policies that led to robust economic growth and much more broadly shared prosperity than the world had ever seen.

    1. Sisyphus says:

      Unbiased evaluation of FDR’s policies suggest that the Great Depression was actually prolonged by his programs. Only the massive stimulus of War spending (with associated federal debt) broke the extended economic malaise. FDR basically was a jobs for federal debt Keynesian. Sure he could create jobs as long as money could be borrowed, but taken too far and hyperinflation kicks in and then we get today’s Venezuela. Luckily, the US could handle the New Deal & War spending at the time to break the Depression and not trigger hyperinflation.

      AOC has already stated that she will support her health plan by running the monetary printing presses, though it was hidden amongst many pages of other leftist re-invention.

      I respect the efforts of FDR when our nation needed leadership.

      AOC is no FDR.

      1. Levorotatory says:

        FDR-enacted rules, regulations, laws, and progressive policies far outlasted his Presidency and subsequent additions and enhancements by Truman created the large middle class of the 40’s, 50’s, 60’s, and 70’s that we have been slowly destroying over the past several decades with supply-side economics and unfair globalization designed to favor corporations, the wealthy, and well-connected. Most regular folks have had enough. The times they are a’changin’…

      2. Marcel Kincaid says:

        “Unbiased evaluation”

        LOL. Labeling your opinions as such should be enough for everyone to put you on permanent ignore.

  36. SuperEntitledMillenial says:

    While Kesselheim was the expert in this case, somehow AOC got all the blame for something he agreed with. It’s like saying drugs exist solely due to the early investment of NIH.. oh wait…

    That aside, it’s obvious from this exchange that the general public (even some academics) does not understand how drug development work, despite the effort of Lowe et al. Should we fix that? If yes, how? Oh and calling all biologists stupid is not a solution.

  37. Georgey Tenety says:

    Perhaps all moot, with the withdrawal from the nuclear INF

  38. RTW says:

    One area that hasn’t been pointed out is where all those evil profits go from these high priced drugs. Most of the discussion has pointed to the costs of doing research marketing (really a small amount compared to the R&D cost) and clinical trials (The really expensive part). What few people forget that besides development of drugs to ward off death and give one a relatively healthy life despite ones personal behaviors (Bacon, cigarettes, no excise and a poor diet) people also benefit financially in two ways – 1) you are able to work longer and perhaps retire healthy. and 2) You most likely have some sort of pension, SS, or retirement plan. If you look at the institutional investments made by the organizations that manage these funds I think you will find that there is a substantial proportion invested in Large, Middle and Small cap Biotech and Pharma because they are generally good investments. Pharma companies are in the business of producing new treatments for disease because its profitable to do so, and the people that invest in these company’s Including the government (ie Social security) buy stock and hold it from these evil companies. What do you want – these Pharma companies to switch to selling Pizza??. Its a much easier business to be in. Yes there are pricing abuses from small one or two product companies that are in it just to make a killing, but the majority of Pharma/Biotech try to base their pricing in very complex models. The CEO just doesn’t pick a number out of the air.

    Another thing – Pharma does contribute back to academia and NIH and other government labs. They often make compound libraries available to these agencies. This represents a tremendous investment over the years. Probably an uncalculatable one. Yes they put restrictions on the use of these things compounds and often have agreements in place where if something comes out of screening the compound set they have rights to potential product leads. I remember that Parke Davis had a collaboration with Fort Detrick to send them compounds to test as anti-malarial drugs even though PD didn’t have a malaria program of its own. I believe we had a contract to synthesize some compounds for them and the NCI. So its not a one way street.

  39. Tim H. says:

    I don’t view AOC’s comments as particularly radical, our economy already exists in a balance between libertarian & socialist ideas, AOC wants to push it a little towards socialist, fairly conservative in comparison with Northern Europe. Like FDR, she seems to get that borrowing socialist ideas keeps the “Riff Raff” from talking about expropriation.

  40. Academic says:

    I think Derrick overly fixates on composition of matter and the final drug that is tested and sold by Pharma. I can name an endless number of core concepts which were wholly discovered by academics, with huge investment from NIH: siRNA was discovered by Fire, Mello and others, and now companies are making drugs based on this. CRISPR by Doudna, Charpentier, and others, now the source of huge investment. Immuno-oncology breakthrough concepts by Allison were funded by NIH again, and now jumped on by Pharma to convert into products that become huge money makers. A truly endless number of receptors were discovered by NIH-funded academics, and then drugged by Pharma. No one doubts that Pharma (not academia) is an expert in making drugs. But NIH did the core investments to make hundreds of proteins into drug targets and usually does not reap rewards. I agree with most of Derrick’s blog but his trashing of academia and its essential role in drug development process (not drug development itself) is quite annoying.

    I see it first hand — I am an academic who has started a VC-backed company and I can attest to how we scour NIH-funded research to get our ideas to choose the proper protein targets in our pathway for drugging and the best indications to go after. All those labs that generated the papers on which we are focusing our efforts get nothing. NIH will get nothing (all the useful IP is generated in our company). I am not saying that this is right or wrong. All I am saying is that it is a fact that NIH will get nothing, yet we use NIH-funded papers as the core of our company. If those papers did not exist, we would not have started this company, and the VC people (and perhaps myself) would not be getting rich off of this.

    1. Derek Lowe says:

      siRNA was a wonderful discovery. But the RNA-based therapeutics are nothing like natural RNA – a vast amount of time, effort, and money went into making variations of the natural nucleic acids that could survive long enough in the body to be therapeutics. Compare as well the number of companies that tried to get this to work versus the number that are still standing.

      Allison’s Nobel Prize for CTLA-4 was well deserved. And NeXstar licensed his patent (well, Berkeley’s) into order to develop what became Yervoy. Medarex took over NeXstar and made the actual monoclonal antibody, and then Bristol Myers-Squibb took them over in turn. Berkeley is receiving royalties.

      I most definitely am not trying to trash academia. As I’ve said, watching academics argue with pharma about who’s more important for biomedical research is like walking past a car and listening to the engine having a fight with the wheels.

      1. jim says:

        At the end of the day, commercial and top executives are just looking at this drinking champagne and telling themselves that they are the most important people to get drugs on the market and that’s why they are paid so much 🙂

        1. Anonymous says:

          I have read about Big Pharma CEOs who donated hundreds of millions of dollars of their personal wealth and get buildings and professorships named after them. Those million$ were acquired from the companies that they led (and sometimes destroyed 🙂 ). These are the same CEOs who laid off the researchers who actually discovered and developed the drugs that Fill The Pipeline that put the millions of dollars In Their Pockets.

          1. Jeffrey R Lowrie says:

            Sounds a lot like a Mit Romney,Bain Capital sorta thing. Kill the company after the big payout.

          2. Hap says:

            That’s more or less what happens with successful startups. I don’t know that it’s relevant to drug prices, but it seems to be the current mindset of pharma operation, and another way in which it is not sustainable.

    2. Anonymous says:

      “siRNA was discovered by Fire, Mello and others, and now companies are making drugs based on this.” – I was at a mini-symposium on RNAi sometime around 2002-2003 and it was mentioned (without refutation) that Merck scientists had put short strands of RNA into cells and observed what would now be considered to be the expected results. Those experiments pre-dated Jorgenson’s experiments in plants (~1990). They might have been inspired by Zamecnik’s anti-sense RNA (Harvard; then into industry) ideas from the 70s and 80s. But Merck did not pursue the observation at that time. (One anti-sense oligo, Eteplirsen, has been discussed In The Pipeline. It was FDA approved for Muscular Dystrophy despite questionable efficacy.

    3. Dr. No says:

      At the core it is about imbalance and inequality. Pharma maximizes its revenue at the infinitesimal second that seperates life from death, to paraphrase Steve Burrill. Pharma wouldn’t be in business if it couldn’t scoop up cheap knowledge and turn it into maximal expensive drugs. Which is why they loose interest as soon as their IP expires and generics take margins away, or if a TA doesn’t return, such as neurology. That said, your doctor and hospital also live of NIH funded insight to pay themselves handsomely and be part of the 1%. Why do doctors make 1 million plus unchallenged? So at the core we are back at income spread and imbalance not really only in pharma though.

  41. An Old Chemist says:

    Derek, you said “This fall I will (I hope) celebrate my 30th year of doing drug discovery research, and never once have I worked on a project where the chemical matter came from an academic lab.” FYI, Millennium pharmaceuticals (aka Medical Merlin Julian Adams drug discovery outlet) in-licensed salinosporamide-A from the labs of E, J. Corey at Harvard in 2003. Then, my previous company in-licensed an irreversible third generation EGFR inhibitor from the university of Auckland (lab of Jeff Smaill). Ron Breslow, at Columbia, discovered the Histone deacetylase inhibitor, SAHA (Vorinostat). And, E. C. Taylor discovered the multi-billion dollar chemotherapy drug Alimta (pemetrexed) for Eli Lilly. There must be many more…

    1. Barry says:

      And the first statin to market was brought in from academia with Roy Vagelos’ lab, I think. Made a pretty penny for Merck before a Lipitor claimed that sector.

      1. An Old Chemist says:

        Oh, I forgot to include the following drugs, in my previous post, and these drugs came 100 percent from academia. Arun Ghosh discovered ‘Darunavir’, and Dennis Liotta discovered a few HIV drugs.

    2. RTW says:

      Yes – I can add another one. Carboplatin came from Michigan State University. I worked with one of the inventors at PD in the late 1980’s He came to work for PD after leaving MSU. We worked on several Pt based anti-cancer drugs in collaboration with the University of VT. Still the vast majority, Its the Pharma company that does the heavy lifting most of the time. Jeff’s work is an extension of the PD/PFE work which was done in collaboration with the University of Auckland many years earlier. I applaud their interesting prodrug approach in an already crowded target area. But I am surprised that this particular chemical matter wasn’t covered by the many PD/PFE patents in the area, or those of competitors also working on EGFr inhibitors. They found a really nice patent hole to work in. They also have a good leg up as they benefit from what’s been done before and can design better clinical trials based on some of the failures of past ones. Lets face it second and third generation drugs often do well. Take Lipitor as an example. Very different chemical matter than what came before, but late to the market. Still much was learned and it became a very big block buster from a small to mid sized company making them into a Pharma juggernaut.

  42. Anonymous says:

    “the first statin to market” – Compactin was discovered at Beecham Pharm (UK; then Smith Kline Beecham, then GSK) and it was identical to ML-236B which was discovered earlier at Sankyo Co. (Japan; now Daiichi Sankyo). Merck then fished mevinolin (lovastatin, mevacor) out of a related fungal broth. Mevinolin = Lovastatin = Mevacor was the first approved statin. The target, HMG CoA Reductase, is a different story.

  43. John says:

    Using Occasional-Cortex’ logic everything that DARPA comes up with that finds its way into the military is unfairly enriching military-industrial complex companies. So when does she go after the $200M costs for a stealth fighter and try to recoup DARPA investment from Boeing, Raytheon, etc.?

    1. Marcel Kincaid says:

      “Occasional-Cortex”

      Grow up.

  44. yfp says:

    The reward should be proportional to the risk taken. Academia take risk to find knowledge and they are awarded with fame and tenure. Investors take risk in making drugs and they are awarded with financial gain. Compared to publishing a science paper, putting anti PD1 and anti CTLA-4 through human trial are huge financial risks for investors in drug companies. Medimmune’s anti CLTA-4 failed many trials despite the same mechanism of action. There is a long and risk journey from a scientific paper to a drug (BTW anti CTLA-4 from BMS only had minor effect in melanoma patients, in contrast the hype people ascribed to it). People should appreciate that. For any grievance from academia about the drug company, I suggest people invest their own money in BMS or Gilead to become an owner of the enterprise to see how they going to feel when their own money are threw to the endless failed clinical trials that was based on sound scientific papers.

  45. Alex says:

    Lots of links in this article!

    Any links to where you call on other elected officials to have more knowledge in fields outside their own?

    Or is AOC special for some reason?

    1. Virgil says:

      Errr, no because this is not a political blog, its a drug development blog, so when politicians wander over into this territory, damn right they get singled out for scrutiny! While your narrative goes along with AOC’s recent twitter comments on “this is what it’s like be a woman in politics”, it’s not founded in facts. Derek is an expert and used his expertise to address AOC regarding factual errors in her narrative. If that makes someone a sexist then I guess we’re all screwed!

  46. Marcel Kincaid says:

    https://twitter.com/AOC/status/1092612682849624064

    “This is what being a woman in politics looks like: Disagreements aren’t labeled as differing opinions. They’re labeled as one’s knowledge being ‘inadequate.’ As a reminder, I’m not the one who testified about Big Pharma under oath to Congress. It was an expert witness.”

    1. Design Monkey says:

      That’s what being politician is: lying all the time. She’s not discriminated for her gender, she is criticized for her incompetence. Any guy in her place would get the same treatment. She is pulling false victim act. That stinks.

      1. chemist says:

        This is how everyone in the Democratic party acts. They have no policy platform besides “everyone’s a victim”

        1. Hap says:

          The current Republican platform seems to be “Everyone (except us) should be a victim. Let’s get working on that” or maybe “What would Cthulhu do?”. With that , it’s kind of cute to suggest that others should have them.

          1. Hap says:

            “them” = principles.

          2. chemist says:

            No, the current Republican (or Trump, rather) platform is that America comes first. If you don’t feel that way, please kindly deport yourself.

          3. Hap says:

            I assume your party’s full motto is actually “America first….we’ll screw up the rest of the world later”, or more likely (considering the varieties of its collaborations and dalliances) “Russia first”. An alternative statement considering its achievements would be “America(‘s White Rich) First”, though I imagine that would be a little too honest (and would thus completely exhaust any remains of honesty the party might possess).

        2. Design Monkey says:

          This was about stupidity of a specific person. However, if so called “chemist” wants sweeping statements, then republicans are not only idiots, but also a half baked Nazis. And their little Hitler-trump should be tried in Nuremberg and hanged.

          And that “America first” has absolutely the same type of stink that “Deutschland uber alles” had.

  47. Jorge Serrano says:

    Con el dinero baila el perro.

  48. Carla says:

    thanks for the interesting information.
    Can someone explain to me the purpose of those hearings if it is not to educate those in power?
    If I understood your post correctly, Mr Kesselheim should have known all this, right?
    So he should have said, that the issue isn’t so clear cut, right? (instead of simply agreeing with the voiced preconceptions)
    If those hearings are not about answering questions for a better understanding, then why have them at all?
    Sure, it would be great, if every politician would be able to put the time in to inform themselves in depth about every topic that comes across their desks, but I personally don’t see this happening. So, they have to trust people like Mr Kesselheim, to give then the facts and further understanding on a topic, right?

    1. Anonymous says:

      Carla wrote: “So he should have said, that the issue isn’t so clear cut, right?” — Whenever I read about Congressional testimony, I get the impression that the Inquisitors (Representatives and Senators) want black/white yes/no answers. They do not like (and will sometimes attack) wishy-washy it-depends answers. (“Well, which is it, Dr Smartypants? Yes or No? You don’t know! Do you? And you call yourself an expert! Get out and never darken these halls again!”)

      In general, scientists are able to accept ambiguity (and design better experiments to resolve it); politicians, not so much. I think that some witnesses are chosen because of their ability to simplify complex subjects and provide the yes/no answers that Congressmen want. (Anyone here ever testify before Congress? How was it?)

      I can’t find a complete, clear list of scientists in the 116th Congress, but here’s a start (also linked in my handle): http://www.businessinsider.com/ new-scientists-in-congress- senate-house-of -representatives-2019-1

      Also, not all of those with a trace of STEM background actually work or think like a scientist. (Some MDs may be excellent care givers or surgeons but that doesn’t mean that they understand where the drugs they prescribe come from, the topic of this Pipeline thread.)

  49. CR says:

    Derek:

    You are better than this statement: “This fall I will (I hope) celebrate my 30th year of doing drug discovery research, and never once have I worked on a project where the chemical matter came from an academic lab.”

    This is anecdotal. You’d be the first to slam a lay person that made such a statement.

    1. CMCguy says:

      CR Derek is better than that as believe simply relating the experience of I would guess probably >90% of the med chemists in never directly working working on a compound where the complete structure came out of an academic lab (making those who have anecdotal). I am one who has encountered such a project and even with a defined compound we had to go back and fill in major gaps because data needed to publish does not cover what is required for an IND and of course the chemistry route was no where close to process friendly (however this can also be said of some med chem groups I have worked with as well).

      Many factors are at play why most companies avoid acquisitions of chemical matter even with sound biology data, beyond (a former) inherent prejudice to focus on internal efforts to make and evaluate compounds, there is frequent huge resistance to deal with unrealistic expectations of Univ. Tech Transfer Departments.

      1. CR says:

        Sorry, trying to make the case that it doesn’t happen because you haven’t seen it is simply anecdotal evidence. The same argument that gets trashed on this site (and for good reason). I just expected a bit more from Dr. Lowe.

        1. sort_of_knowledgeable says:

          Derek wasn’t just giving anecdotal evidence that because he hasn’t seen it doesn’t happen He was saying that the data shows it doesn’t usually happen, and that his experience was in accordance with statistics.

          The full quote

          “I’m not saying that there are no drugs that have been born in academic labs, of course – there certainly have been (for a look at one, try Lyrica/pregabalin). But as one of those links details (in an analysis of the 1998-2007 period), such drugs are definitely a minority. This fall I will (I hope) celebrate my 30th year of doing drug discovery research, and never once have I worked on a project where the chemical matter came from an academic lab.”

  50. Tim says:

    Isn’t there a movement in academia to publish the methodology first and then later publish the results regardless of what the experiment finds? A lot of people are talking about how the economic realities of grad student research jobs create an incentive to publish results that are difficult to reproduce. Why not publish the methodology before conducting the experiment and open source the raw data (prior to any curating)?

  51. Bobsyouruncle says:

    So whose head to we put in the guillotine? What is his name?

  52. Joe F. says:

    Taxpayers are always entitled to know what they are getting in return for their hard-earned dollars. Even the most uneducated tax payers have a right to know how government is spending their money. “Taxation without representation (ROI) is tyranny.” Sounds dramatic, I know. However, it is the entire reason the US exists. AOC, and all elected officials really should be holding themselves accountable by revealing how and where tax dollars are being spent.

  53. Sam says:

    I see strawman, I see moving the goalpost, but I still don’t see where you are contradicting her.

    1. Hap says:

      Most of the costs of drugs comes from trials, not from finding drugs. NIH funds initial R+D (they’ve done translational research, but I don’t think it’s going so well), and the amount of R+D they pay for is not most of what is required to make drugs. Their R+D finds biology and chemistry to be used in finding more drugs and potential sources for drugs – they fund the development of tools to make drugs. A few drugs (as noted above, and Taxol?) have been developed more directly from government-funded research, but even in those cases required lots of private money to get through trials – to make the drug candidate into a working drug (to prove that it works and to make it consistently in a form that works). As the expert should have known. NIH does get money back occasionally from drugs, but not often, even less often, I think , then they find one.

      It doesn’t appear that the goalposts are moving. If you want to work on drug prices, NIH funding is probably not the correct target, because the NIH doesn’t fund them (mostly), and when it does, there is already a mechanism to get money back or mandate availability when they aren’t available or punitively priced.

  54. Henry says:

    NIH continues to dump a lot of money into research training, when the future remains insecure in the grant system. With three-fourths of research being unreproducible, it seems that Pharma has decided not to waste millions of dollars a day waiting for academia and would rather make its mistakes in-house. If more institutions are sharing royalty income, fewer scientists (esp. PhDs) are likely to apply for risky and time-consuming NIH grants with their best ideas.

  55. Anonymous says:

    Henry wrote, “… money into research training … With three-fourths of research being unreproducible, …” — It can be valuable training to try to reproduce prior results. Maybe part of the REQUIRED training should be to check recently published papers. It could be part of the lab rotation for first years or part of the final year pre-thesis write-up. It need not be a publication, just an internal report to be submitted to the funding agency. “You gladly accepted funding from us for 4+ years, so you owe us 4-8 weeks to check this paper. And you don’t know how many trainees have been asked to check this paper, so you better not cut corners or you’ll be complicit if there’s a problem and you say there isn’t.”

  56. T says:

    Those links are interesting, and one kindoff touches on this point, but has anyone looked at approved drugs over the past x years, and instead of noting their origin (pure industry, industry via biotech, industry via biotech via academia), counted the percentage of the overall development costs spent by industry, biotech, and academia (where applicable). E.g. If drug A was a pure industry drug, its 100 % to industry, but if drug B came through the academia-biotech-industry route, how much did each of those three pay during its development. Given the huge cost of trials, I would imagine that even for that route, the investment costs are overwhelmingly weighted towards the final pharma company? This might most clearly illuminate the issue?

  57. Schrodinger's Cat says:

    No one ever accused AOC of being intelligent. She just runs her mouth and promises things that can’t be delivered, while cashing in $200k. Maybe we should reserve that kind of money for intelligent scientists who deserve rather than a loud mouth millennial who sucks.

  58. Heather S. Duffy JD PhD says:

    As an Academic that made it up to the Prof level and then left to go in to start-up biotech I can say that we need both. We need the initial pathway ID etc that is mostly done at academic labs but the reason I left academia was that I was tired of watching cures for diseases in mice that never got translated to help patients. I don’t care if you can cure heart failure in mice, show me it works in people! Start-up biotech is absolutely vital to take those early discoveries and make them in to something for patients OR to find out that it only works in mice. We need investment from the NIH for the first steps and then from Angels and VCs at the second step. The third step is to sell up to a big Pharma that can afford to do clinical trials. I love AOC but her saying that NIH money is paying for drug development shows her need for an adviser that actually works in the business……. I’m available!

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