From the Editor
What if …
A drug company’s New Year’s resolutions.
Might it resolve to spend far more money on innovative research and development than on marketing?
Making New Year’s resolutions is a time-honored tradition. Whether we resolve to lose a few pounds, exercise regularly, or quit a harmful habit, we all partake in self-improvement as the new year dawns.
What would a large corporation resolve to do in the new year? We can only imagine, but a corporation that discovers and manufactures CNS pharmaceuticals might resolve to:
1. Test new drugs in patients who resemble “real world” patients, not just in patients with no medical problems, no substance abuse, and no history of treatment resistance.
2. Develop drugs with new mechanisms, not just another “me too” agent.
3. Publish all data (positive and negative), not just favorable results.
4. Develop drugs for children, rather than following the tradition of developing drugs for adults and then waiting many years (during which practitioners use those drugs off-label in children) before finally conducting trials to secure FDA approval of pediatric indications.
5. Conduct studies to guide practitioners about the safety of new drugs in pregnant women with mental illness.
6. Spend far more money on innovative research and development than on marketing.
7. Kick the habit of direct-to-consumer marketing, so that physicians can prescribe the best agent in their clinical judgment, not the drug the patient demands because she saw it on TV.
8. Accelerate the discovery of pharmacogenomic biomarkers to help match drug and patient, maximize efficacy, and minimize serious side effects.
9. Be more transparent about the fact that many clinical trials are being conducted in developing countries because U.S.-based trials have become too expensive and pose other “disadvantages” (such as a higher placebo response rate and more side effect complaints).
10. Establish mutually beneficial partnerships with the National Institutes of Health and academic research institutes to translate neurobiological discoveries into new and physiology-driven pharmacotherapeutic interventions.
11. Pool grants with competitors so that continuing medical education (CME) programs are no longer sponsored by a single company and are designed without real or perceived influence by an industry sponsor.
12. Better inform the public about the pharmaceutical industry’s positive aspects, such as being the only U.S. industry that: a) develops new medications for disabling psychiatric disorders; b) donates billions of dollars worth of drug samples to indigent or uninsured community patients; and c) provides hundreds of thousands of well-paying jobs for scientists, managers, and sales representatives.
13. Remind the world that hundreds of disabling and fatal diseases still have no available treatments, and a huge financial investment and years of basic and clinic research are needed to discover the needed treatments for them.
14. Justify the high cost of new drugs by demonstrating how profits are ploughed into discovering new drugs (in other words, show convincingly that the pharmaceutical industry works for the public good, not just for shareholders).
15. Stop buying lunches for doctors who attend speaker programs, and instead make donations to their designated charities.
I cannot vouch that this fictional account of a pharmaceutical company’s New Year’s resolutions reflects reality. But if it does, I wonder if such resolutions—like those of almost all of us—would falter soon after the new year starts… .