In my ongoing effort to remember what I have read, some notes on The Drug Hunters: The Improbable Quest to Discover New Medicines; Donald R. Kirsch, Ogi Ogas.

The popular media portrays pharmaceutical companies as fat cats scheming to make the most money from those unfortunate enough to require their product.  While there are some cases of this, drug companies are better compared to gold-prospectors who find enough mineral wealth to pay the bills with the occasional strike-it-rich dream to keep them motivated.

Tile Mosaic – Graz Austria

The Next Big Thing Challenge

New drugs are very difficult to find and bring to market.  By one estimate, only 1 in 20 (5%) of all projects are funded by a pharmaceutical firm. Of these funded, only 1 in 50 yields a drug.  In other words, if a drug prospector has an idea for a cure, there is only a 0.1% chance it will become commercially viable.  Drug companies spend most of their effort on creating copy-cat drugs of those already approved.  For original research, the focus is on drugs treating chronic conditions in which the medication needs to be taken for months, years or decades.  A quick cure is a bad business model if your return on investment chances are less than 0.1%

The Drug Eras

Kirsh breaks drug hunting into a series of time frames, the earliest being simple trial, error and superstition from our early ancestor days.  Botanical origins trace the role the emerging fields of science had on identifying plants that could cure disease.  Industrial and Synthetic eras continue the use of science to better hone drug finding. 

Mostly Art Supported by Science

Kirsh is an insider with a sympathetic view (mostly) of the drug industry and thus makes a good commentator.  He provides some excellent examples of both well-known discovery stories (penicillin, quinine for malaria) and those less well known (the birth control pill and a cure for syphilis). 

The conclusion of the book is that drug research is not an engineering process (although copying an existing drug to create a copy cat is pill is) it relies more on luck and artistic merit; it is akin to knowing how to develop a block buster movie:

“…drug companies can never be sure that they will get a drug that works the way they hope it will.  The reason is as simple as it is profound: there still are no clear scientific laws, engineering principles, or mathematical formulae that can guide an aspiring drug hunter all the way from idea to product… The thing about trial and error is that if you keep on trying and keep on being willing to make errors, eventually you will find something that works. …Big Pharma must price their few successful drugs to cover the immense costs from their myriad unsuccessful drugs.”

 A good read for those interested in history, business, medicine or how did that pill get to the bottle in your bathroom.