“Everybody’s restless, and they’ve got no place to go
Someone’s always trying to tell them something
they already know,
So their anger and resentment grow”
—Warren Zevon, Mohammed’s Radio
I have one of those modest proposals for those of us who write about the drug discovery business. I realize that I may be about to kill someone’s business model here, but please: can we declare a moratorium on articles with titles like “The Productivity Crisis of Pharmaceutical R&D”? All of you journal editors, all of you pharma-business magazine types: you know in your hearts that it’s time to stop.
Don’t get me wrong; I’m not trying to deny that there’s a crisis. Watching some of the companies in this business has been like watching a sharp, clear, thousand-frames-per-second video of a fast car steering into a muddy ditch. A muddy ditch full of water moccasins, with . . . no, I’ll stop. But naming that crisis, even in elaborate detail, is only the first — and smallest — step in doing something about it. By now I think that we can assume that the first box on the form has been thoroughly checked off. It’s been clear for at least 10 years that we’ve got big problems, so anyone who hasn’t heard by now is probably not someone who’s going to be a lot of help.
And yes, I know that I’ve been as guilty as anyone else in this regard. But as of this moment, I’m publicly reformed: you won’t see any more of those pieces from me. In my defense, at least I generally kept myself under a decent word count when I went on in that fashion. I think that it’s been some of the longer articles of this sort that have pushed me over the edge. The problem with all of them is that they spend their entire time going over the difficulties we already know about and pointing out the issues that we can already point to ourselves. Then, after this long, elaborate windup, there’s no pitch. Right when everyone gets to the point when it’s time to suggest courses of action, the articles conveniently end.
From one perspective, who could blame the authors? After all, proposing solutions is the hard part, and if your editor will let you wind things up before then, why break a sweat? But while the first run of these oh-dear-we’re-in-trouble articles could get away with that, by now the routine is getting pretty stale. You can see the writers edging toward the open door, fingering the release tabs on their parachutes, ready to bail after a couple of hasty concluding paragraphs. You know that they’re going to do it, and they certainly know that they’re going to do it, so why do we keep going through the same motions?
What’s even more irritating, actually, is when those concluding paragraphs try to come off as presenting real solutions, but are instead full of helpful hot air. I actually prefer a hasty exit to someone hanging around just to snow me. “We must re-invent our R&D process,” they tell us. Gosh, thanks! And while we’re on the subject, I’ve been meaning for some time to grow antlers and become a moose myself. It’s right here on my Stretch Goals form. But just how are you going to re-invent the whole R&D endeavor, and just how am I going to break into that lucrative moose market, eh? “We must find ways to reduce our clinical failure rates,” do we? Well, no organic fertilizer, world-famous detective! There are billions of dollars out there waiting to be scooped up by the first outfit that can find a way to do that, and the fact that all that cash is still sitting out there in sun probably means that it’s pretty hard to get to it.
That brings up a fair criticism of my perhaps not-so-fair criticism: anyone who has such ideas is not going to unload them in an opinion piece for free. If I had a serious idea about how to reduce clinical attrition rates, I’d be out there trying to get it to work, not gassing on to everyone within earshot about how we need to be doing it. So no, I don’t really expect to find the key to fixing the drug industry in someone’s editorial piece. But if they’re telling us things that we’ve already heard, and they’re not going to tell us anything that we haven’t, then why are we reading (or writing) these things?
Now I’ve come to the point in this piece where it’s time for me to suggest something constructive, which serves me right. One way I can think of turning the woe-is-us article into something that might be useful is to insist on more facts and more history, and less hand wringing. It’s one thing to go on about how mergers haven’t done what they were supposed to (and I certainly have gone on about that a few times), but it’s another to actually show the productivity numbers (as Bernard Munos and others have done) that prove the point. After all, we’re scientists, and we’re supposed to respect data.
Another sort of article that would be truly worth reading would be an honest account of what various companies have tried over the years. Think about your own experiences — the reorganizations and reworkings that you’ve seen. Splitting up the therapeutics teams, then re-combining them. Flattening the organization, then bulking it up again. Closing sites and moving everyone, versus just buying some outfit and not messing with it (well, OK, that last one doesn’t happen all that often, but you get the idea).
There are companies that have tried all these things, sometimes all of them right in a row, with several going on at the same time. I don’t suppose anyone from one of the big companies is going to be able to tell the story of all the things that have been tried and found wanting, and what might have gone wrong with them along the way, but I’d certainly want to read it. It might at least slow down some executive types somewhere else while they’re deciding on the New Big Plan to Fix Things.
And that brings me to the point where I’m supposed to look into the future. I can’t do any better than to bring up G. K. Chesterton’s game that he called “Cheat the Prophet.” As he put it, humanity has been playing it forever, and here’s how it works: everyone gathers around and listens to the wise sages and seers talk about what’s going to happen. Once the wisdom has been handed down, the crowd nods, smiles, and goes off and does something different. Simple, but amusing.
I don’t expect us to be able to resist a good round of Cheat the Prophet, either. So how are we going to be doing R&D in another 10 or 20 years? In some way that’s truly different than the way we do it now, and I’m not going to commit myself any further (or pretend that I can). Our current model hasn’t really been working, not for a while now. Something else is going to replace it, and that’s all I can be sure of.
Derek B. Lowe has been employed since 1989 in pharmaceutical drug discovery in several therapeutic areas. His blog, In the Pipeline, is located at http://www.corante.com/pipeline and is an awfully good read. He can be reached at email@example.com.