Drug discovery, as imagined by someone who writes ad copy for a living: “Here at MegaPharm, we’re committed to making lives better. That’s why we spent half a billion dollars last year on research into cancer, Alzheimer’s, diabetes, and heart disease. And our scientists won’t give up until they’ve discovered the cures. MegaPharm: where tomorrow can’t come fast enough.”

You can fill in the accompanying visuals: photogenic lab-coated scientist holding up a flask, shot of someone using a multiwell pipetter, that sort of thing. So what’s not to like? Well, several things, and let’s take them in order. First off, if we can speak frankly, good ol’ MegaPharm is only committed to making lives better insofar as it can make money doing so. No company ever really loses sight of this objective, or at least they’d better not. And given the way that human nature operates, that’s probably the way it should be, since that incentive will tend to provide the best chance of a real benefit actually coming out the other end of the MegaPharm pipeline.

Admittedly, a tag line of “. . . committed to turning a buck” doesn’t give quite the same warm glow, but if you’re a shareholder this sort of emphasis should at least cross your mind. The unstated assumption that connects these two worldviews is that if a company really can make lives better, then it will be able to provide this service in exchange for money. Another unstated corollary is that people should in turn expect to pay for such things should they become available, and should not then be taken by surprise when a bill is presented. No one likes having it put in such terms, but those are the real ones. The notion that the only thing that gets MegaPharm moving in the morning is the prospect of brightening someone’s day is (at best) a happy fiction.

Now let’s get to that half a billion dollars. Even if they didn’t think of it after the first sentence of the ad, this one will get the listeners focused on the money involved. And they’re probably not going to assume that MegaPharm won the lottery at some point; those 500 million dollars came from profits on the drugs that were already being sold. What kind of money must these people be making, that they have half a billion dollars sitting around, eh? It’s definitely worth reminding people that drug discovery takes plenty of cash, but not if they wind up convinced we have an endless spigot of the stuff.

What about that list of diseases? Nothing much wrong with them, except that we’ve been working on that same list for many years. And our success rate is . . . variable, at best. I’d say that everyone has known someone who eventually died of cancer. Far fewer people, though, know anyone who’s been cured of it. And unfortunately, no one knows anyone who’s ever been cured of Alzheimer’s. It’s understandable that ad copy takes a can-do attitude toward these things, but people have been hearing a lot of can-do attitude for years now, and have probably gotten pretty good at discounting it. So what good does it do us with the customers? We also don’t help ourselves when we do discover a new treatment, one that helps some people to some degree, but tell the ad writers to make it sound like the next miracle drug.

Now we get to those unstoppable scientists back in the labs. As one of them myself, I’m always glad to have some acknowledgment that we exist. A good chunk of the general public seems to think that doctors discover drugs. Another subgroup seems to think that they’re all discovered in university labs, after which the drug companies swoop down, buy everything for pennies, decide on the package colors and theme song, and sit back to watch the profits shower down. So it’s good to remind people that there are a lot of us out there, and that we find plenty to occupy our time.

But I have to say that I don’t use the word “cure” very much. That one’s magic, and has to be invoked very carefully. A cure, to most people, is something that makes a disease go away as if it had never been there at all. (The other thing a cure does is to go away itself after the disease does, taking its further costs with it). We have a lot of trouble meeting those criteria. To be honest, in all of medicine, there aren’t that many cures available (and of those, quite a few come from surgery rather than from pharmaceuticals). So the problem is that what we can do, in most cases, comes across as a second-best outcome even when it’s actually very much worth having. Compare “We can cure your disease,” to, “We can keep your disease from killing you,” or, “We can make your disease get worse much more slowly,” and keep in mind that each of those should be often be followed by “. . .as long as you take this medication every day for the rest of your life”. Not so inspiring, but compared to having no options, they should be valued more highly than they are.

I made up the MegaPharm slogan that ends the ad, of course, but it’s not far off the sort of thing you hear for real. And it’s better than some of the ones I’ve heard proposed, such as “XYZ Pharma: Where progress is our only problem!” or the likes of, “Yesterday’s drugs at tomorrow’s prices.” But most of the serious ones, which presumably companies paid someone serious money to dream up, suffer from that gauzy any-minute-now feeling, which is one of the very things I’m campaigning against here.

Fine, then: can I do any better? If we’re not going to go around telling people that we’re ready to cure them out of the goodness of our hearts, what should we tell them? Well, how about this, set to visuals of people who look like they’re actually working: “Alzheimer’s. Cancer. Diabetes. Here at MegaPharm, our scientists know that discovering drugs for these diseases is the hardest thing they’ve ever done. But they’re not giving up. Because they and their families will need these treatments, too. Finding them costs us money – a lot of money – and takes all the time and work that we can give. We’re trying to make all of that worth it.” End with a shot of someone looking at a printout or screen and getting an eyebrow-raised half-hopeful look as they see the latest results, in line with Isaac Asimov’s line about how the real sound of a scientific breakthrough isn’t “Eureka” – it’s someone saying, “Hmm, that’s funny. . .”

There, I offer that one up for free, all rights waived, etc. Perhaps I’m too trusting, but I keep thinking that if people understood what drug research is really like, they’d have more sympathy for it, and for the people who try to make it work. The industry’s current approach doesn’t seem to be breeding much of either, so why not?

Derek B. Lowe has been employed since 1989 in pharmaceutical drug discovery in several therapeutic areas. His blog, In the Pipeline, is an awfully good read.