Pharma for Good

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Taking inspiration from the tech industry, here’s why we need a pharma-based leadership movement to serve vulnerable populations.

In a world where 90% of drugs fail to reach the market, there are clear inefficiencies in selecting and developing potentially important treatments.

On the one hand, there is a good reason for this. The clinical trial process is extremely difficult for pharma companies to navigate and rightly so: Any drug needs to be safe and efficacious, and the onus is on manufacturers to demonstrate this.

On the other hand, there are huge problems around the economics of drug development. It usually costs $1 billion to get a drug to the market, and that means investors often play it safe. In a sense, it’s perfectly understandable when the stakes are that high –– but it also results in a vicious cycle whereby money is pumped into novel treatments for conditions with tried-and-true development pathways, leaving fewer resources for the development of treatments for underserved diseases.

When investment is focused on safer –– and in many cases more lucrative –– bets as opposed to potentially lifesaving or life-changing treatments, ultimately, it’s the most vulnerable populations that lose out.

To break this cycle, a new paradigm of leadership is needed within the pharma community to change the risk and reward for the development of potentially transformational medicines.

I believe we should be looking to our peers in the tech industry for inspiration. There is a thriving “Tech for Good” movement in which technology drives positive change in society. So why are we not talking about a “Pharma for Good” movement in which leaders focus on funding and developing the treatments that are of the greatest benefit to society?

At the moment, the closest thing we have to resembling such a movement are government grants and funding from philanthropic foundations, which are often set up by the families of people who are afflicted with difficult-to-treat diseases. These are wonderful, but this is not sustainable because it’s extremely difficult for such an organization to fund a drug all the way to market. I always compare this to getting to the 20-yard line but not scoring the goal.

I have personal experience of what can happen to good causes with philanthropic funding. Diabetes is more prevalent in vulnerable populations and is the leading cause of blindness among working-age adults. Six years ago, myself and colleagues in our field of medicine (ophthalmology) received a $1-million grant from the Duke Endowment to pay for specialist cameras to carry out proactive eye exams on diabetic people in rural, underprivileged parts of the U.S.

It’s a fantastic scheme, with more than 10,000 images read and medical recommendations provided where necessary. And yet, there is now also a sense of, “Where do we go from here to move this forward?” While the work has made a difference, it can’t be pursued with the same vigor as when people are being fully compensated for their work.

The same principle applies in drug development, and given the nature of the U.S. market, we need a “Pharma for Good” movement in which the most important treatments are pursued with an unashamed profit motive. If it costs $1 billion to develop a drug, then venture capital and, increasingly, private equity, are needed to fund this and achieve profitable returns. It simply won’t happen with philanthropic-only funds.

If we can grow a “Pharma for Good” movement –– made up of a consortium of pharmaceutical leaders, physicians, patient advocates, regulators, and financiers –– we could finally start to get somewhere and make the drug development process more sustainable.

By identifying an area of medicine where there can be a return on investment — while at the same time driving cost savings to society by preventing underserved populations from getting sick — everyone will win. It’s on all of us in the pharma industry to focus more on the stakeholders, not just the shareholders.

Dr. George Magrath is CEO of Lexitas, which runs clinical trials for pharma and biotech companies.

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