eGuidelines.co.uk: Drug development is no longer affordable in the UK

Should you feel sorry for Pfizer? Having to close down its state-of-the-art research and development laboratories on a stunning 340-acre landscaped site bordering on the Royal St George’s golf course must be a kick in the teeth. Ironically, the company’s decision to end its 57-year-old association with Sandwich saw its shares jump by 5.5%. It’s the 2400 workers who get my sympathy vote.

I was fortunate enough to be shown round the plant a few years ago. It’s amazing how ignorant many doctors are about the time, money, effort, expertise, and equipment that goes into drug development; how many bureaucratic, safety, and legal hoops have to be jumped through; and how strict the rules on advertising and promotion are. After a stroll around Sandwich, I could see why it takes so long, and costs so much to get from the original hypothesis to the prescription pad. It’s not just a game of molecular roulette, pick out a winner, whack it in a capsule, give it a zingy name, and hey presto—there’s your blockbuster.

Norvasc^®, Istin^®, and, most famously, Viagra^® , were all developed at Sandwich. The profits for the latter have been lessened by the available of cheaper internet versions, some of which have less sildenafil citrate, and more horse hair, talc, or rat poison. But cheap Viagra can’t be blamed for the closure at Sandwich. It’s far more to do with big earners like Lipitor^® coming to the end of their patents and not enough to replace them in the pipeline.

In our litigious, risk-averse, and over-regulated world, the costs of research and development are so prohibitive, and the competition from China and India so fierce, that it’s hard to see how the UK can continue to be a major player in drug development and production. The Treasury’s patent box scheme, which charges tax on any profits arising from patented drugs and interventions at just 10%, encouraged GlaxoSmithKline to put £500 million into UK research and development.¹ But many other big drug companies are deciding that the costs of drug development are prohibitive, and leaving it to smaller biotech companies to take the risks and make the breakthroughs, before stepping in to buy them out.

This is where the UK still has plenty to offer, not just in terms of its scientific expertise, but in the number of entrepreneurs prepared to put their own money on the line to make the next breakthrough. Those I’ve met are really excited by the prospect of personalised medicines, cancer vaccines, and stem-cell research, but their fear is that even if they do produce a drug to change lives, the cost may be too great for many healthcare systems. The problem is not one of innovation, but of affordability.

Most of the large companies still make huge profits because they have no qualms about shutting down huge laboratories in one country and opening up others in places where labour is cheap and volunteers for drug trials are plentiful. The Western world may soon reach saturation point for medicalisation (how many tablets can one person swallow?), so it’s time to focus on those emerging markets.

As for the Sandwich labs, I think the NHS should buy them for a song and start making our own drugs. If we can’t afford research and development at the moment, we could focus on generics with that trusted NHS brand and plough any profits back into the service. It’s just the sort of innovation I’d expect from a GP consortium in Northeast Kent. And before too long, we’ll all be able to get reasonably priced NHS sildenafil without having to dabble in online horse hair.

References

Ruddick G. GSK commits £500m to UK after 10pc tax rate is introduced in pre-budget report. The Telegraph website. http://tinyurl.com/68v65ks G

View Phil’s tour dates, books, DVDs, and Private Eye columns at: www.drphilhammond.com

Please to rate this article, view others comments or make your own.