Letter by Tracey Regarding Article, “Bypassing Big Pharma”
To the Editor:
As a pharmaceutical industry scientist who has both spent many years trying to identify effective therapies for myocardial ischemic injury and been involved in past collaborations with Drs Downey and Cohen, I was disappointed by the tone of their recent editorial.1 The authors describe the reality of drug discovery: that identifying novel therapies is inherently risky and that numerous approaches unfortunately more often lead to failure than success. Whereas it may be true in hindsight that the “wrong” drug was chosen in some cases, it is more likely the target was the culprit, because, as the authors point out, current preclinical animal models do not translate well to the clinical setting. These targets have been championed by academics, clinicians, and industry alike, so it is specious to imply that the pharmaceutical industry is primarily responsible for these failures. Pharma has invested, and lost, many years of effort and hundreds of millions of dollars attempting to find a way to prevent myocardial ischemic injury, so it should be no surprise when the industry is cautious about dedicating further resources. Moreover, to suggest that “well-heeled” pharmaceutical companies are delaying clinical progress by not supplying drugs for testing shows a lack of understanding of the multitude of factors that affect such a decision, not the least of which being the commitment to patient safety, as well as the increasing legal and regulatory scrutiny that the industry faces.
I believe that I speak for many of my industry colleagues when I say that I am excited to hear about the possibility of using remote preconditioning to prevent ischemic injury in the heart. I would be thrilled to eventually hear that the technique has been demonstrated to save lives, with or without the involvement of the pharmaceutical industry. All of us, pharmaceutical industry investigators, academicians, and clinicians, want the best for patients, and where the best treatment comes from is immaterial. Nevertheless, the suggestion that big pharma is something to be bypassed not only does a disservice to patients but fails to recognize the important contributions to public health that have resulted when academic researchers, clinicians, and the pharmaceutical industry work together.