[LINK] Prizes and open source for drug research (proposed, and some politics)

post by NancyLebovitz · 2013-05-15T18:23:32.791Z · score: 5 (8 votes) · LW · GW · Legacy · 18 comments

Trying to get drug research to happen in spite of the drug companies:

The article also has rather a lot about US government opposition to the proposed treaty, which includes a requirement that member nations spend 0.01% of GDP annually on neglected diseases, and Bill Gates' opposition as well.

Is there any reason why non-profits aren't doing drug research?

Love's idea suggests the use of cash prizes -- rather than patents -- to incentivize research; say, $2 billion for an effective therapeutic drug for Chagas disease. A cure, once developed, proven, and awarded a prize, would then exist as open-access intellectual property, with manufacturers around the world competing to produce the drug in the most cost effective manner. Implementing the idea, Love said, "is effectively leveraging the power of the free market twice, once to produce the thing you want and then again to manufacture it as economically as possible." The concept is known as delinking.


To combat the problem [of isolated research groups], the R&D treaty would create an observatory, an open platform for researchers in disparate corners of the globe to pool data and coordinate their work. Grants given to fund their studies would come with provisions requiring that the research exist on that public, cloud-based observatory.


Love's concept of delinking is outlined in a proposal for an R&D treaty, which remains in limbo at the WHO in Geneva. It will have its fate decided in late May, at the annual World Health Assembly (WHA), the democratic forum of members states that governs the WHO.


Scannell worked as a consultant in the drug industry and then as an equity analyst, but quit last year to team up with Young once more at small biotech firm Scannell described as "heretical." The company is called e-Therapeutics, and its approaching drug design via the pair's background in networks. "Go back to how the drug industry says it discovers drugs. It looks for individual targets and then it optimizes drugs for high affinity binding on that target," Scannell said. The strategy, to Scannell's and Young's eyes, fails to take into account the complexity of biological systems.

"If you look at the structure of protein-protein interaction networks in cells, or the metabolic networks, these have been designed by evolution to be robust. You've got feedback loops, you've got parallel pathways, you've got redundancies. And what that says is, if you start your search process looking for an individual molecular component you want to perturb to influence a disease, probably evolution has designed your cell that, if you perturb that component, nothing is going to happen." Given the approach, Scannell said, "Maybe it shouldn't be surprising that 95 percent of drugs going into clinical trials fail."

"Historically, you can make a very strong case that the way drugs were discovered when it was cheap and easy -- you can't do all this now because of the regulators, but some of this you might be able to do -- was essentially through broad phenotypic screening, very often in man," Scannell said. "Drugs were regarded as potential tools that might do something useful, and then people essentially searched for uses for the tool. And today we do the exact opposite. Which is we say, we want something that cures Alzheimer's disease, let's design something that cures Alzheimer's disease, and frankly that just doesn't work."


"He [Bill Gates] slowly, as Foundation and as a philanthropist, is being drawn into more open-source policies," Love said. "If you look at the licensing he does on his own government-funded research, he has experienced a little bit of frustration when he doesn't get sufficient openness in the research he's funded himself, so he's begin to put things that much very much like open-source provisions in his own licenses," Love said. "That has been progress, and people have noticed that. It used to be that if you applied to the program to fund libraries -- I know somebody that did this -- she was told you had to eliminate the words 'open-source' because they couldn't fund anything that had even the words."


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comment by PhilGoetz · 2013-05-15T22:16:00.250Z · score: 6 (6 votes) · LW · GW

Not to dismiss the idea, but I notice the idea of prizes is very popular with decentralizationism-hipsters like Wired Magazine who claim this empowers the little guy. The reality is that prizes are a way for big companies to get more work for less money. Look at the Netflix prize: For a million dollars, they got research results from many teams, and a million dollars wouldn't have even funded the work of the team that won. The team that won, probably lost money on it, if you count the hours they put in.

comment by tondwalkar · 2013-05-28T15:36:09.307Z · score: 0 (0 votes) · LW · GW

It's a way to cash out on your reputation. The team that won the Netflix Prize may have ended up with a net gain, if you count the value of having "won the Netflix Prize" on their resume (in terms of both job opportunities and higher salaries afforded), and in order to offer such a reputation boost, Netflix had to have built up a reputation for itself.

comment by Luke_A_Somers · 2013-05-15T22:02:41.495Z · score: 4 (4 votes) · LW · GW

"He [Bill Gates] slowly, as Foundation and as a philanthropist, is being drawn into more open-source policies,"

There's something I never expected to read.

comment by Lumifer · 2013-05-17T14:20:31.726Z · score: 0 (0 votes) · LW · GW

You need to update your priors faster :-) Bill Gates now looks quite different from his Microsoft days.

comment by Luke_A_Somers · 2013-05-17T20:17:03.610Z · score: 0 (0 votes) · LW · GW

Should I? How much does it matter to my decisions, that I should be actively seeking this information out? I knew the Gates couple are philanthropists of extraordinary magnitude. It was the Open Source part that was surprising.

comment by NancyLebovitz · 2013-05-15T22:34:42.350Z · score: 0 (0 votes) · LW · GW

It surprised me too. That's why I included it in the excerpts.

comment by Randaly · 2013-05-15T21:11:12.006Z · score: 4 (4 votes) · LW · GW

Is there any reason why non-profits aren't doing drug research?

It costs billions of dollars to bring a new drug to market. No non-profits\ has billions in spare cash lying around (that's not already earmarked for current programs), so currently no non-profit can afford to do drug research.

comment by NancyLebovitz · 2013-05-15T21:50:37.468Z · score: 2 (2 votes) · LW · GW

I was imagining non-profits with a purpose of drug research who'd raise money just for that.

comment by Randaly · 2013-05-15T23:01:05.096Z · score: 2 (2 votes) · LW · GW

You believe that a new non-profit which doesn't expect any kind of result for the next ~12 years will be able to consistently raise hundreds of millions of dollars per year for over a decade? That's not very plausible- around 0.01% of current charities have that kind of revenue, and drug creation isn't a particularly inspiring topic.

comment by NancyLebovitz · 2013-05-16T00:32:38.509Z · score: 0 (0 votes) · LW · GW

I was underestimating the size of the problem.

Still, I don't know whether the rules are as stringent and the costs as high all over the world, nor whether a non-profit which had researchers with excellent credentials would be unable to raise that much money.

comment by DanArmak · 2013-05-17T20:23:48.818Z · score: 0 (0 votes) · LW · GW

If rules were relaxed or costs were lower somewhere else, then wouldn't for-profit drug development move there as well? Whatever the funding model, the actual research and laws that govern it are the same.

comment by Izeinwinter · 2013-05-22T17:05:26.755Z · score: 3 (3 votes) · LW · GW

Prizes would not fix most of the issues. This is going to sound very left wing, but if you want cures for the things the market are ignoring, then the appropriate mechanism for that is the government. Taking it to the limit, the simplest reform for medical research would be to stop granting patents on medicines and then redirect the savings this would create for national health systems as all medicine becomes "Generic" into a gigantic "International Institute For Health"

The idea being that the total health budget for the governments involved would be exactly the same, but incentives would now align better, and at least twice as much money would go to actual research as there would no longer be any need for marketing new drugs.

Uhm. I think I just persuaded myself that patent law is a just a bad idea, full stop. It certainly is not working as intended in the tech sector, and this looks like an argument that we can do better in medicine too.

comment by ChristianKl · 2013-05-25T16:00:13.149Z · score: 0 (0 votes) · LW · GW

The idea being that the total health budget for the governments involved would be exactly the same, but incentives would now align better,

Did Soviet Russia produce a lot of new drugs for the money that they invested in that research?

comment by Izeinwinter · 2013-05-28T18:19:27.868Z · score: 0 (2 votes) · LW · GW

The National Institute for health does produce new treatments. So does the state research programmes of the rest of the first world - Research is one of the core competencies of government - if you can persuade politicians to pour enough money into it, returns are good. Most importantly, government can - and does - undertake research projects no corporation would ever attempt. CERN is not something the private sector would fund this side of the singularity. And in this case, government is /already/ paying for the research. The monopoly rents extracted by pharma come out of taxpayer pockets, so for all intents and purposes, they are nothing more than government contractors. And verily, they suck at their jobs.
Heck, this even holds in the US, despite the accounting dodge. Mandatory insurance is a tax. So, when I propose that the governments of the west wake the heck up and move the research they are already paying for in-house so that half the money stream no longer gets wasted on marketing and CEO boni, that is not communism. It is just sensible policy.

comment by ChristianKl · 2013-05-28T21:13:51.617Z · score: 0 (0 votes) · LW · GW

The National Institute for health does produce new treatments.

Which specifc treatments of the last two decades do you mean?

comment by Lumifer · 2013-05-17T01:53:36.707Z · score: 3 (3 votes) · LW · GW

Is there any reason why non-profits aren't doing drug research?

Yes. It's very expensive (say thanks to the FDA for that) and very uncertain. You need to invest tens and maybe hundreds of millions of dollars into a project that has a >90% chance of failure. In the real world it would be pretty hard to find sufficient donors for that.

comment by Petruchio · 2013-05-17T14:00:20.690Z · score: 0 (0 votes) · LW · GW

You are right, the costs of putting new drugs in the market are extremely high, and maybe 1 in 10 make the cut. Very few people would be willing to invest that much money on such a return. Investing in a pharmaceutical company would give an investor a financial return, and investing in an efficient charity will give a philanthropist the best return for lives saved.

comment by NancyLebovitz · 2013-05-18T13:49:15.133Z · score: 0 (0 votes) · LW · GW

The article may imply some limits to efficient philanthropy. Improving the process of drug research would save (produce?) a huge number of QUALYS, but there's no way to tell in advance what the cost is likely to be or what the odds of success are.