WHERE ARE THE WONDER DRUGS OF BIOTECH?

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Apr 7, 2003

In 2000 I wrote an article on Pharmacogenomics, another science born out of the Human Genome Project. It tries to correlate an individual’s genetic make up to his or her response to drug treatment, in other words, personalized medicine.

In that article I also discussed how I thought that Pharma companies would go about it. Today, I think that even though my initial approach was right, it was rather naive. It did not take into account the profit factor. That is, I approached it as a scientific problem without considering the economic aspects of it.

Initially I proposed (my example was hypertension) that the companies ask the doctors to ask a representative number of their patients that were cured or improved by a particular drug if they wanted to participate in a study to determine their genetic make up, that is, their genotype.

Those that accepted will be asked to give a blood sample, with which the company will genotype them. According to the results, they will be able to match drug, good response and genetic make up.

In this way, they will have a first approximation of what type of patients should be treated with a particular drug. Thus, when a patient went to a doctor, he or she will be asked to take a genetic test the result of which will tell him what drug to prescribe.

With so many anti-hypertensive drugs in the market it would be possible to divide the patients in groups according to the drugs. In this way the companies will have a ballpark figure of the amount of each drug they will have to make.

This will increase the price of each drug, since they will have to make less of it. The smaller the number of patients that use one particular drug, the higher the price. Now, even though I have no way of knowing how big could the increase in price be, I think that it will never be as high as the price of a new drug, since the development of a new one takes from 10 to 15 years, costs about 500 millions dollars and experience tells you that it will never be good for 100% of the patients.

The cost of the genotyping study could not add much to that of the drugs, since with the technology that has been around in the last four or so years, the cost of doing it is very low. One could genotype more than 10,000 patients (which is a very representative number), probably, for less than $5 million. And the study should not take a lot of time, probably two years.

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