Can We Define a More Cost-Effective Path to Better Therapy? Reminiscences from the Front Line

With our aging society, medical costs keep on increasing globally. As research has dramatically changed the world we live in, could more effective research diminish the cost of health care?

I believe this is not that difficult, if therapeutic research was better organized. Having had an unusually complete view of the generation of a new drug class, the TNF inhibitors—currently the most profitable drug class (sales ~$27 billion)—from defining the hypothesis to proving it in laboratory and clinic, convincing payers of its cost-effectiveness, I can detect major opportunities.

Failed experiments, especially in the clinic, and needless duplication result in major costs. Keeping therapeutic research open, academic, non-competitive until target validation and drug and dates are needed will reduce cost as championed by Al Edwards of SGC in Toronto.

But the greatest cost reduction would come from more effective therapy, given at an early stage. For this, better diagnostics need to be linked to therapeutics, and we need to learn to develop combination therapies.