I took a genetics & society class my last semester of college for personal interest and became very interested in genomics and pharmacogenomics.
I'm no expert but here me out. Brief background to express my point.
In 2003 geneticists announced that they were able to map the human genome, which is basically the complete set of a humans genetic information measured in DNA sequences.
Pharmacogenomics is the use of genomics and genetics in the discovery of new drugs. Pharmacogenetics is the genetic basis for difference in drug response in humans. Every year there are over 2 million adverse drug reactions (ADR's) reported and over 80,000 deaths related to them.
Here's how this is relevant- Nowadays, due to the mapping of human genome, geneticists are able to determine how people will react to certain drug treatments based off their genes. This newfound glory, so to say, can allow for drug companies to develop drugs that are less susceptible to adverse drug reactions within patients, as well as proper dosage instructions based upon individuals ability to metabolize a drug (genetic testing can tell how each person metabolizes a certain drug based on genes).
The problem is money. Pharma companies would have to invest heavily into R&D to develop these new forms of drugs. But the long-term benefits in my opinion far outweigh the initial costs. If these new drugs were created then there would be far less lawsuits against pharma companies, revenue would increase due to the safer nature of drugs, and lastly the public view on pharma would most likely become positive.
Now here's the investment aspect of all this. As this issue becomes increasingly publicized over the next few years (which it without a doubt will), with biotechnology constantly improving and ADR continuing to pile up, I feel that this transition is inevitable. Would you take the risk and invest heavily for the long term in some of the big name companies that would most likely have the resources to accomplish this (Pfizer, Merck, Lilly, J& J, Novartis, BMS etc..)?
what are peoples thoughts? you don't need to be an expert, this topic is really an ethical debate more than anything.
Your underlying assertion that pharmaceutical companies use genetics to develop new drugs with less adverse events is confused. Genetics is rarely, if ever used, for informing the discovery of new drugs with reduced adverse events.You don't design a new drug based on the genetics of drug metabolism - you might use genetics to inform the identification of a new target or mutation, but that is different.
Where genetics is useful for with respect to adverse events is selecting the right patient sub-populations in clinical trials to minimize drug over or underexposure from variable drug metabolism, and titrating the right dose for patients in the real world once the drug is approved. It has nothing to do with the design of the actual drug itself - e.g. "new forms of drugs". Perhaps you are instead referring to pharmaceutical companies investing in R&D in patient genotyping during the clinical testing of the drug to select the right patients, and to inform the titration scheme that goes into the FDA label for real-world usage.
Assuming you are arguing for the latter, then it's not clear what the ethical dilemma is. Many pharmaceutical companies companies already genotype clinical trial patients to test for variability in drug metabolism, and this already goes into labels of many drugs (e.g. how to dose extensive metabolizers vs. poor metabolizers), and some drugs require patients to be genotyped if they are to exceed a certain daily dose of drug. Patients are already genotyped if they may be at risk, or if a drug exhibits high variability in exposure.
Are you arguing that drug companies should pay for every potential patient on their drug to be sequenced/genotyped by diagnostic companies? In either case, this issue of drug metabolism is a non-issue because diagnostic companies and labs already genotype many patients, and as sequencing costs come down, everybody will already be pre-genotyped. There is no investment thesis related to pharmaceutical companies based on this line of logic. You might argue for an investment in a diagnostic company or lab, but that has nothing to do with the development of new drugs.
"should pharma pay for every potential patient on their drug to be sequenced/genotyped by diagnostic companies". - From what I learned (100 level class keep in mind) this process wouldn't take long due to sophisticated technology and my professor argued that the cost of having to treat people each year with ADR's ($136 billion roughly) exceeds the potential cost of sequencing every potential patients DNA for proper drug development. If these companies invested the money to accomplish the screening then there would be less ADR's and better drugs, with the right dosage, for the right patients. The ethical dilemma of genetic discrimination comes into play if patients are denied medication due to their genetic profile.
“…more than 90% of drugs only work in 30-50% of people Allen D. Roses , GlaxoSmithKline" (took that from a class PP slide and found that very scary)
I'm no expert and obviously need to do more research on this subject matter. My apologies for sounding "confused" in my initial post, the intention of this thread was for objective discussion. I find this topic extremely interesting and like to hear others opinions and insights.
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