Elizabeth Theiss's Reviews > The Drug Hunters: The Improbable Quest to Discover New Medicines

The Drug Hunters by Donald R. Kirsch
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The lovely man I married forty-five years ago is now entirely dependent on the drugs he takes every two hours that allow him to move. Since his Parkinson’s disease diagnosis nearly twenty-seven years ago, few new drugs have come to market and most of them have been reformulations or combinations of old drugs. The only one that significantly helps him was developed in the 1960s. Why haven’t drug companies been aggressively developing innovative treatments for Parkinson’s disease? The Drug Hunters is an engaging, accessible, and insightful answer to this question.

The archeological record suggests that humans have been using drug therapies to try to cure diseases for at least four thousand years, with wildly varying degrees of success. Chapters proceed in rough chronological order, describing strategies for drug development from ancient times to the present. Interestingly, most “blockbuster” drugs were invented by some combination of serendipity and hard work, often involving a succession of inventors, refiners, and corporate decision makers.

Today, the lion’s share of new drugs are invented in the labs of mega-corporations whose main goal is profits. A single successful drug like a statin (Lipitor) can earn tens of billions of revenue because millions of people take it every day. On the other hand, a drug for a less common disease has the same costly development process but not nearly the level of profits. As a result, drug companies focus their research efforts on drugs for very common, long term diseases. Development of new antibiotics have come to a near standstill for this reason.

Aside from being an utterly fascinating read, this book left me with many questions. What will happen when bacteria have mutated such that current antibiotics are no longer effective? This is not a theoretical question. A dear friend died of sepsis two years ago when no antibiotic was effective against an infection that began as a small cut while he was gardening. It is critical that routine antibiotic use in veterinary practices stop immediately and that physicians use restraint in prescribing antibiotics unless clearly necessary.

Who will develop drugs to fight diseases that are shorter in duration or affect smaller populations? If the population affected is small or the duration of the disease short, no drug companies will invest expensive development and clinical trials required to bring a new drug to market. Publicly funded research is the only path to drug development in these cases, yet the author doesn’t talk about it.

This brings me to ask whether drugs are public goods, private goods, or something in between. Drugs certainly appear to be private goods, that is, goods that can be subdivided and sold for profit. Private goods are generally left to private markets to provide. And yet, pharmaceutical corporations are failing to provide the quantity and quality of drugs that would allow many more people to live normal lives and indeed to survive. This argues for some government role in the provision of drug development and cost control. Currently, the FDA regulates drugs for efficacy and safety. It would be wise to task the National Institute of Health to invest dollars and space in the quest for new compounds for diseases like Parkinson’s. The cost of research could be offset by the leasing of patents to drug manufacturers. Leases could also specify cost controls for publicly developed drugs.

This is an important book for understanding why drug research is responsive only to certain needs and neglects many diseases.
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Reading Progress

June 27, 2018 – Started Reading
June 27, 2018 – Shelved
July 4, 2018 – Finished Reading

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Mr Andrew Powsey I’ve often thought that the search for new drugs is too important to be left to big pharmaceutical companies who are only out to make a profit. In the UK a government agency should be set up to discover new drugs according to need, not profit. Think about it. No more exorbitant fees for drugs still in patent, thus releasing more funds for the NHS.

Elizabeth Theiss Exactly! Academia has an important role to play here too. Instead of working for drug companies, academics could partner with health agencies.

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