Not surprisingly, my recent post – “Are 90% Of FDA Drugs Approved In Last 30 Years No More Effective Than Existing Drugs?”, drew a range of comments. While many supported my views on the value of new medicines brought forward by the pharma industry in the last 30 years, others decried the pharma industry’s incrementalism and the proliferation of follow-on drugs. One unexpected comment I received was from a former colleague from
“I have vivid memories from the 1960’s of my father using an eye dropper to load theophylline into a rubber pump inhaler. The blue glass theophylline bottle was decorated with a skull and crossbones with the word ‘poison’.
In the ‘70s, I remember a lot of corticosteroid tablets….with much anxiety about their systemic effects.
In the ‘80s, I recall a subcutaneous adrenalin injection that probably saved my life. In the ‘90s, inhaled albuterol worked well but made my heart race like crazy.
This sounds like a commercial but I have to say that GSK’s Advair (inhaled steroid combined with a bronchodilator) has given me five years of complete disease control.
Asthma provides very compelling evidence to show how step-change and incremental advances by the pharma industry deliver spectacular benefits to the patient.”
Drs. Jeffrey Drazen and Eric Chu, in a 2005 article entitled: “Asthma – One Hundred Years of Treatment and Onward” said the following about theophylline:
“Theophylline continues to be an inexpensive and effective asthma treatment. However, it has a low ratio of therapeutic benefit to potentially toxic side effects. Dosing needs to be carefully monitored to be sure that a given patient is receiving the benefits of treatment without its side effects. To complicate matters, theophylline metabolism varies substantially both among individuals and in a given subject. Even when an effective dose is established, it is important to continue to monitor plasma drug levels. Given these difficulties, many consider that theophylline is not a first-line asthma therapy.”
My guess is that there are those that will deem Advair to be not a lot different from theophylline in terms of being a breakthrough for asthma patients. However, oftentimes innovation does not occur in major leaps. Rather, gradual improvements are made over time. No one in his or her right mind would call a modern airliner a “me-too” of the Wright Brothers’ Flyer. Decades of research and experimentation have led to the technological breakthroughs resulting in the aviation marvels of today. The same is true of new medicines.
Slow and steady R&D progress does not appear to be impressive to pharma industry pundits. But to asthma patients, such progress is life changing.
