April 27, 2013 — A Pretty Good Pipeline

With all the ecological concern these days, pipelines don’t have an especially good name. Surely they’re a mixed blessing. They deliver all sort of things we can use, but they can pose terrible risks to the environment.

Here’s one pipeline whose value everyone can agree on. It’s the pharmaceutical research pipeline. I saw an article today directing me to an online brochure detailing just how many new medicines are in the pipeline for blood cancers.

From the brochure: “Pharmaceutical research companies are developing 241 medicines for blood cancers — leukemia, lymphoma and myeloma. This report lists medicines in human clinical trials or under review by the U.S. Food and Drug Administration (FDA). The medicines in development include 98 for lymphoma, including Hodgkin and non-Hodgkin lymphoma, which affect nearly 80,000 Americans each year.”

The brochure includes this chart (click to enlarge), which details the complex process each of these drugs must go through before they’re ready for prime time:

Most don’t make it: not even to clinical trials. Out of many thousands of promising compounds, only about 250 get real scrutiny as possible clinical-trial material. Of these, only five get tried out on real, live patients.

Four out of these five drugs turn out to be ineffective, or deliver side effects that are just too intolerable. That leaves just one chemical compound out of 5,000 to 10,000 that makes it through clinical trials into production.

This, of course, is why new drugs cost so much. The companies have to set aside enough money to pay for all those failed experiments. Patents allow the companies exclusive manufacturing rights for only a limited number of years. Once that time period has elapsed, the generic manufacturers start selling their own inexpensive knock-offs (and, of course, their research and development cost are negligible). The original manufacturers drop their prices to compete, and begin looking to whatever new formula is next coming down the pipeline.

It’s a complicated system. I wouldn’t want to be the accountant who figures out the financial risk and tells the company executives how much they need to charge. But I am glad to know this process is taking place — and that the outlook for new blood-cancer medications is so promising.

With every new drug that emerges from the pipeline, my prospects for living out a normal lifespan, even with my lymphoma — now quiescent, thank God — look better and better.