

Toward a Wikipedia model of drug discovery - elidourado
https://medium.com/plain-text/toward-a-wikipedia-model-of-drug-discovery-79a2c7bcf88c

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jostmey
Eroom’s Law is scary --- It says that it is becoming harder and harder to
develop new drugs. We have essentially exhausted the pipeline of diseases that
can be treated with small molecule drugs. It is time to embrace alternative
technologies such as genetic engineering. Not every disease can be cured by
simply ingesting a pill containing a compound made up of only a few dozen
atoms.

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refurb
I'm not sure I'd lay all the blame of slower/less drug discovery on the
scientists or the science.

The FDA has continuously increased the standards required to get a drug
approved. Take a look at Librium (chlordiazepoxide) for example. It was the
first benzodiazepine discovered. The molecule was first _synthesized_ in 1956.
The anxiolytic effect was discovered in 1957. FDA approval came only 3 years
later in 1960 [1].

There is no way that would happen today. The truth is, as data requirements
increase, so do costs. Increasing costs make development of certain drugs
unviable from a commercial perspective. If you're trying to come up with a
better cholesterol drug now, you're expected to do two multi-year (2-4 yr),
1000+ patient clinical studies. That alone could run you $500M. Even though is
plenty of room for improvement in treating hypercholesterolemia, companies are
shying away from pursuing it due to the unattractive economics.

And as for the limitations of small molecules, I agree that current drugs
cover a lot of space right now ("we've picked all the low hanging fruit").
However, what drive new drug is new science that determine disease mechanisms.
Many of the latest immunotherapy cancer drugs that are coming out (and
resulting in very impressive outcomes) are small molecules.

[1][http://en.wikipedia.org/wiki/Chlordiazepoxide#History](http://en.wikipedia.org/wiki/Chlordiazepoxide#History)

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roadnottaken
What a load of crap. The author has no idea how medical research is actually
performed. It's very hard and expensive and data-collection/analysis is a
tiny, tiny challenge relative to the complexities and costs of developing
novel therapeutics. I'm not saying ResearchKit is a bad thing, but I work in
the pharmaceutical industry and this isn't even a blip on anyone's radar. Get
real.

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refurb
I was going to say. Collecting patient-reported outcomes via iPhone is nice,
but it doesn't do a dam thing for the big costs, which are physician
examinations, sample collection, testing and data analytics.

