Drug Truths: Dispelling the Myths About Pharma R&D

  • John L. LaMattina
Wiley: 2008. 152 pp. £16.95

John LaMattina is the former head of Pfizer's global research and development (R&D) effort, and that may be as much as many people need to know about his book. This is a shame, since most of them could benefit from reading it. Can the book's intended audience (people critical of the drug industry) be persuaded to read a brief in its defence, written by one of its own high-ranking executives?

Drug Truths — an aggressive title — is structured as a chapter-by-chapter rebuttal of various myths about pharmaceutical R&D. Many good points are made about how drug development really works — an area the public knows very little about. Experienced workers in the field will recognize most of the arguments in the book; I've had occasion to use many of them myself over the years. But although scientists in the business know that (for example) the US National Institutes of Health does not discover most new drugs, and that drug development really does take huge amounts of money over many years with extraordinary risks along the way, a surprising number of lay people don't know these things. And too many who are told about them dismiss such talk as industry propaganda.

This book may well end up falling into the same bin. LaMattina often argues his cases well, with a wealth of numbers, illustrations and references, but there are some problems with the book's approach. For one thing, virtually all the examples used are from Pfizer's own programs. This is no real surprise, but after a while, the book starts to feel like 'The World According to Pfizer'. Not everyone will sit still for that: the book's target audience may not realize it, but Pfizer is not the most beloved company in the industry in the eyes of its competitors, and its strategy of growth through repeated massive acquisitions is widely disparaged (and widely feared).

Another problem is that some of LaMattina's 'myths' are actually true, such as the subject of Chapter 3: 'It Takes Industry Too Long To Discover New Drugs'. I work in the industry myself, and I think it takes us too long to discover new drugs — mind you, I don't have many good ideas about how to make the process shorter. But I don't think anyone is satisfied with the pace of pharmaceutical R&D, however necessary all its steps may be. It's useful to explain to people why drug development takes as long as it does, but telling them that this is a good thing is something else again.

That brings up a larger difficulty. At almost no point in the book (as far as I've been able to tell) do any of the industry's actions come in for criticism. Taken at a sitting, the book turns into a paean to pharmaceutical research. There's nothing wrong with that, as far as it goes, but it dilutes the force of the book's points to act as if none of the criticisms levelled at the industry ever have anything behind them. This isn't the case for any industry (or any government, or any large organization at all) and I fear that readers may find themselves feeling as if they're hearing reports from some sort of alternate reality.

Many of the points made by LaMattina are, in fact, correct. The drug industry truly has made a large difference in public health, and really doesn't get enough credit for doing so. The often-repeated criticisms of 'me-too' drugs and R&D budgets versus advertising are mostly specious. Drug Truths demolishes them yet again, but probably to no avail. The central difficulty remains: the people who know most about these issues (and the author most certainly does) have made their living by discovering drugs. Instead of giving them status as expert witnesses, though, this very experience is likely to disqualify them in the eyes of the industry's loudest critics. No obvious solution to this problem presents itself, although turning those same critics loose to discover their own drugs would at least be entertaining.

In the end, LaMattina stands out from many of the other observers of the industry, in that he thinks it's due for a resurgence. Those of us still working in it can only hope that he's right, although the job losses over the past few months don't inspire optimism. Surely the pharmaceutical industry is not just going to disappear. And if it did, surely even its fiercest critics would eventually wish for its return. This book could at least tell them something about what they'd lost.

On our bookshelf

Landmarks in Organo-Transition Metal Chemistry: A Personal View

  • Helmut Werner
Springer: 2009. 348 pp. £73.50.

In a book that is neither wholly text nor wholly biographical, the reader is taken on a journey through the history of organometallic chemistry. Necessarily focusing on some areas in which the author has personally conducted research, the book is full of fascinating insights into the development of one of the largest subdivisions of chemistry. Despite the wealth of content, the book is remarkably easy to read and emphasizes the rapid growth of the subject area and the influence it has had on chemistry, both in the past and continuing into the future.