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Firstly: You're right; I am ill-informed on this. I haven't any doubt that you or your colleagues had and continue to have strong humanitarian convictions in your work, and I was out of line to speak so broadly.

I recognize that the argument I made earlier is something of an old saw. But you and I both know that businesses on the scale of most pharma companies are not run only by researchers and engineers, and that the explicit reasons for business decisions anywhere often stem from any number of unspoken ones. I don't imagine even the coldest of bean counters ever says "we need to make sure this research doesn't lead to a cure," and I doubt such a black-and-white assessment of a complex R&D process even occurs to them. But incentives are incentives, and humans are masters of rationalization.

I'm heartened to learn that your teams never felt pressure to put business interests ahead of patient interests. I sincerely hope your experience is common.



Thanks for your comments. The pharma industry has a lousy public perception, some of which is quite justified, so it can be hard to separate the reality from the perception.

There is also a practical reason why I can assure you that people are usually swinging for the fences, especially in cancer: most of the time you don't even know if a drug will work, let alone work well. There is no way to predict (with the obvious exception of vaccines which owing to biology are destined to be cures from the beginning) what your drug will really do until it hits the clinic. So there isn't even a mechanism to offer people an incentive to develop a drug someone has to take over and over vs. a cure, especially in cancer. Certainly, there are chronic conditions like diabetes where there is no real "cure" on the horizon because of the biology of the situation. But in the case of cancer, you almost have to try for a total success because you know you're likely to get far, far less than that when you hit the clinic. Because of this problem, one of the bigger issues in pharma is that flawed projects are allowed to linger long after they should have just been scrapped because powerful scientists believed they would work and convinced management to keep funding them despite some of their issues.




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