Therapeutic Innovation: Trends and Developments

The rapid advances in molecular biology and genetics, the emergence of new methods for studying diseases, and the rise of bioinformatics have given us hope over the past twenty years that therapeutic innovation would achieve a new level of effectiveness. What is the reality? Certain fields, such as oncology, have benefited greatly from these advances, and the therapeutic arsenal has been significantly expanded in this area—including with the arrival of new treatments tailored to the specific characteristics of the many different types of tumors—heralding what is known as personalized medicine, tailored to each individual, but often at costs that threaten healthcare budgets.

Other therapeutic fields have stalled. We are still waiting for effective drugs to treat Alzheimer’s disease, and in the face of bacterial resistance to “old” antibiotics, we find that our therapeutic arsenal has not been updated. The current Ebola virus outbreak reminds us that we lack effective antivirals or vaccines to treat many viral diseases. Thirty years after the identification of the HIV virus, we still do not have a vaccine to combat this disease.

The costs of therapeutic innovation are rising steadily, and major pharmaceutical companies are abandoning areas that have become unprofitable relative to the necessary investments. With industrial globalization, the production of conventional drugs is increasingly shifting away from developed countries and concentrating in a few factories in India or China. Should an incident occur at one of these factories, the supply of key intermediates used in the synthesis of essential drugs is disrupted, leading to shortages on the shelves of our pharmacies.

Major pharmaceutical companies are becoming buyers of drug candidates that have passed the critical phase of validating efficacy in early-stage patients, adopting a strategy similar to that of large food distribution conglomerates—shifting the risk-taking to the “producers,” in this case researchers and startup founders. Who will finance the “valley of death” in therapeutic innovation in France? This crucial phase in the development of new drugs—between basic research and demonstrating efficacy in humans—is the riskiest of all. It is becoming increasingly prolonged and is proving difficult to reconcile with the time horizons and returns on investment typical of conventional venture capital. Clearly, the United States has successfully established the mechanisms needed to ensure funding for therapeutic innovation. The American biotechnology companies of the 1980s and 1990s are now the research laboratories of major pharmaceutical groups, and European companies’ tendency to gravitate toward that part of the world is not likely to change anytime soon. In therapeutic areas neglected by major pharmaceutical companies, we certainly need foundations funded by tax exemptions on the wealth tax (ISF), or any other means of attracting financial resources from affluent individuals whom we wish to retain in our country.

We have too few success stories in therapeutic innovation in France to refrain from a thorough reevaluation of drug development in our country, which was a major player in the pharmaceutical field for a significant portion of th^e 20th century. By exempting industrial research centers from the 35-hour workweek law, we would give ourselves a slightly better chance of preventing their closure within our borders and, why not, of once again becoming attractive to major international corporations by better targeting the research tax credit toward innovation and its integration with basic research. Let’s avoid creating a “drug development plan,” because therapeutic innovation relies more on the talents of creators than on the speeches and presentations of “committee specialists” who have never been in a real-world innovation setting.

Drug development is not tied to the presence of natural resources or climatic conditions: it is a purely intellectual endeavor that depends solely on the surrounding ecosystem and genuine support for innovation and talent.

All of these various points were addressed throughout the eight courses (with a seminar associated with each course) and a closing symposium.