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To address this gap in knowledge between the academic and corporate worlds ,"[Bartfai] offered to give these lectures as a primer," says Skaggs Institute Director Julius Rebek.

"Since I came here, I have [had] about five colleagues each week asking me something about drug development," Bartfai says. "People have asked me questions like, 'Why did they stop the development of this drug that we have worked on?'"

He has been asked to look at their business plans or to clear up confusion over a decision by a large company with which they collaborate, for instance, or to help make sense of a new request.

The Sociological Imperative

Another perspective Bartfai hopes to address during the upcoming lectures is how the pharmaceutical industry is highly sensitive to the social context in which it exists.

Drug development follows trends and these trends are informed by the public's actual and perceived wants and needs. In America today, that does not simply mean demands from patients and from doctors tending to their patients' needs, but also pressure from patients' interest groups and health maintenance organizations and other large demographic forces.

We are an aging society. The CDC estimates that by the year 2030, there will be 70 million elderly Americans—more than twice the current number. And the United Nations recently estimated that population of people in the world over the age of 60 will reach two billion within 50 years.

This aging of America and the rest of the world means an increased demand for better compounds to combat those diseases and indications specific to the elderly, and the pharmaceutical companies are a weathervane of this demand.

For instance Alzheimer's disease, which is believed to afflict four million Americans, is now a major area of research. Our aging society has recognized and understood the need to confront the problem of Alzheimer's disease, and today, according to Bartfai, there is no self-respecting pharmaceutical company that does not have 5-15 Alzheimer's programs. Yet this has not always been the case.

"If somebody stood up in 1970 and said, 'I want to make an Alzheimer's drug,' he would not only have not got any support within a drug company, but he would also not have gotten a grant from the NIH [National Institutes of Health]," says Bartfai.

Similarly, other targets of pharmaceutical research are aimed at an aging America.

Osteoporosis drugs are needed to combat the deterioration of bones in the elderly, one of the leading causes of loss of quality of life in later years. Some 44 million Americans—most of whom are women—have already developed osteoporosis or the early signs of bone density loss that lead to it. As our population ages, this number will only increase, and osteoporosis blockers are a major target for pharmaceutical companies. Many companies are also taking aim at other age-related ailments like arthritis, Parkinson's disease, and urinary incontinence.

Besides being an aging society, we are a society that is increasingly aware of mental illness and increasingly more willing to medicate it. Antidepressants already make up one of the largest markets in the United States, amounting for around $15 billion annually. However, there is still a great need for a fast acting antidepressant. Normal antidepressants take two or three weeks to take effect, and as many as a third of patients do not respond to the drugs. This is problematic because the core symptom of serious depression is suicidal tendencies. In 1997, for instance, 30,535 Americans committed suicide, making it the eighth leading cause of death in the United States that year. One of Bartfai's own longstanding goals is to develop a quick-acting compound for the treatment of depression. "We just don't know how to make such a tablet yet," he says.

Some of the other drug targets today are high-profile diseases, like AIDS and various types of cancer. From a global perspective, there is a need for vaccines for tuberculosis and malaria, both major health problems worldwide.

"People would like to have vaccines [against TB and malaria] without a shadow of a doubt," says Bartfai, "Even the rich countries have come to realize that helping to eradicated these diseases would be a formidable form of aid, not only to third world, but also to countries such as Russia with 26 million tuberculosis cases."

Other drug targets are not so obvious to those outside the field, such as drugs to control asthma and other respiratory infections and constrictions, preventative migraine medicine, or a decent (safe, less side-effect prone, but efficacious) acne drug—the market for which, Bartfai insists, should not be underestimated.

"If someone came up with [a decent acne drug], it would sell for billions," says Bartfai.



Upcoming Lectures:

TARGET-BASED DRUG DISCOVERY, on Thursday, May 2. Topics to be discussed include validated drug targets: what they are and for whom, a determination of their value, and comparison of targets for the same clinical indication.

SELECTION OF CLINICAL CANDIDATES: MULTIPLE PRESSURES, on Thursday, May 9. The presentation will focus on the key milestones of preclinical drug development—timing, expenditures, backup strategies, outside validations, and orphan drugs—as these factors play out in big Pharma decision making.

Lectures will be held from 5 to 6:30 PM in the Neurosciences Institute Auditorium, 10640 John Jay Hopkins Drive.


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"Since I came here, I have [had] about five colleagues each week asking me something about drug development."

—Tamas Bartfai