Horizontal Chemistry.

In 1976 Raymond Williams commented, 'Culture is one of the two or three most complicated words in the English language.' Such implied difficulty has not prevented Bloomsbury Academic, since the 2000s, from publishing around forty series of their well-produced and generously illustrated Cultural Histories, with, according to their website, a further fifty in progress. Each series contains six volumes, each book covering, in theory, the same chronological period (antiquity, the Middle Ages, the Renaissance, the Enlightenment, the age of empire and the modern age), though there is some variation depending on precise topic. The idea is that one can use these books not only to read 'horizontally' about a subject across time, but also 'vertically' through different subjects in the same period - a idea made easier by the e-texts of the series on Bloomsbury's website.

Imperial Chemical Industries and Craig Jordan, "the First Tamoxifen Consultant," 1960s-1990s.

This paper examines the relationship between Imperial Chemical Industries (ICI), the company that discovered tamoxifen, and Dr Craig Jordan, who played a major part in its success as a breast cancer drug, and who worked as a consultant for the company, but without ever being paid a consultancy fee. Instead, ICI funded junior staff working in his laboratory on topics of his choice. They later paid his expenses as an expert witness in patent-litigation cases, as a result of which the US became a major lucrative market for tamoxifen, and ICI's other anti-cancer drugs. This case study illustrates that, like consultants, drugs play an important part at the boundary between the academic and industrial spheres. However, even if it is blurred, the boundary remains. Owing to the secrecy that often surrounds industrial research, this boundary may lead to a different understanding of what constitutes innovation, and to different narratives with regard to respective contributions.

Tamoxifen from Failed Contraceptive Pill to Best-Selling Breast Cancer Medicine: A Case-Study in Pharmaceutical Innovation.

Today, tamoxifen is one of the world's best-selling hormonal breast cancer drugs. However, it was not always so. Compound ICI 46,474 (as it was first known) was synthesized in 1962 within a project to develop a contraceptive pill in the pharmaceutical laboratories of ICI (now part of AstraZeneca). Although designed to act as an anti-estrogen, the compound stimulated, rather than suppressed ovulation in women. This, and the fact that it could not be patented in the USA, its largest potential market, meant that ICI nearly stopped the project. It was saved partly because the team's leader, Arthur Walpole, threatened to resign, and pressed on with another project: to develop tamoxifen as a treatment for breast cancer. Even then, its market appeared small, because at first it was mainly used as a palliative treatment for advanced breast cancer. An important turning point in tamoxifen's journey from orphan drug to best-selling medicine occurred in the 1980s, when clinical trials showed that it was also useful as an adjuvant to surgery and chemotherapy in the early stages of the disease. Later, trials demonstrated that it could prevent its occurrence or re-occurrence in women at high risk of breast cancer. Thus, it became the first preventive for any cancer, helping to establish the broader principles of chemoprevention, and extending the market for tamoxifen and similar drugs further still. Using tamoxifen as a case study, this paper discusses the limits of the rational approach to drug design, the role of human actors, and the series of feedback loops between bench and bedside that underpins pharmaceutical innovation. The paper also highlights the complex evaluation and management of risk that are involved in all therapies, but more especially perhaps in life-threatening and emotion-laden diseases like cancer.

Targeting the American market for medicines, ca. 1950s-1970s: ICI and Rhône-Poulenc compared.

The forces that have shaped American medicine include a wide set of interrelated changes, among them the changing research, development, and marketing practices of the pharmaceutical industry. This article compares the research and development (R&D) and marketing strategies of the British group Imperial Chemical Industries (ICI, whose Pharmaceutical Division was spun off and merged with the Swedish company Astra to form AstraZeneca) and its French counterpart Rhône-Poulenc (now part of Sanofi-Aventis) in dealing with the American medical market. It examines how, in the process, the relationship between R&D and marketing was altered, and the firms themselves were transformed. The article also questions the extent to which their approaches to this market, one of the most significant markets for drugs in general, and for anticancer drugs in particular, became standardized in the period of "scientific marketing."

Making British cortisone: Glaxo and the development of corticosteroids in Britain in the 1950s-1960s.

Following the announcement in 1949 in the USA that cortisone offered rheumatoid arthritis sufferers effective treatment for their crippling disease, the Ministry of Health came under considerable pressure from the medical profession and the public to make cortisone available in Britain. The Ministry, therefore, urged British companies to start manufacturing cortisone. Among the several pharmaceutical firms responding to the Ministry's request, Glaxo's expertise in the field of vitamins gave them a head start. This paper describes the varied and flexible strategy that enabled Glaxo to maintain this head start, and the scientific and technical capabilities which the company subsequently built up, enabling them to dominate the market for corticosteroids in Britain. Among the drugs to emerge out of the Glaxo project to manufacture cortisone, which began in 1950 and later became a wider R&D programme on steroids, was the topical steroid Betnovate, launched in 1963, which remains a best-seller today. However, although it led to successful new products, Glaxo's programme had limitations. The paper identifies a missed opportunity, in the shape of the biosynthetic route to steroid drugs, often considered as a milestone in the development of the new biotechnology. Whether or not this missed opportunity proved costly to the company is uncertain. However, it illustrates the role of technological path-dependence, and the importance of the integration between different scientific disciplines, in this case chemistry and biology, in pharmaceutical innovation.