Biomedical Innovation: Lessons From the Past and Perspectives for the Future.

Back around the turn of the millennium, the future of the pharmaceutical industry was bright. Amazing technologies were converging to enable a top-to-bottom reengineering of drug research and development (R&D). The "omics," combinatorial chemistry, high-throughput screening, robotic automation, and systems biology, promised to bring order and method to drug research's bewildering complexity. Pharmaceutical executives-many of whom were ill at ease with their scientists' freewheeling ways-were excited. Gushing with an enthusiasm that was typical of the times, a former industry Chief Executive Officer spoke glowingly of the launch of "two to three new blockbusters… each year" driving a quadrupling of revenues.

A forensic analysis of drug targets from 2000 through 2012.

Pharmaceutical innovation is often measured by counting the new drugs approved by regulators. It is a simple and useful metric, but it has shortcomings. One of them is that it says little about the drugs' innovativeness. Are they variations of older medicines or molecules targeting entirely novel modes of action? As prices escalate, and payers and patients demand value, we need a better picture. This article aims to provide it by analyzing the drugs approved by the US Food and Drug Administration between 2000 and 2012. It examines their modes of action, highlights key trends, and discusses their implications for our ability to generate innovation.

Towards new business models for R&D for novel antibiotics.

In the face of a growing global burden of resistance to existing antibiotics, a combination of scientific and economic challenges has posed significant barriers to the development of novel antibacterials over the past few decades. Yet the bottlenecks at each stage of the pharmaceutical value chain-from discovery to post-marketing-present opportunities to reengineer an innovation pipeline that has fallen short. The upstream hurdles to lead identification and optimization may be eased with greater multi-sectoral collaboration, a growing array of alternatives to high-throughput screening, and the application of open source approaches. Product development partnerships and South-South innovation platforms have shown promise in bolstering the R&D efforts to tackle neglected diseases. Strategies that delink product sales from the firms' return on investment can help ensure that the twin goals of innovation and access are met. To effect these changes, both public and private sector stakeholders must show greater commitment to an R&D agenda that will address this problem, not only for industrialized countries but also globally.

Can open-source drug R&D repower pharmaceutical innovation?

Open-source R&D initiatives are multiplying across biomedical research. Some of them-such as public-private partnerships-have achieved notable success in bringing new drugs to market economically, whereas others reflect the pharmaceutical industry's efforts to retool its R&D model. Is open innovation the answer to the innovation crisis? This Commentary argues that although it may likely be part of the solution, significant cultural, scientific, and regulatory barriers can prevent it from delivering on its promise.