Making medicine getting tougher

Joseph Hammang, who oversees science policy for pharmaceutical giant Pfizer, is in North Carolina this week to visit researchers at Duke University and the University of North Carolina at Chapel Hill. He is also talking to state legislators and business executives at health-care forums in Raleigh and Charlotte.

Hammang, 51, is a neuroscientist who helps shape research and development at Pfizer, which, with almost $50 billion in annual revenue, is the world's largest drugmaker.

He acknowledged that the pharmaceutical industry is facing serious challenges: higher research and development costs, regulatory delays and competition from generic rivals.

Monday, after a forum organized by the National Association of Health Underwriters in Raleigh, Hammang spoke to staff writer Sabine Vollmer about the future of medicine making, a business that provides more than 10,000 jobs in the Triangle. This is an edited version of their conversation.

Q: Is the industry's business model broken?

A: No. The model is changing. Oncology is an example. When President Nixon declared war on cancer, we thought it was a single disease. Now it's multiple diseases ... and drugmakers are developing treatments targeting the many different variations. These targeted medicines can be applied to small populations of patients ... altering the blockbuster business model. Science is pushing us into segmented, personalized medicine. That's great for patients, but it also provides challenges.

Q: Will large drugmakers rely even more heavily on buying the rights to discoveries made by others, a practice called inlicensing?

A: Inlicensing has been an important source of new medicines for Pfizer, providing about 40 percent of the company's drug development pipeline. I see us continuing to partner with small companies and academic institutions.

We also established a biotherapeutics and bio-innovations center to advance our understanding of vaccines, biologics, antibodies and stem cells. The idea is to set up small, entrepreneurial research units, which is something other companies have also done. Large drugmakers have learned that moving quickly and adapting quickly is critically important.

Q: What role do large drugmakers play in testing new medicines?

A: It's probably the most important role. Nobody can match large drugmakers' clinical development muscle -- the expertise, capital and leadership to design clinical trials for experimental medicines. You have to put billions of dollars at risk every year with the hope of getting regulatory approval for a couple of new medicines. Small companies, universities and government can't do that.

Q: Why is the pharmaceutical industry having such a hard time discovering new medicines without bad side effects?

A: The problems that researchers are trying to crack today are impressive in their scale. Take Alzheimer's. The world has been investing for years to find better treatments without much luck. But scientists continue the work, because understanding Alzheimer's is likely to crack other neurodegenerative diseases, including Parkinson's. Look at the failed efforts to come up with an AIDS vaccine. We are learning that viruses are a lot smarter and craftier than us.

The more we dig into these diseases, the more difficult it gets and the more money we need to spend. It's frustrating for everybody. But nothing in science happens overnight.