Andy Grove, Time Magazine’s Man of the Year a decade ago and one of the founders of computer giant Intel, is mad again. He was mad 12 years ago, when he was first diagnosed with prostate cancer, at the way the healthcare system treated him.
So mad, in fact, that in 1998 he led Intel to focus on the healthcare system for Intel’s “Internet Health Day,” and subsequent Internet Health Initiative.
That initiative led to Intel working more closely with many of its technology partners to speed progress in technological innovations in medical devices. But it’s been a mixed bag, as many of Intel’s investments in this area, such as in Abaton, ChannelPoint, and CommuniHealth (just to name a few) resulted in nada. Perhaps Intel was just ahead of its time.
On Sunday, Newsweek published an interview with Andy Grove entitled, An Intel Approach to Meds. In the interview, Andy Grove, who was more recently diagnosed with Parkinson’s Disease, suggests that the biomedical community of researchers and pharmaceutical companies is broken and must be fixed. While technological innovations in the computing field have occurred regularly for the past 30 years, he feels medicine and specifically pharmaceutical treatments have stagnated — “the number of transistors on a chip went from about 1,000 to almost 10 billion. Over that same period, the standard treatment for Parkinson’s disease went from L-dopa to . . . L-dopa.”
He’s going to have a hard time changing the pharmaceutical industry, however, because its timeline and structures are largely created and regulated by a morass of large, bureaucratic government agencies who are charged with protecting citizens’ safety over all else. Trust me, drug companies would love nothing more than to get more of its products to market sooner.
But he has plenty of blame to go around:
But in pharma, if a clinical trial doesn’t work–which means the average of all the patient responses is not better than the average of a placebo treatment–they just throw [the drug] away, when in fact the averages may hide stuff that did work, and something that made patients different [such as genetics]. I’ve never heard anyone talk about the opportunity costs of a good drug being thrown away. But a good drug wrongfully convicted means the loss of benefits goes on forever.
Grove pointedly doesn’t speak to how one might go about finding that “something that did work,” other than to generalize about genetics and such.
But Andy Grove’s answer to this question is probably the most interesting:
What stands in the way of more and faster success in getting cures to patients?
The peer review system in grant making and in academic advancement has the major disadvantage of creating conformity of thoughts and values. It’s a modern equivalent of a Middle Ages guild, where you have to sing a particular way to get grants, promotions and tenure. The pressure to conform [to prevailing ideas of what causes diseases and how best to find treatments for them] means you lose the people who want to get up and go in a different direction. There is no place for the wild ducks. The result is more sameness and less innovation. What we need is a cultural revolution in the research community, academic and non-academic. We need to give wild ducks the opportunity to emerge and quack their way to success. But cultural change can be driven only by action at the top.
Many people have been saying this for some time… That the peer-review process is a broken, flawed process to begin with, and one we stick with only because we haven’t come up with something better.
Perhaps it’s time to look for that something better to bring innovation and fresh ideas back into the science of medicine and mental health.