All in the name of research

A Moderator said: Spencer wants to know: "Is money allocated for research solely on how many people the particular disease kills or is it more to do with how much money the drug can be sold for?" Andrew Curl said: Money is allocated to research based on whether there is a un met medical need. If there is then this is an attractive area for medical research. A Moderator said: Adam wants to know: "Why is only 12% of the NHS budget spent on medicine when it is so vital to a patients care?" Andrew Curl said: It is up to the NHS how it spends its money but the amount spent in the UK is only approximately a half what is spent in Europe on medicines per head of population. A Moderator said: Denise wants to know: "Do we need to spend so much on researching new medicines when we could just improve the performance of existing drugs?" Andrew Curl said: We need to do both; we need to use existing drugs in a better way, but we need to spend money on researching new medicines for the future. In the UK the pharmaceutical industry spends £9 million pounds per day on research. A Moderator said: Angela wants to know: "What factors determine the choice and direction of research and projects today?" Andrew Curl said: The answer is where is there a major un met need eg. Cancer, HIV, Aids or where existing treatments no longer work well eg. Some antibiotics. A Moderator said: Lucy wants to know: "How long does it take for initial research on a medicine to something being prescribed to the public?" Andrew Curl said: It takes between 9 and 12 years and costs 500 million pounds. A Moderator said: John wants to know: "Where do you see medical research heading in the next ten years?" Andrew Curl said: Key areas will be gene science, continued cancer research, better immunisation and the diseases of the elderly. Genetic research and utilising data from the human Genoma project is clearly a major and exciting area. A Moderator said: Tonie wants to know: "What disease does the most money go into researching?" Andrew Curl said: Probably the largest area is cancer followed by cardiovascular medicine. A Moderator said: Lee wants to know: "What was the last innovative treatment that came from the UK?" Andrew Curl said: 25 of the top 100 medicines in the world were developed in the UK. These include anti-ulcer treatments, products for high blood pressure and! Viagra. A Moderator said: Neil has a question: "How does the research that is carried out in the UK compare to that of other countries in terms of its effectiveness, innovation, credibility etc?" Andrew Curl said: UK is second only to the United States in its productivity and science is highly respected internationally. A Moderator said: Luke wants to know: "Is it true that pharmaceutical companies are unlikely to research treatments for illnesses that occur outside the developed work because people can't afford to pay for them and hence there's no profit?" Andrew Curl said: No. Pharmaceutical companies spend their time and energy developing medicines for the developing world, including treatments for leprosy, river blindness and other illnesses, which occur only outside the developed world. A Moderator said: Louise wants to know: "If the UK spends so much on research and we have such a good record in developing world beating medicines, why is our healthcare system crumbling?" Andrew Curl said: The issue is that we need to make sure that we adequately fund the NHS to make sure that family doctors and consultants are able to prescribe the most modern and effective medicines for their patients. That is up to the Government. What the pharmaceutical industry can do is make those medicines available. A Moderator said: Sam is asking: "What is being done to Prevent and treat disabling diseases such as multiple sclerosis, muscular dystrophy and rheumatoid arthritis?" Andrew Curl said: Certainly, I know of a lot of research in three areas, which will improve treatment in the future. Unfortunately, there is no way to prevent the onset of these three illnesses. A Moderator said: Jennifer wants to know: "Who decides how much money is spent on researching medicines for each particular illness?" Andrew Curl said: 75% of all medicine research in the UK is undertaken by pharmaceutical companies, who themselves decide where to invest this money. The additional money is provided by government and academic institutions that set their own priorities. A Moderator said: Alex wants to know: "Does the UK help research into tropical diseases or better-known cases?" Andrew Curl said: Yes. A number of research projects into tropical diseases are funded in the UK by both companies and government. A Moderator said: Russ wants to know: "The US are apparently the worlds best at discovering new treatments and yet they have no free state funded healthcare system. Would the UK be better off with a similar system?" Andrew Curl said: That is a question for politicians but it is a proud tradition in the UK to have a state funded healthcare system, supplemented by a private sector. A Moderator said: Taylor wants to know: "Would you say the introduction of computerisation in the industry has made a huge impact on how research is carried out?" Andrew Curl said: Yes. Computerisation has enabled the industry to screen far more potential compounds, often on a virtual basis. This is important because out of every ten thousand products identified in the lab, only one reaches the patients. A Moderator said: Max is asking: "Is it possible to estimate a cost for researching an average drug?" Andrew Curl said: Yes on average is costs £500 million pounds. This is the investment made for each successful medicine before it reaches the patient. Its a high risk business. A Moderator said: Jim wants to know: "There's more money in curing a rich white man of impotence than there is of curing a poor black man of AIDS. Your view?" Andrew Curl said: We need to do both. Aids research is one of the highest priorities. However, for the patient suffering from impotence it is an important issue and it's only reasonable that medicines are developed to meet what can be a distressing condition. A Moderator said: Ella wants to know: "Is the ABPI worried that the general public seem to have no idea about research or the cost of medicines?" Andrew Curl said: Yes. We need to communicate better the value of our research. The UK is one of the centres of innovation and the pharmaceutical industry invests £9 million per day here on medicine research. Ella, please spread the message. A Moderator said: Zoe would like to ask: "Does all scientific research for new medicines test on animals? I always use cosmetics that aren't animal tested but is it possible to make the same choice for medicine?" Andrew Curl said: The pharmaceutical industry only uses tests on animals because no other means of evaluating safety exists. Its a last resort for us and is a requirement of the regulatory authorities in this country. A Moderator said: Sasha wants to know: "In the budget last week, Gordon Brown mentioned that The UK government is to set up new specialist research institutes to try to find treatments and cures for a range of diseases as part of a 10-year plan to boost medical research. Do you think this is encouraging or there should have been something in place way before this?" Andrew Curl said: This is very encouraging and the government to date has been very supportive of keeping the UK as one of the worlds leading centres for medicinal discovery. A Moderator said: Harry wants to know: "Why do we hear about Protecting and preserving continued funding of human embryonic stem cell research – what does this mean?" Andrew Curl said: Stem cell research is an important area for the future and we need to understand the potential for use in future medicines and part of the work is funded by government but there are many privately funded initiatives also in place. This is going to be a key area for industry and patients over the next ten years. A Moderator said: Ashleigh wants to know: "Can I look at the survey the ABPI did anywhere? It would be useful for some coursework I am doing." Andrew Curl said: Look on our ABPI Website www.abpi.org.uk A Moderator said: Kym wants to know: "What is the ratio between actual laboratory research and clinical trials once a medicine has been found? Are we having to spend more and more on the trial phase because of our litigious society?" Andrew Curl said: Laboratory research takes approximately two to three years. Potential medicines are then tested in volunteers and once efficacy has been shown the medicine is used in more extensive clinical trials. These typically take a further three years or so. The key issue is not fear of litigation but the need to prove that a new medicine is safe, effective and offers clinical advantage to the patient. A Moderator said: Joe is asking: "Are we spending as much on treatments for heart disease as we are on cancer since it kills as many people in the UK?" Andrew Curl said: These two areas are the priority and in broad terms spending on heart disease and cardiovascular illness is broadly similar to cancer. A Moderator said: George wants to know: "What future research have you heard about that has shocked / impressed you the most?" Andrew Curl said: Often the most impressive research is not that which offers a breakthrough for a limited number of patients. that is certainly important but what is equally impressive is when the lives of a large number of patients are improved. In this respect continued developments in hypertension and reduction of cholesterol have prolonged patients lives by many years and improve their quality of life. That to me is impressive. A Moderator said: Anthony wants to know: "Is research destined to decline as fewer and fewer scientists emerge from University with ambitions in R and D?" Andrew Curl said: We are concerned about this, particularly as the pharmaceutical industry employs one in three science graduates directly or indirectly. There is no evidence at the moment of any decline in research quality or quantity in the UK. A Moderator said: Frank wants to know: "How can we justify spending £9 million every day on research when there are people in the UK living in poverty?" Andrew Curl said: This is not money that the taxpayer is spending. It is funded by private companies and hopefully the results of this investment will bring benefit to many patients in the future. A Moderator said: Lisa wants to know: "Is all UK research actually done in the UK or do UK pharmaceuticals spend money elsewhere?" Andrew Curl said: the answer is both. UK companies conduct research outside the UK and most international pharmaceutical companies also fund big research project in the UK. A Moderator said: Leslie wants to know: "I have heard that scientists in the US have developed a drug-containing microchip, which can be implanted in the body – do you think this is the future on how we will be taking medicine in years to come?" Andrew Curl said: Yes. This is a possibility for some long-term conditions. Research is taking place now into this as a means of delivering medicines over a long period of time. A Moderator said: Kelly wants to know: "I saw an ad in the paper for people wanted to take part in clinical trials. Is this safe?" Andrew Curl said: Yes. The company placing the advertisement will be a clinical trials organisation, which is licensed by the UK Regulatory authorities. A Moderator said: Graham wants to know: "How much are the public really told about medical research? And truthfully how much do you think we don't know about that is going on behind the scenes?" Andrew Curl said: There is no secrecy; we like to be as open as possible. All data is submitted to the regulatory authorities for independent scrutiny. Like all industries some information is commercially confidential, but even this has been reviewed by independent scientists and the regulators. A Moderator said: Wendy wants to know: "Hello. According to the ABPI the public would be astonished to discover that all the benefits we have come to associate with modern medicines are achieved at such a relatively low cost to the NHS – why is this?" Andrew Curl said: I'm sure there are lots of reasons. Perhaps it's stories they read in the newspapers, or perhaps it's because they are not sure of the cost because they don't pay for them directly - the NHS does that. I like to think it's because they can't believe they are getting such good and effective products so cheaply! But seriously, the fact remains that medicines represent only 12 per cent of the NHS's budget and they represent excellent value for money. The average cost of a prescription medicine is about £10, while a week's stay in hospital is some £1,500. A Moderator said: Joseph wants to know: "Do you think we place too much emphasis on the treatment of cancer in the UK when there are so may other illnesses that can affect us?" Andrew Curl said: Our survey showed that cancer was the illness most feared followed only by heart disease. 75% of those interviewed thought that cancer was to number one cause of death in the UK, so I think that the emphasis placed in it was reasonable. However, we are researching many other disease areas including Alzheimer's disease, depression and Parkinson's for example. A Moderator said: Melissa wants to know: "Is it true that blood pressure is even more strongly related to the risks of death from cardiovascular causes than was previously realised?" Andrew Curl said: High blood pressure has always been known to be one of the contributing causes of cardiovascular disease. It has become even more widely known as GP's now routinely screen potential at risk patients. The treatment of high blood pressure has advanced significantly with the availability of new medicines, many incidentally developed in the UK. A Moderator said: Tara wants to know: "Is research in the UK hindered or held up much by legislation?" Andrew Curl said: There must be checks and balances to ensure that medicines are safe to use. However, it is a question of balance and we must ensure that legislation or regulation does not become unreasonable and so prevent or limit often groundbreaking research. A Moderator said: Darren wants to know: "Do you think we should waste money researching medicines for diseases that are largely ‘self inflicted' i.e. medicines for hangovers, obesity, smoking related diseases etc." Andrew Curl said: The NHS does not discriminate and pharmaceutical companies can't be judgmental of personal lifestyles when developing new medicines. A Moderator said: Polly wants to know: "Will the UK ever catch up with the US in terms of discovering new treatments?" Andrew Curl said: The UK bats above its weight in terms of developing new treatments. It is second to the US but far, far ahead of other comparably sized companies such as France, Germany and Italy, particularly in the field of bio-technology. A Moderator said: Emma wants to know: "One person in 30 has asthma and the rate in children is growing. Despite advances in asthma treatment, around 2,000 people die from it each year in UK alone. Are there any new advances in finding a cure for this?" Andrew Curl said: Asthma is a key area of research and five of the last major twenty five medicines developed in the UK were for the treatment of asthma. Research continues but the key thing for the future will be for doctors to prescribe the best and most recently available treatments, rather than rely on older more conservative medicines. The UK, despite having an innovative and successful research based pharmaceutical industry is less good at prescribing the latest treatments. Compared to Europe the usage of medicines developed in the last four years is half that of France, Germany and Italy. Andrew Curl said: Thank you to everyone who has shown an interest in the subject, if you would like to know more about the pharmaceutical industry and its role in developing innovative medicines in the UK, please log onto our website www.abpi.org.uk Thank you.