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Former Intel CEO Rips Medical Research
Himuanam writes "Former Intel CEO Grove rips on the medical research community, contrasting their lack of progress with the tech industry's juggernaut of breakthroughs over the past half-century or so. 'On Sunday afternoon, Grove is unleashing a scathing critique of the nation's biomedical establishment. In a speech at the annual meeting of the Society for Neuroscience, he challenges big pharma companies, many of which haven't had an important new compound approved in ages, and academic researchers who are content with getting NIH grants and publishing research papers with little regard to whether their work leads to something that can alleviate disease, to change their ways.'"
The only reason Intel has had any motivation to come up with any real breakthroughs in the last 20 years is AMD eating their lunch with the Opetron. All they had in 2003 was the Itanium and we all know how big of a turd that was.
I don't think that the IT industry has the regulatory pressures that the medical industry has, so he isn't comparing like with like.
You break all the laws of physics and you seriously think there wouldn't be a price?
And that's the way it ought to be. Not all things need immediate applications. Many of the most impressive inventions of our time have been a fusion of research that seemingly have few worthwhile applications. Expanding the sum of human knowledge is never a waste of time.
From the article
The fundamental tenet that drives us all in the semiconductor industry is a deeply felt conviction that what matters is time to market, or time to money. But you never hear an executive from a pharmaceutical company say, "Before the end of the year I'm going to have xyz drug," the way Steve Jobs said the iPhone would be out on schedule. The heart of every high-tech executive has been, get the product into customers' hands and ramp up production. That drive is just not present in pharma; the drive to get sufficient understanding and go for it is missing.
Let me tell you, if Intel had to pay $5,000,000 to the widow of everyone killed by an FDIV bug who would have died 3 weeks later (eg, like a drug company has to do), they would be a lot more conservative about getting chips to market.
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Biomedical is a cross between fundamental research, medical research and pharma. The fundamental researchers stumble across things that move through the pipe to pharma. Without them and their "content in writing grants to the NIH", many breakthrough drugs would not exist.
I can hardly imagine what the medical profession would be like had it been subjected to the so-called progress and innovation we've been cursed with in the tech industry in the past couple of decades, but the possibilities are horrifying. Microsoft Doctor? Intel Inside? Intestinal Exploder? "rights management" for your medications? Nursing outsourced to call centers? No thanks, Andy.
Unlike chip makers, pharmaceutical companies need a national government's approval to market their product. How quickly would Intel and AMD have been able to step up the capabilities of their processors if some Digital Restrictions Ministry or some other government agency had to approve every stepping?
First, given the current regulation scheme (the FDA in the US, for example) the distance between a fundamental discovery and an actual drug on the market is much greater in medicine than it is in technology -- Intel does not require approval from anyone to market their next-gen processor. Second, the current patent system makes making trivial improvements on existing drugs (hence extending monopoly protection) much more profitable than researching new drugs (high risk of failing to produce anything).
But even ignoring all these things, on a fundamental level biology is orders of magnitude more difficult than physics. We understand the physics of seminconductors and the mathematics of computation fairly well. We can simulate future processors ahead of time to see if a new cache design will improve performance or not. We have no idea how to simulate a biological system, and barely have quantitative models for event the simplest ones. Let's give it 100 years and try again.
Well Andy, Maybe the human body is just many many times more complex than a calculator.
And it's news that the Pharms would prefer to treat the symptoms rather than cure a disease? There's no money in cures. But keeping people buying pills to treat symptoms - or better yet - reclassifying symptoms as new diseases. Now you're talkin' the shareholder's language baby!
Otherwise it's all just an order for another box of a half-dozen duh's. To go.
We don't understand the human body. We don't know how some drugs even work. It isn't like a computer that we built from scratch ourselves. Two people of exactly the same body mass and type will react differently to the same drug, and we usually don't know why. We haven't mapped the genome, and when we finish mapping it, we won't understand it. We don't know why aging happens. We don't know what causes many diseases. We don't know where viruses came from or how to stop them.
Medical science is mostly things we don't know, so we stick to the few we do and research the heck out of them. Also, Big Pharma aren't interested in cures. Cures hurt profits. They research treatments, not cures. That's what I'd hope is the main point of a rant against Big Pharma. They are paid to keep people sick, but mask the symptoms, not to actually make them well.
Learn to love Alaska
Hey there! I'm in an unrelated field and I don't know how to do your job, but here's a few changes I'd like to see anyway....
So Mr. Grove, let's consider all the faulty products you shipped in just one year of your career at Intel--and now let's imagine every single customer that bought one of those products suing your company for a half-million dollars each, and winning....
~
His argument is not without merit though. There is no financial interest in developing new drugs when old drugs are still protected under obscenely long lasting patents. And researchers are, as researchers are. I highly doubt many of the silicon engineers are eagerly awaiting news of how Timmy used their latest creation to do his high school term paper on. Like whys, most researchers are likely more interested in continuing their research than the 5-20 year battle what ever their last findings will go through before becoming a commercial grade product.
All of that could be put aside though, save for one major factor. There is a HUGE amount of money in the pharmaceutical world. And the sad fact is, more of that money goes to crap like Viagra commercials during the Super Bowl than to the research and development of new drugs and treatments.
I'm not saying everyone in the industry is a greedy whore, heck, I've met and worked with some really great people who are in it for the cures. But the privatization of research, the excessive burden of patents, and the big-business/lobbyist friendly approach of our government over the last 2+ decades have lead to a slowing of development and a maximization of profits.
-Rick
"Most people in the U.S. wouldn't know they live in a tyrannical state if it walked up and grabbed their junk." - MyFirs
OK, so Grove compares apples and oranges, and the liabilities involved with testing medical "studd" are way higher than with microprocessors and other tech stuff... all that and more... but I, in my hart of hearts, feel he has a point. I often wonder what, really, does modern medicine manage to really solve? Diabetes? Nope. Cancer? Nope. Arthrytis? Nope. Ostheoporosis? No. MS? No. etc. (keep that flamethrower down, damn!) I volunteer helping blind people, and just happen to know many eye diseases that are uncurable.
It's a bit depressing, considering it's one of the oldest sciences.
"The agriculture ministry is not in charge of Gundam" - Japanese ministry official.
As a post-doc in the biological sciences, here's my two cents:
First, the reason certain diseases haven't been cured while computer chips have gotten smaller and faster is that curing the diseases is a much harder problem.
I do, however, have opinions about how to improve the pace of scientific research. In my view, the key to improving the pace of scientific research is to reduce accountability. What I mean by that is to adopt an open source model where people join projects because they believe in the project rather than because that's what pays the bills.
What needs to happen is that rather than getting assigned to a particular grant, researchers are given a basic package of funding and then they are free to attach themselves to the most promising projects. As it is, the system is so rigid that the successful projects are unable to grow and the unsuccessful projects linger long past the point where it is clear that they have failed.
which makes it much easier to grab the low hanging fruit. The history of medicine goes back thousands of years and is much more "mature". Any industry accomplishes a lot when it is young, that seems to be the nature of the game. Look at airplanes. There was less than 50 years between the flight at Kitty hawk and testing the first jets. But how much have planes improved in the past 50 years? Not nearly as much because it gets harder and harder to find places to improve. Boeing's all composite design is pretty revolutionary, but it only achieves about a 20% increase in efficiency at best. Same with medicine.
Medicine is also chasing a moving target much more than say microchips are. There are always going to be new challenges in tech, but once a problem is "solved" in the computer world, it tends to stay that way. Compare that to what medical researchers have to deal with. As seen in the news, bacteria and viruses evolve. Malaria is a constantly moving target. Much harder to chase a moving target than a still one.
Monstar L
There's a big difference between applying tools to solve a problem (engineering) and developing those tools from observation of existing systems (science). Someone should remind Andy that the entire information technology industry is still based on understandings of electromagnetism and optics that date back more than 100 years. In contrast, we only learned about DNA about 50 years ago.
Imagine trying to learn about computers by starting from scratch with a Core 2 Duo chip. Now multiply that by 1,000 and you have the human genome. And that doesn't even get into the more complex firmware, software, viruses, etc. of biological systems.
Build a man a fire, he's warm for one night. Set him on fire, and he's warm for the rest of his life.
You make some good points. However, to some extent I agree with Andy Grove's original statement. If you read the medical literature, most of the journals are full of poorly controlled articles, case reports and sometimes wild guesses. There is very little in medicine which is proven, especially in my field. I am a pediatric neurosurgeon and when I am reading the neurosurgical literature it is absolutely amazing what gets published. It almost seems as if articles are accepted into peer reviewed journals just so the the journal can fill its pages for the month. As also mentioned, the placebo effect greatly obfuscates the process. The ability to get a good case controlled trial which can prove or disprove that a medicine or procedure works requires a huge number of patients. In order to get a good study which may even include a sham surgery requires a huge amount of funding which no one is willing to provide, including the NIH, which is continually having its budget cut. Even if the money is acquired, getting the study past the institutional review board discourages almost all research. After all of this, the Health Insurance and Portability Act passed by the congress has imposed onerous standards for using even anonymous patient data. Overall, the legislative and legal environment in the United States is firmly in place against groundbreaking medical research which can prove or disprove whether treatments actually work.
America's a different market. Up until recently, generally speaking, people wanted technology put into performance, not efficiency. You can have both (Tesla) but it will cost you. People from the Union of Concerned Scientists preach that with products available today, you can increase the fuel efficiency of any automobile on the market by 30-80% depending on the auto. Auto manufacturers are only just getting around to it because, finally, gas prices are high enough that Americans are asking for it.
As for Harley's: it's a taste. Like buying the biggest pickup truck you can find and jacking it up to 12 feet in the air. Or owning a hummer. Or a Ferrari for that matter. Now you might say, "a Ferrari? That's cool though!" Sez you. Still gets less than 10 mpg, you can't ever really use its speed without risk of getting caught, so you have an expensive, fuel quaffing car that looks pretty.
Personally, I hate Harleys. People make them loud as a cannon, drive down your road at 6 in the morning to go to work. "Loud pipes save lives," they say, which is utter crap because I can't even hear the tractor trailer next to me with my windows up, how the heck am I going to hear you coming up behind me? Whatever, it's a feeling of power thing, I gather, sitting on a big rumbling beast of metal.
Please mod parent up. This is precisely why this medical model does not work. It is not geared to rid people of illnesses - it is just a legal drug bandits' model! Now you see why considering regulating the medical industry is not that crazy...
The Force actually is with me.
Don't knock it, mate. That Viagra is great stuff. Could be one of the defining inventions of our time. Seriously, think about the number of marriages that have hit the rocks because the girl (usually younger) can't get all of her needs satisfied anymore. One drug has made that a thing of the past.
You are clearly not married.
Someday you will think back to your post and burst out laughing at the idea that you would someday be married to someone who would actually want you to take Viagra to satisfy her sexual needs. You will probably be doing some chore that you have finally gotten around to after having endured three days of constant nagging when this occurs. You will not have had sex for weeks, and your prospects will look grim. Viagra will be utterly irrelevant to your predicament. In fact, if you were stupid enough to even bring it up to your wife, she would just laugh at you and say something like "Boy, bet it'd be tough walking through Walmart with one of those down yer pants, eh?!?"
Trust me man, the next you see one of those stupid Viagra commercials, just change the channel.
Also, as with my Crohn's example above, we have diseases where we dont' even understand the cause. We understand the cause(s) of depression and impotence a lot better though, which is why we have so many drugs for them. But think of the billions of dollars poured into research on those two fronts, and the hundreds of scientists engaged by the likes of Pfizer looking for the next big drug.
Imagine if, instead, we spent that money and used those scientists to research the root causes of diseases we don't know about? We might finally nail down the correct cause and therefore the proper treatment plan...then the hard work of developing drugs can begin. That won't happen as long as we're rehashing the same cures for the same diseases because it's easier and makes a lot of money...
"Life's short and hard, like a body building elf." -- The Bloodhound Gang
Here's a computer problem comparison since that is probably your specialty. There are a MILLION programs out there that can act as calculators, they're very easy programs to write - but there are only a handful of good BLAS libraries out there, those are difficult problems. You'd be called a fool if you suggested that we could make BLAS progress faster by taking the people off developing calculators and put them on BLAS - it's the same as your uneducated assumptions about the medical community.
They make money, thats why. At minimal risk of litigation.
Not that I agree with that, I myself would LOVE better neuro/psychiatric/physiological medications for myself and my family. The sad truth of the matter is given the industry environment it is more profitable for said pharmaceutical company to manufacture drugs with lower risk:net profit ratios than those with a
1)smaller user base;
2)more difficult research;
3)increased chance of litigation.
Given the current business/political environment, this is the reality of Big Pharma.
sig sig sig siggy sig
We understand the cause(s) of depression
Not really. Consider a TV with a rolling picture. The repairman arrives and rolls out a toolbag with a hundred mallets of different sizes, shapes, and hardnesses. He whacks the TV with each one in turn until the picture stops rolling. Then he sells you that hammer and tells you to use it 3 times a day. He warns you that in anywhere from a month to years, that hammer will stop working and he'll go through them all again to find a new one that works. We WISH our understanding of depression and how to fix it was that good!
To get a closer analogy, you'd have to add that some of the mallets make the picture fuzzy, others only let you recieve some of the channels, and sometimes the only way to get vertical hold and anything but the spanish channel is to use 3 or 4 hammers in combination but they cause the commercials to last longer, etc, etc, etc.
If we treated Crohns the way we treat depression, it would have been pronounced cured years ago. Just take these morphine pills, regular transfusions and this IV feeding solution. See? cured!
Part of the problem there is the deceptive commercials that make it sound like they've solved the problem, just take their pills!
I do see your point though, there does seem to be a lot more effort put into non-essential drugs and pretty commercials than in developing drugs to treat serious diseases.
Well provigilman (great name, do you sell it or use it?)
Anyway, I have mixed feelings about this. I think to some degree academia is somewhat content with grants and making money for any given institution compared to getting hard core difference making results. Much prestige is gained my making a university or hospital money with grants independent of real results.
I think also we are comparing two different things. Human/biologic research is inherently more complicated on multiple levels than say processer/material research. For instance there are far more ethical issues involving biologic/human research than processor design. Don't believe me, try submitting a study to an IRB sometime. Then there is cost, the logistics behind putting together any sort of clinical trial of any significance is insanely expensive. Another is just pure complexity. Biological systems are insanely complex we are just starting to learn and sort out the foundations of how stuff really works down to the molecule and I'm still not sure any one individual while ever be able to fully comprehend how it all works. Many of our discoveries before now were more like, I think this might work, try it out and realized it did or didn't make a difference and hopefully didn't hurt anyone while figuring that out. We're just now starting to have rational, well designed approaches to problems.
Processors design and the material research are basic science at its best. You can keep plugging away and until you get a desired result. The worst thing that happens is over costs or delays. Not to mention, processor design is processor design is processor design. chrones disease is not heart attack is not exactly the same as stroke is not the same as kidney stones is not the same as cerebral palsy. That is the number of diseases that fall under medicine or life sciences is huge. If you picked one, put all the brain power and money resources into just one that is spent on processor design and I bet we'd have some kick ass cures for that one disease. But wait, we'd still have thousands to go.
I echo the sentiments of the sibling/parent posters. To sum up:
..."
... and they sort of forgot about making any drugs. Instead, they made money through tactics with which any Slashdotter will be disgustingly familiar.
We have had steady advances in medicine. Just during the time I was in medical school (a decade ago), I was astounded by how much medical science had advanced. By the time I was finishing up on my medical training and getting ready for independent practice, we were being taught: "Remember that treatment for arthritis you learned in second year? Well, we don't do that any more --here's what we do instead
However, from the standpoint of the ordinary patient, there has been a problem in one specific area of medical research: Big Pharma. (That's what they call the largest pharmaceutical industries: Pfizer, Merck, Novartis, GSK, Astra-Zeneca, Wyeth, etc.) This is because they are not bringing new drugs to market.
Don't misunderstand me, now. I didn't say that basic research wasn't taking place, or that it didn't have potential to be developed into useful products. I said that Big Pharma was not bringing new drugs to market. I blame this on the profit-centred, corporate-minded groupthink that has been running Big Pharma. In a nutshell, Big Pharma has been mismanaged.
In the pharmaceutical industry, you can see a new drug coming from a long way off. First there has to be basic research; one in ten research studies will show a promising molecule (ie. possible drug candidate). One in ten molecules will be developed into a stable usable form that doesn't have to be sealed in gaseous form or injected directly into the kidney or other impractical things. One in ten usable molecules will show promise when tested on animals. One in ten animal-tested drugs will go on to clinical trials in humans. One in ten human trials will show something that's worthwhile marketing. (Okay, don't take the one-in-ten ratio too literally; a better estimate is that every drug brought to market came from somewhere around 500 to 1000 possible molecules.)
It takes time to go through all these discovery phases, and to go through clinical trials, get approval from the FDA (or equivalent regional drug authority), etc. There's a very long pipeline to go through before a drug gets to market, so you can see right now what sorts of drugs will be coming out five years down the road.
And Big Pharma has, basically, nothing coming out.
This is because there has been a huge merging frenzy in the past decade, almost like an orgy of nested expressions that would do any LisP programmer proud. Toss in SmithKline and Beecham, blend with Burroughs and Wellcome, sprinkle in some Glaxo, bake at high temperature, and out comes a steaming hot GlaxoSmithKline. Then there's Pfizer, gobbling up Warner and Pharmacia / Upjohn, and then spitting out the bones, a process so repetitious that the people eaten up and summarily laid off produced a T-shirt with the oval blue logo in the style of the Pfizer logo that says, "Pfired!"
It's been great for people juggling stocks. Valuations went up, people made money, CEO's made speeches
Any of you heard of "patent lawsuits"?
Yup, they went through patents! Hey, little company there, you can't sell our drugs, cuz WE have the patents! We have to make our money! My favourite example: a few years ago, a little company called Andrax sees that the patent for omeprazole (brand name Losec, or Prilosec in the USA) will be expiring soon, so they start developing a generic equivalent, preparing studies for the FDA to show that their generic equivalent is safe and equal to the brand name version. The plan is that, a year later, all the manufacturing equipment and research will be in place and they can start mass producing omeprazole the instant it comes off patent.
What happens? AstraZeneca ("AZ"), owner of the original brand name, sues Andrax for violating the patent. They say that the patent actually
404555974007725459910684486621289147856453481154 in hex is "You sank my Battleship?"
[GPG key in journal]