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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.
Test your net with Netalyzr
Former Intel CEO rips automotive industry for not doubling fuel efficiency and halving cost every 18 months.
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.
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.
He's a rich man who is getting sick and old, and he's mad because it has turned out to be hard to find out how to stop people from getting sick and old. He's upset, and I understand that, but he also missed most of the points that might be out there to get.
No question that medicine is a different culture than engineering. I've spent a lot of time in both, and I know. I also know that medicine is NOT particularly creative, and you don't really want it to be. You want your illness to be routine and fixable, and being routine means that nobody has to sweat particularly hard to figure it out. The sweat, and there's plenty, has to be done in research and development, and the difference in development effort between a new therapy for a disease and a new electronic entertainment device is remarkable.
He talks about how the two cultures deal with failure. In engineering, particularly in microelectronics, failure means that you spend money, time, and energy fixing something you broke. In medicine, failure means that you kill somebody. This used to happen a lot, and the modern biomedical research culture is highly biased against failure. It's not OK to die in a study any more, even if the condition we're studying is in and of itself fatal. Changing this would speed up the process of research, but who's volunteering to die for the cause? (And no, offshoring it is NOT the answer - foreign governments are wising up to this quickly, as are domestic ethics consultants.)
He derides modern statistical techniques, misunderstanding the difference between statistical failure and subgroup averaging, and he flatters himself a prophet when he recommends something that pharmaceutical researchers have been doing for thirty years: analyzing failure to see if you can find partial success somewhere.
He writes off in a sentence or two the hardest problem of all, which is figuring out what in the heck is really going on (preparatory to changing it). In engineering, the complexity is finite and human-directed, and the systems are designed with severable components to make the process of debugging and analysis easier. In medicine, the complexity is engineered by a billion years of evolution, not all of it productive or even useful, and very poorly understood. In an organism such as people, where 50,000 poorly-understood genes interact with factorial complexity, just figuring out which end to push on can be maddening. It's the reason that peer review was invented: if you're up a creek with a paddle-less enzyme, there are probably only a few hundred people in the world who can tell whether you're a genius or just confused. Peer review at its best is just like open source. At it's worst it's a lot like open source at it's worst, but the less said of that the better.
I would love to see more acceptance of modern information techniques and more flexibility in medical research. I would love to see better use of rapid prototyping and model systems, and we're heading that way. We've actually come a huge way in medicine just in the last decades, and the pace is accelerating. TFA is just a measure of the fact that, just like software, sometimes the better the system gets, the more you can see how imperfect it is.
(misquoting shamelessly from memory)
PHB: I figure that anything I don't understand can't be that hard. "Reengineer our world-wide network topology: 30 minutes."
Welcome to the Panopticon. Used to be a prison, now it's your home.
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
A while ago Grove was ranting about the bar-code system for blood banks and going on about how they should be replaced with RFIDs. One Intel employee who actually had run a hospital blood bank pointed out that those bar-codes are readable by candlelight. When lives are at stake, you do not introduce unnecessary complications into the system.
Lacking <sarcasm> tags,
You know what is ironic? Computer hardware is a major limiter of research; imagine that. Calculating the most stable structure and interactions between proteins is very computationally intensive. Excluding super-efficient mathematical methods [unlikely] we are stuck with *his* hardware to do the job. If he wants to attack something for his perceived lack of medical progress, he better start cracking on the better hardware so that we can do our work.
Sigs are too short to say anything truly profound so read the above post instead.
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.
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.
After cloning Dolly the sheep, Ian Wilmut was invited to Boston to give a lecture on his work. After his presentation, there was a call for questions and the room was silent. There was zero interest in this research and you'd have to quite naive to not know why. Everybody there was making their living on grants. The last thing in the world you want to put on a federal grant is that you're going to do human therapeutic cloning. So why would you even bother asking a question in the direction. The subject has nothing to do with you if you're an American biomedical researcher who plans to stay employed. And yet at the same time it's some of the most exciting science in decades.
That's fucked up. This is politics essentially censoring science.
Now, I've seen a lot of arguments in this thread about how medicine is so regulated and semiconductors aren't, but I think that's slightly disengenuous. In fact, Intel has broken the law many times in their chip making efforts. This is not a secret. They've been sued probably hundreds of times since the seventies for contaminating groundwater supplies with heavy metals and doing all kinds of mean nasty things that release toxic chemicals into the air, water and dumped across the land. That's just a fact and it shouldn't be surprsing to anyone here at Slashdot. I'm all into recycling and doing my part to save the planet and what not, but being fully aware of Intel's past I'm still using their products right now. I'm culpable as well. What's done is done. They bent the rules and went for it and they certainly had the nuts to go ahead and say fuck it to the rules sometimes even if it meant lawsuits. Intel has been sued for taking chances with peoples health on hundreds of occasions. It's not such a different situation. Let's not pretend they never took any risks and everything was just hunky dory and above board all the way down the line and somehow it's a whole different game for people in medicine.
Admittedly, there is a big time difference in the business models which helps explain the differences. Semiconductors are essentially a glorified form of printing that uses lots of nasty chemicals. So printing and money go hand in hand. Money is printed too, after all. Medicine is a whole other ball of tits. It is supposedly privatized and profit oriented in the US, but it doesn't really work that way on the research level as we see with this story about Ian Wilmut and the questions that weren't asked. Personally, I belive medicine should not and essentially can not be profit oriented in an effective way, certainly not a moral way. It should be government subsidized just like education and the government should be forward thinking and willing to take chances and innovate. The heart of the problem with that plan is that the American electorate seems to be so incredibly dysfunctional and hooked on this psychotic free market rhetoric that real advanced medical techniques based on stem cells, gene therapy and tailored therapies will probably emerge and become popular in the massive state subsidized medical systems of Asia and Europe first.
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.
Minoxidil was a heart medication. Growing hair on bald spots was a side effect that the pharmas did the trials on so they could sell it as a baldness cure.
Viagra... blood pressure medication. Boners were a side effect.
A number of the medications you rail against as fluff were actually discovered while trying to fight something more important. They turned out to be better at the fluff than the intended purpose, but fluff makes money too, and gears were switched so they got marketed for the side effect instead of the intended effect..
Start a happiness pandemic
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]