[roenxi]

> I’m fond of saying that the most important single statistic about the drug industry is the clinical failure rate, which is (by any reasonable standard) appallingly high.

He starts off on the wrong note, there is nothing at all wrong with a high rate of clinical failures. If anything, the reasonable argument standard might be that this rate is too low. It implies researchers are trying things that they expect to have a 10% chance of working out. That means we're missing out on all the cures and techniques that have a 1% chance of working out but but nonetheless do work.

Failed attempts cost society nearly nothing and successes will have compounding benifits for, y'know, lets optimistically say the human race survives for centuries. 1% or 0.1% success rates sound completely reasonable with that sort of lopsided risk profile. There isn't much of a reason not to try anything and everything that has the faintest chance of helping and see what happens.

[halperter]

Rather notably, companies are profit-driven, not good-for-society driven. If 99% of your attempts which cost millions to do fail, the company either has to raise the prices of the drug insanely high or not work as a company. In addition, most drugs aren't humanity saving or crucial for humans to live. You could solve all forms of cancer tomorrow, which would be a great thing, but you aren't "saving humanity". You add less than a decade or so, maximum, to the average human lifespan. This isn't critical to humanity's existence, so this "try or die" mentality doesn't work.

If this try or die mentality does work, why don't we try every possible amino acid chain in every configuration possible? It's an infinitesimally small chance but try or die "outweighs". This is evidently absurd.

[asdff]

This goes to show why private r and d is not going to get us that star trek future. Private capital is too risk adverse and short term in outlook for a lot of potential innovation. Interesting to think about how stifled our innovation potential is these days, given that things are expected to be immediately and massively profitable if they are to be invested into.

[roenxi]

Lowe mentions costs 0 times though, he isn't making an economic argument. If you want to make an economic argument then 90% is probably the consensus on what is optimal given that is what people are doing.

> If this try or die mentality does work, why don't we try every possible amino acid chain in every configuration possible?

You tell me. If someone wants to start working through the amino acids one by one I'm not going to say they should be stopped; sincerest good luck to them. I'm just not going to be the one funding it.

> You could solve all forms of cancer tomorrow, which would be a great thing, but you aren't "saving humanity".

This is a straw man. "Saving humanity", whatever that means, is outside the scope of medicine and I never argued for it. Nobody did. It isn't relevant.

[halperter]

I mean, economics is pretty important for a business, no? The issue with the idealistic "do everything we can" is that we have limits. Money is one of the most, if not _the_ most important parts. When clinical trials take tens of millions to do, it is economically infeasible to try things at random; there needs to be an informed approach. I can see why you call my argument about cancer a strawman, and I'd like to clarify that as a general concept, just because humanity could survive for a few more centuries (paraphrased), we can't just be trying randomly. The person who randomly creates protiens that have a _miniscule_ chance to cure an important disease would be much better off putting their efforts into not just guessing and checking.

TLDR: I just have an issue with their "we should try every combination with no regards to constraining factors" approach

[oatmeal1]

Curing all cancer would be bad for the world, because 90% of those cancer kills are old people.

[dlcarrier]

For a great example of an extreme success rate being a bad thing, look at Japan's legal system. Prosecutors only take cases that they think they will win, and that assumption is now baked into the system, to the point that they are no longer very good at prosecuting, and anyone that is prosecuted is effectively presumed guilty.

[adolph]

Failures also have lots of valuable information. There was a recent Complex Systems podcast about efforts to glean pharma trials.

https://www.complexsystemspodcast.com/episodes/ruxandra-tesl...

[refurb]

> Failed attempts cost society nearly nothing

The world does not have unlimited resources. Money spent on one project is money that can’t be spent on another.

[DivingForGold]

Except that governing bodies approve many of these drugs which, further down the line, consumers may experience high failure rates or even toxicity, which in other industries such results would be considered outright fraud subject to legal action. if sold to consumers.