I led a lot of data and analytics work for pharma companies on clinic trials and the point about complexity is hard to overestimate. A pretty good analogy for bringing a major new drug to market is comparing it to building a new space flight system, individually it might have one less zero on total cost, but that's more of a factor of humans bringing dozens of drugs to market at any one point so there are economies of scale rather than it being any less complex.<p>Also, the article does a good job of describing one side of clinical trial complexity, finding participants and getting them through the funnel, but there's a whole other source of complexity in clinical trials that mean you need massive global efforts: different global regulators have different criteria for 'approving' clinical trials. An indicative example, the Japanese regulator needs to see evidence that the drug was tested in Japan during a trial. They're one of _many_ national regulators that say that.<p>So even if you _could_ find all a trials participants in one country you likely wouldn't be able to get it approved by many national regulators.<p>There are 100% valid epidemiological reasons, but often these differing national rules are there for policy purposes outside of drug safety, for example, if you mandate trials need to take place in your country it provides a nice investment in biotech for your economy or by creating specific rules as a lever to control cost in your national healthcare system (e.g. NICE in the UK).
<i>If researchers could test a new cancer treatment, instead of just hoping that the right patients turn up on the right day, they could instantly let everyone with that cancer know that they could join a trial.</i><p>This already kind of happens - it’s why clinical trials are done in academic centers by research-focused physicians. They know roughly how many patients they have and are happy to try and recruit them.<p>No doubt there are more efficiencies to be driven out of trials, but when you need to monitor patients for 12+ months, regularly screen them and run tests, that’s just not going to be cheap or quick.
The article advocates conducting trials in a single country, to massively simplify the complexity. I understand the attraction, but doesn't that lead to drugs that work fine for that population, but not for others (less effective and/or more side effects)? If I recall correctly I have recently read articles that some drugs are already too specific to one population, and not enough information is available about best treatment options for other populations.<p>I imagine doing trials in a single country only increases the risk of that happening.
Apologies for what is basically off-topic hijacking, but I've been a reader of the Economist since ~2005, when I was a uni student the first time. I've got pretty diverse political views, but neither Dems nor Republicans would claim me as their own, nor indeed would anarchists, fascists, or just about anybody else. I suppose I'd be classified as an independent, but the point is just that over the past 2-3 years the Economist has basically become unreadable for me, not necessarily because I find their political views increasingly obnoxious (which I do), but because it seems like their views have become simplistic to the point of being naive - their recent pieces on Putin and Ukraine being Exhibit A in this regard. Didn't The Economist used to have deep, or at the very least DEEPER analysis than they now offer? Just wondering if anybody else feels the same way and has found anything else that works for them. The closest thing for me has been Foreign Affairs, but of course along with very deep analysis on foreign policy is the fact that oftentimes one is reading a very biased opinion from a career civil servant (notwithstanding that the articles are invariably well written and well argued). One might even argue that knowing the writer is biased makes for more interesting reading because you're constantly questioning their claims; reading the Economist, as the saying used to go, was like hearing declarative statements from God. The Financial Times and WSJ are both too 'shallow' and financially focussed for what I'm talking about - if I just want headlines and news synopses then any of the NYT, the WSJ, and WashPo will do, but I'm talking about consistently in-depth discussions and analysis of current issues.<p>Any ideas are very welcome!
"Regulating tests of treatments: help or hindrance?"
<a href="https://en.testingtreatments.org/book/9-regulating-tests-treatments-help-hindrance/" rel="nofollow">https://en.testingtreatments.org/book/9-regulating-tests-tre...</a>