The current system is like Churchill's description of democracy: the worst system, except for all the others.

Biology is extremely complex. There's no substitute for actually trying things out on subjects in vivo. For many diseases we don't even know the cause (Alzheimer's for example). Drug companies have all the incentive in the world to improve the system to get better odds; it's not like they want drug discovery to be such a crapshoot.

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ramraj07 7 months ago | parent | next [-]

It’s ironic that you brought Alzheimer’s as an example since it exactly proves your point - drug companies pushed a therapy that targets a highly questionable _symptom_ of the disease, even though every single step of the process gave negative or inconclusive results. It was all about ego and desperate attempts to make profits using iffy drug candidates.

And “biology is complex” is the type of truism I hinted at. You can always say that whenever you fail. Biology is complex and Alzheimer’s is the most complex of them all, to be sure, but I hope you’re aware of the. Alzheimer’s cabal allegations that the entire field was mutilated by a bunch of people into believing and pursuing the wrong hypotheses for decades.

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clooless 7 months ago | parent | prev [-]

We also don't understand how some drugs work, either (e.g. Tylenol).

	▲	cess11 7 months ago \| parent \| next [-]
		I'd say we have a rather good idea about the mechanisms for pain relief from paracetamol. Even Wikipedia has a decent summary: https://en.wikipedia.org/wiki/Paracetamol#Pharmacodynamics
	▲	pfdietz 7 months ago \| parent \| prev [-]
		A utility-maximizing drug discovery system would, I think, devote some effort to biological experimentation on healthy humans, giving them chemical probes to see how that affected their biology. As is, ethics requires we get this information accidentally, for example from that famous recreational drug chemist who gave himself Parkinson's Disease with a botched synthesis that made a highly neurotoxic chemical. And some of the information comes from drug trials. A useful drug is not the only value obtained from a drug trial -- each trial is also a test of a hypothesis about the mechanisms of a disease. One of the books of the "Colossus" trilogy (about a computer that takes over the world) had the computer doing this sort of medical experimentation on randomly selected drafted subjects, with the idea of maximizing overall utility. It shows the problem with utility maximization as a goal, similar to the requirement that people give up a healthy kidney if someone else needs a transplant.