Big Pharma's Commedia

The Divine Comedy begins with the middle-aged poet Dante wandering alone through a dark forest, having lost his way on the " true path. " Driven deeper by frightening creatures blocking his escape route, he spies a human form that reveals itself to be the ghostly embodiment of the great Roman poet Virgil. Virgil offers to serve as Dante's guide out of the dark forest to Heaven but warns him that to get there they must first pass through Hell and Pur-gatory. Trusting his guide, Dante sets forth. What follows is a pilgrimage unlike any other recounted in Western literature, and Dante finds himself fundamentally changed forever. Despite their ongoing financial successes , the big pharmaceutical companies have got to feel a bit like Dante at the beginning of a tough journey. Frightening creatures appear on an almost daily basis: A dwindling pipeline of potential new blockbuster drugs, endless news reports about excessive drug prices, competition from gener-ics, stunning liability judgments, and demands for greater transparency in clinical trial data continue to push big pharma deeper into a dark forest of public approbation. The creatures are dangerous: within the last few weeks, Merck and Company announced plans to close five manufacturing plants, three research laboratories, and to lay off 11% of its work force (Berenson, 2005). There is little empathy to be found in this world, as a recent Kaiser Family Foundation Health Poll Survey lists pharma's public approval rating at an all time low, although still more favorable than that of big oil and tobacco companies (Kaiser Family Foundation Health Poll Report Survey, 2005). There is an abundance of literature examining what precipitated this dramatic fall into the darkness of distrust. But the current negative press is nothing compared to the problems that big pharma will encounter unless it addresses its current predicament. Pharma faces a trip through Hell and Purgatory before a better future is realized, but it must first find a trustworthy guide to get it there. A Virgil for Pharma There are many would-be Virgils vying for the attention and resources of big pharma, but only one resumé stands out. In the postgenomics era, the ability to unravel the mechanisms of disease in the context of the entire human organism through the marriage of basic and clinical research is within our grasp. Focused scientific research is the Virgil that offers the best hope for pharma to …