Former Intel CEO Rips Medical Research 484
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.'"
Breakthroughs? (Score:3, Insightful)
Apples with oranges (Score:3, Insightful)
Basic Research (Score:5, Insightful)
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.
Liability... (Score:5, Insightful)
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.
What an ass (Score:1, Insightful)
tech innovation? (Score:5, Insightful)
Unlike chip makers (Score:3, Insightful)
Unlike chip makers, pharmaceutical companies need a national government's approval to market their product. How quickly would Intel and AMD have been able to step up the capabilities of their processors if some Digital Restrictions Ministry or some other government agency had to approve every stepping?
No so easy (Score:4, Insightful)
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.
Translation: "I'm elderly and scared of death" (Score:5, Insightful)
This just in - WATER IS WET (Score:5, Insightful)
Otherwise it's all just an order for another box of a half-dozen duh's. To go.
It's not like computers (Score:5, Insightful)
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.
That's A Big "No Shit" (Score:4, Insightful)
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....
~
Re:Breakthroughs? (Score:2, Insightful)
Yet here we have dozens of pharma companies, plus universities, all slaving away over a cage full of infected monkies, hugely profitable all the same, because there's so many different ailments of the human race, where a processor is pretty much a processor.
Re:Breakthroughs? (Score:5, Insightful)
- G
Re:Apples with oranges (Score:3, Insightful)
It's not like Merck or GlaxoSmithKline could refab a molecule and offer an exchange. When you take into account the FDA and lawsuits hanging over their heads like Swords of Damocles, it's *almost* a wonder how they still manage to stay in business.
(Almost, until you find they're able to shuffle trivial patents for known good medicine in and push those off to customers...but that's a rant for a whole nother topic.)
Not without merit (Score:5, Insightful)
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
Put down the flamethrowers for just a femtosecond (Score:4, Insightful)
It's a bit depressing, considering it's one of the oldest sciences.
Re:Apples with oranges (Score:4, Insightful)
1) Increased cost of development
2) Slower time to market
3) Increased cost of production
None of those prevent discoveries. They do raise the financial entry barriers for startups, however.
Re:Basic Research (Score:4, Insightful)
I'd say that the medical industry has been feeding on the community for way too long. Medical procedures are insanely expensive and the equipment and medicine costs are through the roof. But it's not like medicine got any better in the last 30 years, only the scale has been slowly tipping in our health's favour, but it should have swung completely over already.
The medical industry has consumed more input than it has given back for a very long time. It's time we start seeing some payback to *everyone* who put money in the system: the consumers of medical care.
You're completely forgetting that this is "medicine" we're talking about here, and not "biology". One was to observe nature, the other one for curing people.
The key to progress is less accountability (Score:1, Insightful)
As a post-doc in the biological sciences, here's my two cents:
First, the reason certain diseases haven't been cured while computer chips have gotten smaller and faster is that curing the diseases is a much harder problem.
I do, however, have opinions about how to improve the pace of scientific research. In my view, the key to improving the pace of scientific research is to reduce accountability. What I mean by that is to adopt an open source model where people join projects because they believe in the project rather than because that's what pays the bills.
What needs to happen is that rather than getting assigned to a particular grant, researchers are given a basic package of funding and then they are free to attach themselves to the most promising projects. As it is, the system is so rigid that the successful projects are unable to grow and the unsuccessful projects linger long past the point where it is clear that they have failed.
Re:tech innovation? (Score:3, Insightful)
50 years ago the computer industry didn't exist (Score:4, Insightful)
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.
Re:Translation: "I'm elderly and scared of death" (Score:3, Insightful)
Re:No so easy (Score:2, Insightful)
Another problem is lack of computational power. (Take that Intel!). One might want to simulate how proteins, DNA, and such interact. Again, here we know the physics of interactions, quantum mechanics, but can't resolve this scale for reasonably sized molecules (let alone on the scale of a whole cell). So, for computational reasons scientists often must use cruder, more heuristic models, like molecular dynamics.
Science vs. Engineering (Score:5, Insightful)
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.
Re:Some obvious reasons tech CEOs dont grok med (Score:2, Insightful)
Re:Basic Research (Score:5, Insightful)
Bzzt. Wrong. Endoscopic surgery. Cardiac stents. Infinitely better drugs. Colonoscopy. Go back to 1977 and have a stroke, a heart attack, a major car wreck, testicular cancer - hell, go back then and have chronic stomach ulcers. The treatment for those used to be a partial resection of the stomach through an open incision. Now, it's a course of antibiotics. Those were just the examples that occurred to me over the course of five minutes. There are a lot more.
Re:Next up... Car industry. (Score:5, Insightful)
As for Harley's: it's a taste. Like buying the biggest pickup truck you can find and jacking it up to 12 feet in the air. Or owning a hummer. Or a Ferrari for that matter. Now you might say, "a Ferrari? That's cool though!" Sez you. Still gets less than 10 mpg, you can't ever really use its speed without risk of getting caught, so you have an expensive, fuel quaffing car that looks pretty.
Personally, I hate Harleys. People make them loud as a cannon, drive down your road at 6 in the morning to go to work. "Loud pipes save lives," they say, which is utter crap because I can't even hear the tractor trailer next to me with my windows up, how the heck am I going to hear you coming up behind me? Whatever, it's a feeling of power thing, I gather, sitting on a big rumbling beast of metal.
The essence of the game: keep 'em hooked! (Score:2, Insightful)
Re:Breakthroughs? (Score:3, Insightful)
Anyway I'm convinced a big reason of the different pace of IT development resides in technology bringing closer the dream of powerful men to be able to control the world by themselves. Never fear the masses they keep in ignorance anymore (don't you feel you're kept in ignorance? the control is presently kept with money, tech and judges: math, science and law; yet lovers of math and science are called nerds and geeks, and the now-impossible task of knowing the law is delegated to lawyers. QED).
Since any theory needs to make prediction, mine says that the society controlled using money is becoming obsolete, so it will be driven to a totalitarian and corrupt status quo, while opposition will give up money for a heavily technology dependent alternative which later on can turn into an authoritarian state by simply changing constraints. Your freedom is going to keep being reduced in either way. If the status quo wins, they win. If the opposition wins, they win.
The upside of this grim perspective is that you stop fearing what's in the book of revelations and the other myths
Re:Not without merit (Score:4, Insightful)
Wow.. that statement is just fundamentally stupid.
A new drug is either better than an old drug, or it isn't.
If it's better, then it doesn't matter if the patent on the old drug is 5, 10, 20, or 100 years long - your new drug will sell better than the old drug. And if it's worse, it still doesn't matter how long the patent on the old drug is - nobody is going to use your new drug.
If anything, long patents ENCOURAGE new drug development, because you can develop a slightly better drug and then compete patented-drug to patented-drug, whereas if patent duration is short, by the time you develop your new and improved patented drug, you have to compete with a now un-patented drug that is sold at generic prices.
Re:Lack of progress?! (Score:1, Insightful)
You are clearly not married.
Someday you will think back to your post and burst out laughing at the idea that you would someday be married to someone who would actually want you to take Viagra to satisfy her sexual needs. You will probably be doing some chore that you have finally gotten around to after having endured three days of constant nagging when this occurs. You will not have had sex for weeks, and your prospects will look grim. Viagra will be utterly irrelevant to your predicament. In fact, if you were stupid enough to even bring it up to your wife, she would just laugh at you and say something like "Boy, bet it'd be tough walking through Walmart with one of those down yer pants, eh?!?"
Trust me man, the next you see one of those stupid Viagra commercials, just change the channel.
Re:Basic Research (Score:4, Insightful)
The "medical industry" is not a research industry. It's a service industry, and provides the service of health care to an aging population that refuses to take basic steps to assure its health, such as universal health care, better pre-natal care, eating a better diet, exercising, and visiting a dentist once a year. So don't be surprised that the industry continues quite well providing that health care.
Re:But, some things are easy... (Score:4, Insightful)
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...
Re:Breakthroughs? (Score:5, Insightful)
Science needs to stay spread out and constantly looking at different things, not rehashing the same stuff over and over because it's easy. I mean, you never know, the cure something like Crohn's might lead by accident to the cure for cancer! That's why you need to blaze new trails and constantly strive for incrimental improvements across all disciplines of medicine.
You're still talking out of your @$$ (Score:5, Insightful)
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.
Re:Breakthroughs? (Score:4, Insightful)
Of course, we have how many different drugs to help old men get it up?
...which was developed in an attempt to treat angina [wikipedia.org].
Re:Apples with oranges (Score:3, Insightful)
It is more than that... I once read a really insightful quote from no one less than Mr. Bill Gates who said (in scope of the Melidan-Gates Foundation) paraphrasing a lot:
"medical research is different from technology research, in that, in technology research you can throw a large sum of money and add some engineers to improve a given technology. But with medicine, you can keep throwing money for years to find a cure against Malaria without results"
I think he is quite right in that sense. Intel can increase megahertz all they want just by throwing enough money whereas medical issues are a hundred times more complex.
And you also have the ethical issues. just some days ago I read a research on the Spanish Flu [wikipedia.org] in which the researchers used (and killed) monkeys to make the trial tests... It really makes you sad to read the research paper explaining how they infected the poor animals and the "euthanased" them...
Re:Basic Research (Score:3, Insightful)
We are so much better off medically in the last thirty years that we have gotten spoiled and we have taken all the advancements as givens.
I hate it too, but (Score:2, Insightful)
They make money, thats why. At minimal risk of litigation.
Not that I agree with that, I myself would LOVE better neuro/psychiatric/physiological medications for myself and my family. The sad truth of the matter is given the industry environment it is more profitable for said pharmaceutical company to manufacture drugs with lower risk:net profit ratios than those with a
1)smaller user base;
2)more difficult research;
3)increased chance of litigation.
Given the current business/political environment, this is the reality of Big Pharma.
Re:But, some things are easy... (Score:4, Insightful)
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.
Re:But, some things are easy... (Score:3, Insightful)
Anyway, I have mixed feelings about this. I think to some degree academia is somewhat content with grants and making money for any given institution compared to getting hard core difference making results. Much prestige is gained my making a university or hospital money with grants independent of real results.
I think also we are comparing two different things. Human/biologic research is inherently more complicated on multiple levels than say processer/material research. For instance there are far more ethical issues involving biologic/human research than processor design. Don't believe me, try submitting a study to an IRB sometime. Then there is cost, the logistics behind putting together any sort of clinical trial of any significance is insanely expensive. Another is just pure complexity. Biological systems are insanely complex we are just starting to learn and sort out the foundations of how stuff really works down to the molecule and I'm still not sure any one individual while ever be able to fully comprehend how it all works. Many of our discoveries before now were more like, I think this might work, try it out and realized it did or didn't make a difference and hopefully didn't hurt anyone while figuring that out. We're just now starting to have rational, well designed approaches to problems.
Processors design and the material research are basic science at its best. You can keep plugging away and until you get a desired result. The worst thing that happens is over costs or delays. Not to mention, processor design is processor design is processor design. chrones disease is not heart attack is not exactly the same as stroke is not the same as kidney stones is not the same as cerebral palsy. That is the number of diseases that fall under medicine or life sciences is huge. If you picked one, put all the brain power and money resources into just one that is spent on processor design and I bet we'd have some kick ass cures for that one disease. But wait, we'd still have thousands to go.
Re:Breakthroughs? (Score:3, Insightful)
Also, I'm not well-versed in Crohn's disease, but I have to think from my perusal of online sources that your case is substantially worse than the typical case. I do not doubt that some people have it even worse than you, but based on what I've read and the few discussions I've had with my friend who has the disease, it seems to me that you're wedged far into the tail of the unenviable side of the bell curve on this score. It seems to me that the typical case involves a series of mild inconveniences: dietary restrictions, a drug regimen, and usually at most one bout of surgery.
But maybe Crohn's is a lot worse than I ever suspected, and maybe it was a bad choice for the example in my post. My point is that ED in particular is a serious condition that meaningfully affects the day-to-day quality of life of tens of millions of Americans. It is not as serious as many medical conditions, but it is also much, much more widespread than most. And yet people tend to deride it as a frivolous and undeserving avenue for medical research, in part because of society's prudish and irrational willingness to discount happiness to the extent that it is a product of sex.
At least give me this much: the fact that there exists a worse condition in the world is not by itself reason enough to divert research funds from every other condition until it is solved. Otherwise, only the very worst condition in the whole world, no matter how obscure, would receive 100% of the research budget, which clearly seems like an inefficient allocation of resources. ED would give up its funds in favor of diseases like Crohn's, but so too would Crohn's give up its funds for diseases like bone cancer. Even bone cancer would probably lose out to some obscure flesh-eating condition that affects one in a billion humans but is the most horrific thing, once contracted, that any of us can imagine.
Re:Basic Research (Score:2, Insightful)
I am not exaggerating.
Re:Not without merit (Score:1, Insightful)
As well, have a look at the University of Rochester, where I have worked in the past. They have had some huge breakthroughs, like the HiB vaccine, and they did a huge amout of work on COX-2 inhibitors. Throw in the very active clinical trials sections, and you have what I think is actually a very dynamic institution taht works well with industry.
In the end, universities and Big Pharma are important partners in bringing about new discoveries. The relationship is symbiotic and essential.
Agree: Big Pharma, not "research", is the problem (Score:5, Insightful)
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
Re:Apples with oranges (Score:1, Insightful)
It might make YOU sad, but it doesn't me. If killing kittens with my bare hands was an actual way to save human lives, I'd do it all day, every day. Sorry, kittens, you're cute and all, but you're not HUMAN.
Re:You're still talking out of your @$$ (Score:4, Insightful)
So comparing a single cell to a CPU, is like comparing a 2 transistor radio to a modern CPU's. Living organisms are vastly more complex and you simply cannot ignore interactions with other cells and organisms. (aka HIV and immune response)
We havn't even begun to discuss the huge time frames it takes to drugs approved these days. Its (IIRC) 10 years of human trials which is after 10 years of animal trials. 20 years from discovery to a drug you can use. Or more.
Personally I think this Intel guy has let success get to his head. He clearly has no idea what hes talking about.