Does a drug discovery process geared towards profitability affect how health issues are tackled?
Funding is one of the most significant hurdles scientists face, particularly in the world of drug discovery, where the cost of research and development can easily exceed billions of pounds for a single treatment. This financial barrier drives public and private funding bodies to prioritise resources on areas with the highest market potential.
In the UK, funding disparities are evident. £1.1 billion dollars was allocated between a span of five years from 2016 to 2021 for rare disease funding. Meanwhile Cancer Research UK invests nearly £400 million annually to cancer research, and that’s just one organisation. Over five years, this would significantly surpass the total allocated to rare diseases, highlighting the troubling disparity.
As for pharmaceutical companies, profitability often dictates which drugs make it to the market as investors prioritise research with the potential for substantial financial returns. Even antimicrobial resistance, recognised by WHO as one of the top global public health threats, struggles with limited funding and remains largely neglected by major pharmaceutical companies due to its limited revenue appeal and high development costs. Diseases with higher revenue potential – such as common or chronic conditions like diabetes and cancer – that affect larger and wealthier populations are favoured due to their promise of higher sales and profitability. After all, why cure a rare disease when there’s a goldmine in treating the most common ones?
This approach creates an uneven playing field, side-lining the rare or neglected diseases with low revenue potential, that often affect low-income and marginalised populations. This market-driven focus, though pragmatic, may also narrow the scope of scientific innovation and slow down progress in addressing less profitable yet critical health challenges. Ironically, these overlooked areas can sometimes lead to revolutionary discoveries. One notable example is the development of mRNA technology, which was initially viewed as unstable and impractical compared to the more established DNA-based technologies. Yet researchers like Katalin Karikó and Drew Weismann persisted despite limited funding and frequent rejection of grant applications, with this research ultimately being the foundation of the lifesaving COVID-19 mRNA vaccines, earning them the Nobel Prize in 2023. Focusing resources solely on “safe” investments can hinder the potential for ground-breaking discoveries that have the potential to revolutionise medicine albeit being less lucrative.
Policies like the European Orphan Drug Regulation encourage research into rare diseases by offering incentives such as tax breaks, reduced regulatory fees and 10 years of market exclusivity for approved treatments. Some pharma companies participate in public-private partnerships like the Drugs for Neglected Diseases Initiative (DNDi) and Medicines for Malaria Venture (MMV), collaborating with public institutions and NGOs to support and advance research into these important yet underfunded areas. To promote more research into antimicrobial resistance, the UK has introduced an innovative subscription-style payment model where the government pay pharmaceutical companies a fixed annual fee for access to specific antimicrobial drugs, regardless of usage, incentivising the development new antibiotic medicines while ensuring sustainable long-term investment in this vital field.
Ensuring that innovation thrives without letting profitability dictate or limit its direction is essential. When financial incentives align with overlooked societal needs, they can channel investments into underfunded areas, paving the way for breakthroughs that benefit all. By fostering a healthcare system where no disease or community is overlooked, we can improve the quality of life for countless individuals worldwide. At the end of the day, curing diseases shouldn’t depend on whether they come with a good profit margin – everyone deserves a shot at good health, no matter how “marketable” their condition is.
