Money has thrown society out of kilter. Banks that once appeared to have mountains of cash have collapsed. As a consequence of the global recession, governments now recognize that banking is too important to be left to the bankers. States have taken action, from wresting control of financial institutions to introducing new regulations. I believe the financial meltdown has implications for pharmaceutical research. The running of large pharmaceutical companies carries a social responsibility that is as heavy as running any bank. Recently, however, this unwritten contract between society and drug companies has not been fulfilled. Is our health now too important to be left to big pharma? To illustrate my concerns, let’s look at the treatment of heart disease. Many important cardiovascular drugs have been invented: statins, ACE inhibitors, beta blockers, fibrinolytics. But in the last 10 years, few of significance have emerged, even though the pharmaceutical industry has spent unprecedented amounts of money on research and development: in each year of that decade, Pfizer spent about $6 billion, Eli Lilly $3bn, and GlaxoSmithKline $z.sbn.

This splurge is reminiscent of how banks misused their funds before their collapse, but the industry has been insulated from the recent economic changes and has accumulated vast cash piles from the sales of medicines (in the UK, mostly through sales to the National Health Service). On average, each top-zo pharmaceutical company has access to about $7.sbn in cash. Could the cash piles of big pharma be mobilised in a more efficient way for the public good? Two years ago such a suggestion would have been scorned. Now, however, it should be considered. As was the case with the banking sector, I believe that there is a real risk that the big pharma industry might collapse. Increasing spending on R&D cannot be continued indefinitely with such meagre progress. If a collapse of the pharmaceutical industry does occur it might not be for decades, but one of the biggest lessons of the banking collapse is that no one can predict economic forces with much certainty. The fall of big pharma could be imminent. There is another way to fund the development of new treatments. Many innovative ideas that have changed society have arisen from the combination of curiosity and academic freedom found in universities. This is where small amounts of funding can produce big results. In recent years, university research has been exploited by industry to produce new drugs.