DEVELOPMENT AND INNOVATION IN CARDIOVASCULAR MEDICINE - Innovation in the Biopharmaceutical Industry - page 40

Therapeutic advances arise in a number of ways. They result from (1) innovation
and refinement in drug design to achieve better structure-functional relationships.
However, they also result from (2) a better understanding of how to use drugs, and
defining the patient groups that will benefit from them. There is a tendency to regard
the second as being of less fundamental value and that the information they provide
can be generally applied to the entire class of drugs. This however, is not the case,
since benefit may be related to particular pharmacokinetic or other characteristics
of a particular formulation. Therefore it is important that research and development
leading to new uses of existing drugs or innovative formulations of delivery systems
should be encouraged and recognised for its value.

Conclusions

This historical review clearly shows that all major advances in cardiovascular
medicine are built on a process of continuous innovation, which in many cases
can be traced back to a technical development in a non-clinical or even non-medical
field.
Clinical medicine shows a remarkable ability to harvest developments from
outside its own area and apply them to solve diagnostic and therapeutic challenges.
The ability of physicians to work across a wide range of scientific fields at “the
bench and bedside” has been an important aspect of this. This can be attributed to
the traditionally strong place of science in the medical curriculum.
The final medical advance that can result from a discovery may not be obvious
even to the scientists initially involved; they frequently depend on interaction with
experts and innovations in other fields.
For most classes of drug therapy, the prototype agent is usually superseded by
more effective, specific and safer follow-up developments.
Aspirin, streptokinase and -blockers are excellent examples of drugs which

benefit patients whose diseases were not considered for their use for years or even
decades following their initial introduction. Innovations that lead to better use of
existing drugs are as important as their initial discovery, and must be encouraged.
These issues have important implications in developing systems that reward,
encourage and facilitate medical advances. Innovations are often initiated by
“eureka” moments of discovery, but their full potential is almost always depen-
dent on a process of continuous innovation and development through a complex
network of interaction. This suggests that investment across the entire innovation
process is needed to sustain developments in medicine. Targeting investment at
particular areas of research, for example, in biotechnology will only be successful
in leading to applicable advances if discoveries can be taken forward through an
established clinical, non-clinical and industrial network.

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