Drug Culture

There will be, as there has always been, screeching from the PhRMA cabal that giving Medicare negotiation authority will spell the end of new drugs in the USofA!!! And so on. It is still the case that PhRMA, as a whole, spends more on SG&A than R&D (that's Derek Lowe's take, who has been a bench chemist in PhRMA, is generally on the side of PhRMA). There's no shortage of moolah in the drug business. No, there is not. And, just an aside (always mentioned in essays such as this): the USofA and New Zealand are still the only real countries that permit direct-to-consumer adverts for drugs.

So, in keeping with this situation, today a Boston drug developer (Karuna) announced the successful completion of a Phase III trial of a schizophrenia drug. In the PR, the company claims

KarXT is the first potential medicine of its kind with a truly new and unique dual mechanism that does not rely on the dopaminergic or serotonergic pathway to treat symptoms of serious mental illness.

Now, that reads like gibberish to most civilians. The key verbiage is 'new and unique', which the naive` reader is coerced into believing that Karuna has 'discovered' a 'new and unique' compound. Well, not so much.

It turns out that if you wiki the active ingredient(s): xanomeline and trospium, you find that these are ancient, in new drug development terms, compounds.

Xanomeline was discovered by Lilly and Novo some 30 years ago. They gave up on it, and it eventually came to Karuna (no, I'd never heard of them either; but they are of Boston, so a bit less likely to be a scam).

In order to reduce the side effect which caused Lilly and Novo to scrap the compound, it was decided to mix in another existing compound which is known to affect said side effect. As I type, it remains a mystery why the bench chemists at Lilly and Novo couldn't figure out this synergy way back in the 90s; the compound that Karuna chose was well known at that time. The compound is trospium (synthesized in 1967).

Trospium chloride is used to treat overactive bladder.

Now, I think that's hilarious!! May be you don't. The point, naturally, is that Karuna (and whoever may have been on the ownership lineage after Lilly and Novo) spent not a penny to 'discover' their compounds. They just looked up Active Pharmaceutical Ingredients, took one from column A and one from column B (yes that's Chinese menu meme; the announcement came from Karuna's Chinese 'partner'). As I've written more than once earlier, studies of actually new compounds in recent decades have shown 90%+ based on 'free' research from the Damn Gummint.

PhRMA freeloads off the American taxpayer, full stop.