Forbes magazine unintentionally hosted a good drug discovery strategy debate. It started with a prominent pharma industry bank analyst Jack Scannell critiquing therapeutic R&D productivity. His points: 1) targeted drug development has been less productive than other approaches, and 2) high-throughput R&D technologies really haven't been productive either.
John LaMattina, formerly Pfizer's head of R&D fired back, also in Forbes ("Analysts get it wrong again"), which attributes lower R&D productivity to.........pharma mergers and more demanding regulators and payors. (Never mind that increasing R&D productivity has been the rationale for much of the industry consolidation.)
Both make good points, though. HTS and genomic technologies have definitely under-delivered. But, while the industry in the early days of HTS and genomics truly WAS guilty of treating drug discovery as a numbers game, researchers have become much smarter more efficient in their use of these technologies. (Whereas some R&D centers initially built labs to maximize compounds screened per day ("100,000 per day capacity!"), most are using HTS (and other technologies) to more inexpensively examine smaller focused libraries.)
Note: neither side cites budgets (neither pharma nor NIH) as an inhibitor of R&D productivity.
Scannell says that the numbers don't lie - 33 of the 50 first in class drugs studied started from a phenotypic-centric philosophy, but LaMattina counters that this is explained by the lag inherent with tech adoption, and that a wave of targeted compounds is on the horizon.
This is tough analysis to choose a side on - I think the phenotypic approach has been the benefit of low-hanging fruit (i.e. development to date has benefitted from easy molecules, but there aren't nearly as many easy ones left), while the targeted approach just has an inherent intellectual appeal. ("If we know what causes disease "X," why not just target it?")
(That being said, one of the more significant tech flops of the last decade or so has been "Rational Drug Design.")
I'd also nominate one other reason for low R&D productivity not mentioned by Scannell or LaMattina: organization structure. Innovation becomes the exception and not the rule as organizations grow bigger, while risk tolerance seems to decline. That bigger organizations stifle drug development is reinforced by the notion that many of the successful therapeutic programs were once considered UNsuccessful programs, as LaMattina's story of the invention of Viagra indicates. Another reinforcing story is that of Gleevec's development from Daniel Vasella's book: only the singular efforts, passion, and strength of Dr. Brian Druker kept a Novartis committee from killing off the lead that became known as Gleevec.
Let's hope that pharma R&D rises soon, whether because pharma mergers have slowed, or because productivity is catching up with the technology.