Show Notes
Drug development has never been more expensive, in terms of output per dollar spent. This trend, called Eroom's law, is surprising, considering incredible technological advances. Ben and Saloni talk to Ruxandra Teslo about why this has happened and what can be done about it. How can we reform clinical trials to make them more efficient and abundant? Why are so many pharma companies moving early trials to Australia? What's wrong with ethics boards and how can we fix them without compromising on safety?
More from Works in Progress Podcast
** We’ve paused the Works in Progress podcast feed, so head over to our dedicated Hard Drugs podcast feed to listen to future episodes, if you hadn’t subscribed there already! https://harddrugs.worksinprogress.co/ **
** We’ve paused the Works in Progress podcast feed, so head over to our dedicated Hard Drugs podcast feed to listen to future episodes, if you hadn’t subscribed there already! https://harddrugs.worksinprogress.co/ ** GLP-1 drugs like Ozempic and Mounjaro have transformed the treatment of obesity as well as diabetes, can help treat heart disease, kidney disease, sleep apnea, and maybe even Alzheimer’s. But they are far from the only medicine with more than one use. Aspirin, colchicine, minoxidil, and Viagra were all found to treat more conditions than expected, and about a third of drugs end up with a second approved use. In this episode, Jacob and Saloni explore the idea of drug repurposing: taking a medicine made for one disease and finding it works against others. They trace how GLP-1 drugs emerged from an adorable Gila monster, why some drugs have multiple uses, why so many of those uses go untested, and how patents, competition, prizes, and platform trials shape whether we ever find them.
Alberta is the only part of the world that has people but not rats. Rats came to the new world on ships to New York, Boston and Philadelphia during the Industrial Revolution. From there they spread west at a rate of 24 kilometers a year and by 1950 they were on Alberta's border. But Albertans stopped them coming any further. In the US there is a culture that lives in dense cities, the women usually work, and yet they still have an average of six children each. The ultra-Orthodox have a number of pro-fertility norms, most of which wouldn't work for the secular world but some we could learn from. Sam, Pieter, and Aria discuss a handful of pieces in Issue 24 of Works in Progress. They talk land reclamation, vaccinating wild animals, the Squamish Nation's housing development in Vancouver and how The Glorious Revolution caused the Industrial Revolution. Buy your copy here: https://worksinprogress.co/print/
In the nineteenth century, cities often grew a thousandfold while increasing wages, the size of homes, and delivering great public goods like electricity and plumbing to their people. What made them so extraordinary? They had a hybrid of laissez-faire and top-down control. Landowners could build almost anything they liked but street networks were laid out with near-Soviet thoroughness decades in advance. Transport and utilities, meanwhile, ran as regulated monopolies. They were funded by users, turned a profit, but prices were controlled. Samuel, Ben and Aria discuss what made this system work and why it was dismantled.
Malaria is caused not by a virus or bacterium, but by a complex, shape-shifting parasite that has evolved alongside us for millennia. This has made vaccine development a brutal challenge. In this episode, Jacob and Saloni are joined by Katharine Collins, who co-invented the second malaria vaccine, called R21, during her PhD. They discuss the gruelling process of reverse-engineering a vaccine and eureka moments along the way. They ask whether the biggest barriers to new vaccines are scientific or financial, and what it will take to finally eradicate one of natureʼs most vicious killers. Hard Drugs is a podcast from Works in Progress about medical innovation presented by Saloni Dattani and Jacob Trefethen. You can watch or listen on YouTube, Spotify, or Apple Podcasts. Saloni’s substack newsletter: https://www.scientificdiscovery.dev/