Therapeutic innovations : developments and trends

The meteoric progress of molecular biology and genetics, the emergence of new methods for studying disease, and the rise of bioinformatics have given us hope over the last twenty years that therapeutic innovation would see new efficacy. But what has been achieved? Certain fields, such as oncology, have benefited greatly from these advances, and the therapeutic arsenal has been largely renewed in this field, including with the arrival of new treatments adapted to the specificities of the many different types of tumor, heralding a so-called personalized medicine, adapted to each individual, but often at costs that jeopardize healthcare budgets.

Other therapeutic fields are at a standstill. We are still waiting for effective drugs to treat Alzheimer's disease, and faced with bacterial resistance to "old" antibiotics, we note that our therapeutic arsenal has not been renewed. The current Ebola epidemic reminds us that we have no effective antivirals or vaccines to treat many viral diseases. Thirty years after the identification of the AIDS virus, we still have no vaccine to combat this disease.

The costs of therapeutic innovation are increasingly high, and the major pharmaceutical groups are abandoning areas that have become unprofitable in relation to the investment required. With industrial globalization, the production of conventional medicines is increasingly moving away from developed countries and concentrating on a few factories in India or China. An incident in one of these plants can block the supply of key intermediates in the synthesis of essential medicines, leading to supply disruptions on our pharmacy shelves.

The big pharmaceutical groups become buyers of drug candidates that have passed the critical phase of validation of activity in the first patients, adopting a strategy similar to that of the big food distribution groups, shifting risk-taking to the "producers", in this case researchers and start-up creators. Who will finance the "valley of death" in therapeutic innovation in France? This crucial phase in the creation of new drugs, between basic research and proof of activity in humans, is one of risk. It is getting longer and longer, and is becoming difficult to reconcile with the duration and returns on investment of traditional venture capital. Clearly, the United States has put in place the tools needed to finance therapeutic innovation. The American biotech companies of the 1980s-1990s are now the laboratories of the major pharmaceutical groups, and the tropism of European groups towards this part of the world is not about to change. In the therapeutic fields neglected by the big pharmaceutical groups, we certainly need foundations funded by a tax exemption on the wealth tax (ISF), or any other means of attracting financial resources from the wealthy people we want to keep in our country.

We have too few examples of successful therapeutic innovation in France to refrain from a profound reflection on the creation of medicines in our country, which was a major player in the field for a significant part of the ^20th century. By freeing industrial research centers from the 35-hour working week, we could give ourselves a little more chance of avoiding their closure in France and, why not, regain our attractiveness to major international groups by better targeting the research tax credit on innovation and the link with fundamental research. Let's avoid creating a "drug plan", because therapeutic innovation needs the talents of creators more than the speeches and presentations of "committee specialists" who have never been in a real innovation situation.

Drug creation is not linked to the presence of natural resources or climatic conditions: it's a purely cerebral activity that depends solely on the surrounding ecosystem and real support for innovation and talent.

All these different points were addressed throughout the eight lectures (a seminar was associated with each lecture) and a closing colloquium.