The development of new drugs is a complex and lengthy process. It starts with an idea and requires a wide range of skills to bring that idea to fruition: synthesis or extraction of more or less complicated molecules, proof of their therapeutic effect in cell cultures and animals, testing for toxicity, and clinical studies. Along this path, many potential drugs are withdrawn, and even successfully tested drugs face the additional hurdle of regulatory approval.
Finally, the drug reaches the market, where it must be followed closely, because many adverse reactions are detected only with a large number of patients and after years of use. There are several thousand drugs currently on the market, with a worldwide value of about $3 trillion. But conditions in the drug market are far from optimal. Ideally, drugs should have a favorable risk-benefit ratio. Compared with other drugs with the same indications, new drugs should be selected on the basis of their safety, effectiveness, and cost. But the financial interests involved tend to distort the process by creating incentives to overestimate the benefits of new drugs, underestimate the risks, and, above all, boost prescriptions.
