Medicine is just one of those things that conflicts with market-based systems. Nature reports this week that drug companies are reluctant to pursue pharmacogenomics and instead have been eliminating drugs that are effective in minorities of patients from further study.

In other words, a genetic profile may identify a population, maybe 20% of those afflicted with an illness, that would greatly benefit or be cured by a drug under investigation. These drugs are said to be tailored, or pharmacogenetically developed for specific patient populations. The problem? Drug companies want blockbuster drugs that will maximaize profit, and don't want to spend millions developing a drug that won't help everybody, even if it could cure a minority of patients.

A July report based on dozens of pharmaceutical company documents and filings with the Securities and Exchange Commission says companies often abandon drugs that would benefit only a genetic subset of people, and even obstruct research on genes that would predict drug response.

"There's lots of hand waving about how big companies are going to develop pharmacogenetic drugs," says Adam Hedgecoe, coauthor of the report, published by the UK Pharmacogenetics Study Group.

"But companies are using pharmacogenomics to weed out drugs at an early stage," he says. "[They] don't develop a drug that's only going to work for 20% of the population."

In one example, a leading drug company refused to provide its product to academic researchers for a clinical trial assessing genetic and lifestyle factors that predict response to a drug for Alzheimer disease. The company only agreed after the researchers threatened to sue. Companies have also prevented scientists from publishing data that stratified drug responses by genetic factors, he says.
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The success of the tailored cancer therapies Herceptin and Gleevec has also shown industry that such drugs can earn significant profits, he adds.

In the absence of tests that can single out people who would most benefit from a drug, however, most drugs continue to be prescribed indiscriminately. Some biotechnology companies such as Third Wave Technologies in Wisconsin and Massachusetts-based Genzyme Genetics are trying to develop tests that can be marketed along with drugs.

Huzzah for the free market. In spite of examples of pharmacogenomic or tailored drugs that make a profit (not a huge profit, but a profit) they refuse to pursue pharmacogenomics since it won't give them "blockbuster" drugs. It's a damn shame.