Thank you, and thank you for inviting me to give this talk.
I put this slide together from the journal Nature Reviews . I've modified the data so that it's hopefully more understandable to a lay audience. It basically illustrates the cost of bringing a drug to market over the last 60 years. The costs are corrected for inflation, and what you see is a process that in many ways looks like it's going out of control. The cost of generating new drugs is going up and up as a consequence, in part, of regulation.
The scare started back in the time of the thalidomide scare when the drug called thalidomide was given to women in the first trimester of pregnancy and produced a large number of kids born without limbs as a consequence of the teratogenic effects of these drugs. There was a great deal of effort put into regulating the drug manufacturing industry as a result.
These are the costs; these are not the profits made by the drug companies. The natural tendency, looking at these data, would be to say that we have to stop making drugs because they are just costing us too much money, that we need to go back to the drugs that we've had in the past, and that's where we need to put our effort.
The next slide quotes a piece from the National Post, from last fall, which basically says this isn't really part of the picture. The drugs only amount to some 9% or so of the costs of bringing medical assistance to patients, so we can't just assume this is unnecessary. We'll see in the next slide why that is.
The other message was the notion that governments should think like investors, with long-term assessments of the relative return on investment, which I think is what the witnesses here today are going to be speaking to.
If we go to the next slide, you will see that an economist, Frank Lichtenberg, estimates that relying on existing drugs will get us nowhere, that the costs of health care will continue to increase and that the drugs are necessary. We still need to develop new drugs because, as it says in the second bullet point here, organisms are evolving constantly. We're playing a constant game of catch-up against drugs, and some organisms are very difficult to deal with, such as MRSA, the multiple-resistant Staphylococcus aureus, which is running rampant in a number of hospitals across Canada and, indeed, across the world at the moment. Diseases like that, like Clostridium difficile, are diseases that are modern diseases and need to be treated with modern medicines.
Perhaps I could just speak about the kinds of things going on at Brock University. I echo Dr. Tyrrell's comments about the value that we put on the Canada research program and the Canada Foundation for Innovation in bringing tier 1 researchers—literally as tier 1 Canada research chairs, in many cases—back from other countries to Canada, or by recruiting them from other countries themselves.
If we look at the work here, one of the things going on at Brock University at the moment relates to daffodils, as you see in the picture. Daffodils produce a chemical compound called galanthamine. Most of you are younger than I am and so you never have to worry about Alzheimer's disease—at least not yet. Galanthamine is used in the treatment of early-stage Alzheimer's disease.
Our tier 1 Canada research chair, Vincenzo De Luca, has been working on an efficient extraction of this particular compound—that's the structure of it up there on the screen—to make it more efficient and bring it quickly and cheaply to market. It's not an unknown compound but a known drug, and what we're looking to do is to decrease the cost of production. Despite the fact that southern Ontario looks like a very busy place growing grapes and everything like that, we have acres and acres and acres of land that can be used for growing interesting crops like the daffodil.
The next one is the Madagascar periwinkle, which is the source of two major anti-cancer drugs—you see those at the bottom of the screen—vincristine and vinblastine. This plant is sold as an ornamental and you can buy it in your local Home Depot and put it in as a border plant, but it produces two major anti-cancer drugs, which are useful against a whole range of cancers. Vincenzo De Luca, our tier 1 Canada research chair—who, by the way, we recruited from North Carolina despite the fact that he has his Ph.D. from the University of Montreal—has some 4,000 variants of the Madagascar periwinkle. He's trying to find the best, high-producing plant that will allow us to make vincristine and vinblastine, currently very expensive drugs, much more accessible to the market.
The next slide is actually an interesting one in a way. There's this chemical here called pancratistatin. It's an incredibly powerful anti-cancer drug but it only works in vitro. You can only kill off cancer cells in the test tube. Once you inject it into people it becomes ineffective because it's not very soluble. It doesn't actually work in the organism, so the question is what do you do with a compound like that? You have something that's a good candidate but it doesn't do the job.
Another of our tier 1 Canada research chairs, Tomas Hudlicky, who came to us from the University of Florida in Gainesville, is working on variations of this particular compound to make it more accessible. In fact, he has tested a number of variants of this compound that have greater solubility and are effective at the kind of dose that would be useful as an anti-cancer drug.
Although it's patented at this point, I echo Dr. Tyrrell's comment about how much money you can spend on this to get it through the next stages, through the initial studies to animal studies to human studies. It's a huge job, as you saw from the first slide that I showed you, so at the moment we're working with a small company called Lorus Therapeutics in Rexdale, Ontario, hopefully to move this forward and to produce what essentially, for the treatment of cancer, will be a new drug, although the compound, as I said, has been known for some time.
My final slide speaks to some of the issues that I know are not going to be a surprise to any of you but that you know full well: how to reduce the costs of treatment, the costs of aging, the treatment time, and the duplication of tests and so on. Getting information quickly flowing through the system is obviously one of the things we've heard about.
One of the things that really need a lot of attention is preventative medicine to stop people needing to go to a hospital for treatment. For example, using simple exercises to improve balance will reduce the percentage of falls by people over 65. Falls represent a major source of death for people over the age of 65. Being over the age of 65, I take that quite seriously, and I'm sure many of you do as well.
These things are very important. They don't cost a lot. They can be franchised. Get the right method. Get people improving their balance, and things will improve at very little cost to the system.