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Andy Grove is the founder and former CEO of Intel. He also has PD. He gave an address on Sunday at the Society for Neurosciences Convention, asking "Where's the Cure?" You can post comments at: http://www.newsweek.com/id/68221 A Research Revolution Former Intel CEO Andrew S. Grove says the pharmaceutical industry could learn a lot from the computer and chip businesses.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /> By Sharon Begley Newsweek Web Exclusive Nov 4, 2007 During the time Andrew S. Grove spent at Intel, the computer chip company he co-founded, the number of transistors on a chip went from about 1,000 to almost 10 billion. Over that same period, the standard treatment for Parkinson's disease went from L-dopa to . . . L-dopa. Grove (who beat prostate cancer 12 years ago and now suffers from Parkinson's) thinks there is something deeply wrong with this picture, and he is letting the pharmaceutical industry, the National Institutes of Health and academic biomedicine have it. Like an increasing number of critics who are fed up with biomedical research that lets paralyzed rats (but not people) walk again, that cures mouse (but not human) cancer and that lifts the fog of the rodent version of Alzheimer's but not people's, he is taking aim at what more and more critics see as a broken system. On Sunday afternoon, Grove is unleashing a scathing critique of the nation's biomedical establishment. In a speech at the annual meeting of the Society for Neuroscience, he challenges big pharma companies, many of which haven't had an important new compound approved in ages, and academic researchers who are content with getting NIH grants and publishing research papers with little regard to whether their work leads to something that can alleviate disease, to change their ways. He spoke with NEWSWEEK's Sharon Begley just before he left for the neuroscience meeting. Excerpts: NEWSWEEK: What spurred your interest in and concern about the slow pace of drug discovery? Twelve years ago I was diagnosed with prostate cancer, which has a great advocacy community, and I became an advocate for putting more money and time into research on it. But I got disappointed with the lack of real output. Not much has changed 12 years later. The other thing that bothered me as I learned more about biomedical research is that I didn't see important aspects of R&D emphasized, such as progression biomarkers [chemicals, such as those in the blood, that indicate whether a drug is working]. Then I was diagnosed with Parkinson's, and found out that a major development taking place in this field was FDA licensing for deep-brain stimulation [to treat Parkinson's], which is a big step. But when I looked around there were no other big steps or even medium steps; the same drug that was the mainstay of Parkinson's treatment in the 1960s, L-dopa, is still the mainstay today. I became convinced that something was wrong here. In what way does the semiconductor industry offer lessons to pharma? I picked the semiconductor industry because it's the one I know; I spent 40 years in it, during which it became the foundation for all of electronics. It has done a bunch of unbelievable things, powering computers of increasing power and speed. But in the treatment of Parkinson's, we have gone from levodopa to levodopa. ALS [Lou Gehrig's disease] has no good treatment; Alzheimer's has none. Why is the speed of progress so different in semiconductor research and drug development? The fundamental tenet that drives us all in the semiconductor industry is a deeply felt conviction that what matters is time to market, or time to money. But you never hear an executive from a pharmaceutical company say, "Before the end of the year I'm going to have xyz drug," the way Steve Jobs said the iPhone would be out on schedule. The heart of every high-tech executive has been, get the product into customers' hands and ramp up production. That drive is just not present in pharma; the drive to get sufficient understanding and go for it is missing. How do the two industries deal with failure? When I started Intel we couldn't make a device twice in a row in the same way. I earned my reputation by being part of a team that figured out why a thing was not reproducible, what you need to do to make results come out the same way twice in a row. The attitude [in high-tech] is, something went wrong for a reason, let's find the gold nugget. In 1970, Dov Frohman [at Intel] was investigating insulator leakage, and it led him to invent a brand-new device that is now a fundamental building block of cellphones, cameras, MP3 players and computers. But in pharma, if a clinical trial doesn't work--which means the average of all the patient responses is not better than the average of a placebo treatment--they just throw [the drug] away, when in fact the averages may hide stuff that did work, and something that made patients different [such as genetics]. I've never heard anyone talk about the opportunity costs of a good drug being thrown away. But a good drug wrongfully convicted means the loss of benefits goes on forever. What stands in the way of more and faster success in getting cures to patients? The peer review system in grant making and in academic advancement has the major disadvantage of creating conformity of thoughts and values. It's a modern equivalent of a Middle Ages guild, where you have to sing a particular way to get grants, promotions and tenure. The pressure to conform [to prevailing ideas of what causes diseases and how best to find treatments for them] means you lose the people who want to get up and go in a different direction. There is no place for the wild ducks. The result is more sameness and less innovation. What we need is a cultural revolution in the research community, academic and non-academic. We need to give wild ducks the opportunity to emerge and quack their way to success. But cultural change can be driven only by action at the top. 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