Edit: Josh Sommer directed my attention to How a Healthcare Company Can Accelerate Translation of Scientific Knowledge to Practice, which was mostly what I had in mind.
The mainstay of drug discovery is automated molecular screening, dose-escalating response curves, and clinical trials. It works, but it’s painfully slow and expensive. Meanwhile, patients with both chronic and acute diseases are continually given drugs with known efficacy. This has been going on for a very long time. Certain cost conscious elements of the health care system — health insurance companies — keep detailed records of this information on a per-person basis. I called up my prescription benefits provider last week and they provided me a copy of my historical prescriptions without a problem. I assume this is true of most, if not all, providers. I think these data could be very valuable.
For instance, I have (although there is no evidence yet of recurrence) a rare disease called Chordoma. If a sample of the Chordoma population’s drug histories were collected, certain inferences could potentially be drawn. Given known incidence rates for diseases, you have certain expectations. If you know 1:100 people taken should have had rheumatoid arthritis1 but they are under-represented or missing, two things are possible2: people with Chordoma do not get rheumatoid arthritis, or people with rheumatoid arthritis take drugs that might incidentally treat Chordoma.
Does the sample of patients’ drug histories conform with expectations? If not, why? Considering the cost of clinical trials, this seems like it might be a low-hanging fruit, especially for patient-led non-profit research/advocacy organizations. I recognize that a straight-forward pre-existing drugs regiments are unlikely to be curative, but they may hint at promising avenues of exploration. (For example, does the group taking a drug for RA seem to have slower disease progression.) Such hints might not be possible to derive from in vitro and animal models.
Note: I am neither a medical researcher nor a medical doctor. I am just a guy whose reach exceeds his grasp. I took a cursory glance at PubMed and asked around to a few researcher friends of mine to see if they knew of anyone who tried what I suggested. So far, I found no evidence that this has been attempted. If someone wants to correct me, please leave a comment. If you know someone who might be able to correct me, please forward them this blog post. Thanks.
1. Adjusted for Age, Ethnicity, Sex, etc.
2. Well, several things, but two relevant to my argument.
