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Patrick Vallance, who recently moved from University College London to GlaxoSmithKline, would like to see more movement between academia and industry. Geoff Watts reports
“I probably spend more time thinking and talking about science now than I did in academia. Disease states, pathways, cell types . . . every day I'm faced with major scientific issues across a range of areas.”
The man making this surprising observation—surprising to him as well as to me—is Patrick Vallance. Until a year ago he was professor of clinical pharmacology at University College London (UCL); now he's GlaxoSmithKline's senior vice president for drug discovery. And nor is his more frequent engagement with science the only surprise he's encountered since he changed jobs.
“Many of the projects we're working on in drug discovery are higher risk and more forward looking than some of the things I saw coming through grant panels in academia—the sort of thing that might have been rejected as too speculative. I also realised that I had never previously sat down and talked about what things would look like in 2012 or 2015. That's an everyday discussion in this industry. There's no alternative.”
But what prompted him, in his mid-40s, to move into industry? As much as he now relishes the surprise aspects of his work, they clearly don't account for the job change because he wasn't anticipating them. So, was it boredom with the academic world, perhaps?
“It certainly wasn't that I was fed up. I was very happy at UCL running my research group and a big division of medicine.” He had though served for two years on the scientific advisory board of the drug company, enjoyed it, and discovered (another surprise) “a breadth and depth of science and practical outcomes of science, which I found invigorating.” Although his reasons for accepting GlaxoSmithKline's offer were, he insists, entirely positive, he imagines that some people will have been thinking predictable thoughts. He laughs: “You've sold out; you're going to be paid more; you're no longer interested in the same things you were.”
The rewards, of course, can't be denied. Nor can the facilities. To have met at the company's headquarters in Greenford, Middlesex, on the date we had agreed would have been tricky for me. No problem, said Vallance's assistant. The company has a foothold in central London. This turns out to be a smart townhouse in Berkeley Square. And Vallance remarks that the infrastructure and support on which he can now count frees him to do more of the work for which he was hired. It's a marked departure from an administratively overburdened life as a senior academic.
The work itself involves responsibility for drug discovery—“the part of the process that goes from the initial hit of a chemical on a target through to proof of concept in the clinic”—throughout the whole company. In giving Vallance the job, GlaxoSmithKline knew it was taking on someone who'd been prepared to criticise the industry even while sitting on its scientific advisory board. Giving evidence about clinical trials to a Commons' select committee on health in December 2004 Vallance said that “some studies funded by industry have been more helpful to marketing than to advancing clinical care” and that “some of the design flaws in commercial studies may be conceived to exaggerate benefit or to obscure access to the clinically important result.”
This conflict between commercial and scientific imperatives is surely what lies at the root of the discomfort that some doctors feel about joining industry. In clinical medicine all decisions (theoretically, anyway) are driven by facts, reason, and benefit to patients. But drug companies have commercial departments that, although eager to deploy objective evidence if possible, also exploit other forms of persuasion. Image, emotion, prejudice, and a variety of other influences that contribute to successful marketing can lie uncomfortably with the norms and values of scientific medicine.
Vallance concedes that in this respect there can be “tension” within the industry. But pointing out that vested interest isn't confined to drug companies, he quotes his own experience of attempts to change practice within the NHS and what can happen when reason comes up against entrenched positions or the political realities of the way the service is organised.
I'm not sure how sound it is, jurisprudentially, to defend your own position by pointing out that the other guy's behaviour isn't perfect either. But it's an understandable response to the holier than thou faction among academic critics of the drug industry.
In his evidence to the select committee, Vallance said that the National Institute for Health and Clinical Excellence (NICE) should consider setting defined targets for new treatments. The idea would be to bring “academics, clinicians, patients' groups, and industry into the target setting process before a specific product is developed or even considered.”
He offers the current dispute over drugs for Alzheimer's disease as an example: “The data at this stage can be interpreted by different people in different ways. You end up with a battle that becomes political rather than scientific. It would, I believe, be helpful if NICE could say, ‘These are the sorts of advances we think would be important in this disease area.' I don't think anyone wants NICE to design their clinical trials for them, but if we could agree where we think advances would be universally seen as important, it would give some guide to what we should all be aiming for.”
Would the industry as a whole like this idea? Vallance can speak only for GlaxoSmithKline, which, he says, tries to follow the paths of science and patient need. “My view of drug discovery is that if we don't base it first of all on where scientific breakthroughs have been made and where unmet patient need is, we're not going to end up with the drugs we want.” Purchasers, he adds, are increasingly tough and aren't going to buy medicines that don't make a substantial difference.
Meanwhile he would like to see more movement between academia and industry. And not just through career change but for career development periods lasting a few years. Academia, he thinks, could learn a thing or two from the hard realities of industry. As his experience shows, to work within its silken but firm embrace can be intellectually invigorating.
Not that intellectual challenge is everything, of course. Nice house this, I say, as I'm preparing to make my way out into Berkeley Square. Vallance agrees: “But I don't work in this building all the time, you know.”