Science, medicine and industry: are we getting out of the black hole in sepsis research?
Abstract
In this issue of Intensive Care Medicine, Finfer and colleagues describe an important new clinical trial which (re-)examines the effects of a not-so-new drug—recombinant human activated protein C (rhAPC)—on outcome in sepsis [1]. This publication is important because it describes—at an early phase—the basis for and protocol of a study, which will hopefully not only clarify but also potentially change clinical use of this drug. The decision to inform the intensive care community of the trial right from the beginning also motivates this editorial, which reviews some aspects of the complexity of the relationship and interactions in the triangle of three major players (but not always ideal partners) involved in pertinent clinical research: science, medicine and industry. The primary objectives of each of the three stakeholders are quite different. The pharmaceutical industry wants to make profit, but is also very much interested in bringing new products to the market (necessary for its sustainable development) and in innovation (which improves its image in the eyes of society). Science is curiosity-driven, with the aim of furthering our understanding of human biology, physiology, and mechanisms of disease, also to discover better ways to treat disease. Finally, the objective of medicine is to help patients to get better quickly and to recover a good quality of life. Naturally, the patient and society cannot be left out. They expect, if not cure, then the best possible care, and…
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