Achoo no more?

From the March 4, 2009 edition of The Journal Record
By Stephen Prescott, M.D.

Cure. It’s a word we’ve all heard too often in the context of medicine and disease.

Cancer. Alzheimer’s. Heart disease. You name the deadly illness, and Google will ferret out millions of sentences in which it’s appeared alongside the “c” word.

Alas, talk of cures usually proves so much hype. With vaccines and other methods of intervention, we can prevent many diseases. And there are some, like certain cancers caught in their earliest stages, we can cure.

But in biomedical research, the best we can usually hope for are discoveries that improve our ability to diagnose and treat diseases. Sometimes, a new insight will also show us ways in which changing our behaviors – diet, exercise, exposure to certain environmental factors – can lessen our chances of developing a particular illness.

Still, last month, researchers made a finding that, even to the most hardened among us, raised hopes for a cure.

The illness? No less than that ubiquitous scourge, the common cold.

The scientists announced that they had decoded the genomes of the 99 strains of the common cold virus and cataloged its vulnerabilities. The study’s authors said the findings had unmasked the virus’s “Achilles heel” and that “a very effective treatment for the common cold is at hand.”

Strong words, indeed. And a welcome relief to us all, particularly the millions who suffer from asthma and chronic obstructive pulmonary disease.

Except there’s a catch.

You see, this is one of those rare instances where the science appears willing, but the market is weak.

With the typical cost of developing a new drug approaching $1 billion, the payoff needs to be big. But because colds are largely a minor nuisance, most people would be unwilling to pay for expensive drugs. And unlike, say, a cholesterol-lowering statin drug, cold medication is not something you would use every day for the rest of your life.

Plus, garnering the Food and Drug Administration’s approval would be a tough row to hoe. A treatment for such a mild condition would pass regulatory muster only if clinical trials revealed a spotless safety profile.

In short, even with this breakthrough, I’d bet on a Chicago Cubs world championship and a Dow at 20,000 before I’d put my money on a cure for the common cold.

This is not the first time we’ve faced the problem of medications that don’t fit the current business model. Unfortunately, it’s already cost us countless lives in the realm of developing (or, more accurately, not developing) vaccines and treatment for rare diseases.

To reap all the fruits that biomedical research has to offer, we must get away from our current “only the moneymakers are worth the effort” method of doing business. Until then, though, we’ll just keep fighting colds the old-fashioned way: with warm drinks and rest.

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