History of the pharmaceutical industry

The pharmaceutical industry, as we now know it, is barely 60 years old. From very modest beginnings, it has grown rapidly, reaching an estimated value of US$100 billion by the mid 1980s. Its current value is likely double or more this figure. There are well in excess of 10 000 pharmaceutical companies in existence, although only about 100 of these can claim to be of true international significance. These companies manufacture in excess of 5000 individual pharmaceutical substances used routinely in medicine.

Table 1.2 Some pharmaceuticals that were traditionally obtained by direct extraction from biological source material. Many of the protein-based pharmaceuticals mentioned are now also produced by genetic engineering

Substance

Blood products (e.g. coagulation factors)

Vaccines Antibodies Insulin Enzymes

Antibiotics

Plant extracts (e.g. alkaloids)

Medical application

Treatment of blood disorders such as haemophilia A or B

Vaccination against various diseases

Passive immunization against various diseases

Treatment of diabetes mellitus

Thrombolytic agents, digestive aids, debriding agents

(i.e. cleansing of wounds) Treatment against various infections agents Various, including pain relief

The first stages of development of the modern pharmaceutical industry can be traced back to the turn of the twentieth century. At that time (apart from folk cures), the medical community had at their disposal only four drugs that were effective in treating specific diseases:

• Digitalis (extracted from foxglove) was known to stimulate heart muscle and, hence, was used to treat various heart conditions.

• Quinine, obtained from the barks/roots of a plant (Cinchona genus), was used to treat malaria.

• Pecacuanha (active ingredient is a mixture of alkaloids), used for treating dysentery, was obtained from the bark/roots of the plant genus Cephaelis.

• Mercury, for the treatment of syphilis.

This lack of appropriate, safe and effective medicines contributed in no small way to the low life expectancy characteristic of those times.

Developments in biology (particularly the growing realization of the microbiological basis of many diseases), as well as a developing appreciation of the principles of organic chemistry, helped underpin future innovation in the fledgling pharmaceutical industry. The successful synthesis of various artificial dyes, which proved to be therapeutically useful, led to the formation of pharmaceutical/chemical companies such as Bayer and Hoechst in the late 1800s. Scientists at Bayer, for example, succeeded in synthesizing aspirin in 1895.

Despite these early advances, it was not until the 1930s that the pharmaceutical industry began to develop in earnest. The initial landmark discovery of this era was probably the discovery, and chemical synthesis, of the sulfa drugs. These are a group of related molecules derived from the red dye prontosil rubrum. These drugs proved effective in the treatment of a wide variety of bacterial infections (Figure 1.1). Although it was first used therapeutically in the early 1920s, large-scale industrial production of insulin also commenced in the 1930s.

The medical success of these drugs gave new emphasis to the pharmaceutical industry, which was boosted further by the commencement of industrial-scale penicillin manufacture in the early 1940s. Around this time, many of the current leading pharmaceutical companies (or their forerunners) were founded. Examples include Ciba Geigy, Eli Lilly, Wellcome, Glaxo and Roche. Over the next two to three decades, these companies developed drugs such as tetracyclines, cor-ticosteroids, oral contraceptives, antidepressants and many more. Most of these pharmaceutical substances are manufactured by direct chemical synthesis.

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