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Lifestyle Drug Market Booming NEWS agent failed in trials, but had the same It was with the appearance of Vaniqa producing the other HAT drugs, and hair loss side effect associated with that a solution began to take shape. As donate US $5 million a year for five other chemotherapy drugs. During this Aventis was threatening to drop its years for monitoring, treatment and re- period, Cyrus Bacchi, from Pace panel of HAT drugs, BMS was examin- search and development. University, New York, noticed that ing new uses for failed drug candidates The result is current widespread ac- DFMO showed marked anti-try- and found that DFMO in a cream cess to a much-needed drug. 55 million panosome activity in animals, and in preparation enabled hirsute women to people are exposed to HAT in 36 coun- 1983, Belgian physician Henri Taelman eradicate facial hair. Topical applica- tries, with only 4 million of those used the renamed eflornithine to treat tion eased the problems of administra- under surveillance. There are half a a comatose woman in Antwerp. She tion in a resource-poor setting and million new cases a year, with perhaps began to revive within a day, earning existing production facilities could be 60,000 deaths, according to estimates eflornithine the soubriquet “the resur- used as the source. Jannin’s group per- by the World Health Organization rection drug.” suaded BMS to donate the drug for five (WHO). By contrast, the rate of disease However, set against the backdrop of years, and additional lobbying trig- in 1960 was 1 or 2 per 10,000. war, economic deterioration and col- gered Aventis and Bayer to continue Potter Wickware, San Francisco lapse of rural health infrastructure in countries such as Angola, Congo and Sudan, the potential of eflornithine to mitigate HAT suffering languished. Lifestyle drug market booming This, combined with eflornithine’s dif- Lifestyle drugs—medicines that treat conditions associated with lifestyle such as ficult administration procedure—it re- weight-loss tablets, anti-smoking agents, impotence therapies and hair restorers— quires two-week hospitalization and are now a major research and development area for the pharmaceutical industry. continuous IV infusions, requirements In fact, companies have invested over $20 billion in research into such drugs since http://www.nature.com/naturemedicine difficult to satisfy in HAT-endemic re- the 1990s. The reason why is clear: the market lifestyle for drugs is forecast to rise gions—means that the compound had to over $29 billion by 2007 from its current $20 billion. no real revenue value for pharmaceuti- The market is driven predominantly by Western countries, where an image-con- cal companies. In 1995, Aventis halted scious, aging society its production, along with that of two is prepared to pay other drugs for HAT. Simultaneously, high prices for com- Bayer AG threatened to stop making a pounds that promise fourth anti-HAT drug, suramin, leaving to slow the aging a growing number of patients in Africa process, improve bereft of treatment for their disease mental agility, re- after the three-year stock ran out. duce weight gain Anticipating the calamity, health and rejuvenate sex- agencies such as the World Health ual function. © Group 2002 Nature Publishing Organization (WHO) and the Centers Perhaps the first for Disease Control and Prevention, lifestyle drugs were AP Photo/Barbara Mather and non-governmental organizations Viagra for erectile Médecins Sans Frontières (MSF) and dysfunction (ED) and the anti-depressant, Prozac, whereas newer products include Epicentre, began looking for a way to the anti-wrinkle agent, Botox. Although the sector is far from saturated, competi- persuade pharmaceutical companies tion is already tight. For example, in the area of ED, new products include Abbot’s not only to resume production, but to Uprima (apomorphine), which was launched in Europe in May 2001, and Lilly provide the drugs free or below cost. ICOS’s Cialis (tadalafil), which is expected to receive marketing authorization in Jean Jannin of WHO’s Department of the EU later this year. Both are considered to offer advantages over current thera- Communicable Disease Surveillance pies such as faster onset of action and duration of efficacy and will undoubtedly and Response in Geneva, was instru- cannibalize Viagra’s share of the ED market—worth an estimated $2 billion in mental in the lobbying effort. “We es- 2001. tablished a special network to try to Weight-loss drugs also represent a potentially large and profitable market as find a solution. The first step was to only two prescription medicines are currently available (Xenical and have Aventis give WHO a license and Reductil/Meridia). Novel products such as Regeneron’s Axokine and Phytopharm’s transfer the technology to produce the P57 are expected to show great promise as new and efficacious anti-fat drugs. drug.” Pharmaceutical companies will doubtless be showing keen interest in newly dis- But there were two problems: WHO covered properties of the leukemia drug, Geevec. Apparently the compound re- and MSF are not drug manufacturers, stores color to gray hair (NEJM 347, 446; 2002). and because eflornithine is difficult and In other areas of lifestyle drugs, smoking cessation drugs include expensive to make, alternate producers GlaxoSmithKline’s GW468816 (glycine receptor), which is currently in phase 1 tri- were not easy to find. Second, availabil- als, and Roche’s Tempium (lazabemide) in phase 3 trials. GlaxoSmithKline’s Zyban ity of drug in itself was not enough. (bupropion) is currently the only available drug to assist in smoking cessation and Equally important were surveillance had sales of $174m in 2000. For full details see www.reutersbusinessinsight.com. and screening, training of health work- TIM ATKINSON, LONDON ers and rehabilitation of clinics. NATURE MEDICINE • VOLUME 8 • NUMBER 9 • SEPTEMBER 2002 909.
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