Not-so-magic Bullets: Searching for Better Policies to Govern Drug Discovery

Abstract

In his upcoming book, Strange Pill: Evidence, Values, and Medical Nihilism, philosopher of Jacob Stegenga charts a history of the term “magic bullet”: a drug that is both specific and effective, curing the patient without side effects. Stegenga argues that the early 20th century was a “golden age” for magic bullets, with the discovery of drugs like penicillin and insulin, and that late 20th/early 21st century medicine has not been able to deliver drugs that are nearly as effective. I propose, by interviewing Stegenga, to outline why recently discovered drugs tend to have tiny effect sizes and bad side effects (and therefore a poor cost/benefit ratio.) I will then outline proposals for how the modern medical research agenda can be restructured so that its products more closely resemble “magic bullets,” an outcome that would save the NHS money and improve the patient experience.