Don't Miss Out

Subscribe to OCA's News & Alerts.

Diagnosing Big Pharma's Dangerous Pathology

-------------------------------------------------
QUOTE: "...it would appear that the leadership ranks of Big Pharma are populated by the wrong species: There are too many hedgehogs and not enough foxes. This hedgehog-and-fox metaphor dates back to Archilochus, an ancient Greek poet who wrote that 'the fox knows many things, but the hedgehog knows one big thing.'"
-------------------------------------------------

Though I don't have any inside knowledge or insight into what ails the pharmaceutical industry, I am keenly interested in how Big Pharma might return to health. The symptoms are well documented: Feverish costs, underwhelming pipelines, and a personality defect that is making it increasingly unpopular with the public.

There's certainly no shortage of advice. For example, leaders at a recent conference roundtable ( www.bioagendaprograms.com ) suggested remedial business school education for executives, outsourcing all R&D, and focusing on the long term (effectively telling Wall Street, "up yours").

But I also speak to industry insiders and have heard recurrent criticism of the silo mentality, that is to say the compartmentalization of people and processes, and the rigidity of leadership.  That makes me wonder if the problem isn't closer to home: the culture within Big Pharma. Improving the long-range health of pharma is not straightforward, not least because the problems are systemic, reaching every facet of the business.  On page 26 we focus on the decline of the sickest patient, Merck, and what might be just possibly the first signs of recovery there.

From what we report, it would appear that the leadership ranks of Big Pharma are populated by the wrong species: There are too many hedgehogs and not enough foxes. This hedgehog-and-fox metaphor dates back to Archilochus, an ancient Greek poet who wrote that "the fox knows many things, but the hedgehog knows one big thing." Isaiah Berlin, writing in 1953, divided "writers and thinkers, and, it may be, human beings in general" by one deep difference. There are those
- the hedgehogs - "who relate everything to a single central vision
... in terms of which they understand, think, and feel"; and those - foxes - "who pursue many ends, often unrelated and even contradictory
... their thought is scattered or diffused, moving on many levels, seizing upon the essence of a vast variety of experiences and objects for what they are in themselves."  Recently Phil Tetlock, a psychologist at the University of California, Berkeley, has shown that the political predictions of foxes are significantly more accurate than those made by hedgehogs.

How does this translate to the pharmaceutical industry? My sense is that the business has thrived under the control of hedgehogs, not just at the top but all the way down the chain of command. These hedgehogs can be recognized (and here I'm adapting a description from The New Yorker on political punditry1) by their aggressive extension of the explanatory reach of their "one big thing" into new domains, by their display of bristly impatience with those who "do not get it," and by their considerable confidence that they have the only correct approach.

But since drug development has become a much more complex, connected enterprise, the hedgehog leadership approach may be at a dead end. In its place we need foxes to orchestrate the strategies to deal with the scientific challenge of developing novel therapies that are superior to existing options or effective for recalcitrant ailments for which there is no current therapy. To again paraphrase The New Yorker, these are your colleagues who know many small things, who are skeptical of grand schemes, who "see explanation and prediction not as deductive exercises but rather as exercises in flexible 'ad hocery' that require stitching together diverse sources of information, and are rather diffident about their own forecasting prowess."

I know who I'd put my money on. Of course, I'm an outsider and things might not be so clear-cut when you're in the thick of drug development. If you're in the industry, we'd welcome your thoughts, which you can share with the entire readership of The Scientist (identified or anonymously) on our Web site, on the discussion thread at the end of this editorial. Perhaps the answer does still lie with the "great leader" strategy, on which so much pharma success is based. Certainly, simple, decisive statements are easier to get behind, internally and externally. Better still would be hedgehogs who are willing to embrace the culture of foxes. I wonder if such a chimera exists?

References
1. L. Menand, 'Everybody's an expert," The New Yorker, Dec. 5, 2005.

--