2025 Vision for Pharmacy - Speculation 4

The fourth of six Speculations by eminent pharmacists to assist you with your submission for a chance to win a prize on a vision for pharmacy in 2025. See the end of this article for details.

Advances in the Pharmaceutical Sciences

By Professor Tony Moffat – The School of Pharmacy, University of London

One of the expected breakthroughs is the development of more and better vaccines to combat infectious diseases. During the next five to ten years, a reliable vaccine against HIV/AIDS should be produced following a trial programme in Thailand which appeared to reduce infection rates by more than 30%. It is possible that a vaccine against malaria will also be produced which will significantly reduce the numbers of people killed by this disease every year.

Many important drugs such as the anti-retovirals will be out of their patent period and will be available as much cheaper generic products to allow the world's population to have better access to these life-saving drugs. In addition, the real cost of drugs will come down as the rise of the pharmaceutical industries in China and India increase their capacity to produce drugs at affordable prices.

Research into the development of ant-infective agents is sure to have produced a range of these drugs by 2025. There is clearly a need for new antibiotics, such as those for the treatment of HIV/AIDS, and many pharmaceutical companies around the world are working in this area. Infectious diseases which today have become resistant to some front line drug treatments such as TB, malaria and MRSA may well be tamed by new types of drugs and drug combination therapy which will greatly increase survival rates.

New blockbuster drugs will probably become a thing of the past as new drugs now have to be proven to be better than existing ones before they are given a marketing authorisation. Regulations concerning the introduction of new drugs are likely to continually increase which will further reduce the rate at which new drugs come onto the market.

However, the discovery and development of new anti-cancer drugs will still progress as our understanding of the fundamental mechanisms of the causes of cancer continues to evolve. The use of multi-drug regimens will increase as therapy improves in this area. The use of monoclonal antibodies is particularly exciting as an anti-cancer therapy.

Pharmacogenetic testing will gradually revolutionise the way in which clinical trials are organised by only choosing the patient population who are likely to benefit from the new therapy. This also means that the same genetic testing will have to be done on the patients who receive the drug after it has been licensed. This will lead to much more individualised therapy instead of giving the same dosage regimen to all patients.

The number of medicines licensed for children will be sure to increase as the regulatory authorities demand that new drugs be tested for use in children before a licence is given. The granting of increased patent lifetimes for drugs that were originally developed only for use in adults but can now be proven to be safe and effective in children will increase the armoury of drugs that can be give safely to this group of patients.

There will more biotechnology products available which will give an added dimension to their supply and usage. However, they will still be expensive to buy as they cost a lot to manufacture and store, and their use often involves the use of sterile procedures.

We may even see gene therapy used routinely for some hereditary diseases which are caused by single-gene defects, such as cystic fibrosis, haemophilia, muscular dystrophy and sickle cell anemia.

New drug delivery systems will be needed for many of these new drugs and we are likely to see a continuation of the development of novel system involving nanoparticles. Anti-cancer drugs injected into the site of the cancer need to be kept there whilst those drugs given orally or by injection need to get to their site of action, be concentrated there and have their effect for as long as possible whilst at the time having the minimum of toxic effects on the rest of the body. The targeting of drugs in this way is best accomplished by the use of pro-drugs, polymer conjugates of drugs or drugs in polymer vesicles such as nanoparticles and developments in this area are sure to blossom.

One thing is sure, that pharmacists will be needed in ever increasing numbers to take on the expanding roles in the discovery, development, supply and use of all these new medicines.

CPA is encouraging its member organisations and its members to make a submission on what they feel will emerge to have an impact on health care directly or indirectly relating to pharmacy by 2025. A prize will be awarded to the member organisation or member sending in the best submission.

The Presidents Message from Commonwealth Pharmacy Day can be read online.

Full details can be downloaded here: 2025 Vision for Pharmacy (PDF)