It seems a lot of people out there really think there are cures “They” don’t want you to know about.

In particular, there seems to be a surprisingly pervasive belief that drug companies aren’t working on cures for disease because it’s far more profitable to chronically maintain patients on medication.  This also explains (so the reasoning goes) why drug companies offer so many incremental therapeutics, and so few revolutionary treatments.

If only this explanation were true.

Drug companies, in fact, are desperate to identify radically improved treatments for dreadful disease.  Even if you don’t accept (as I’ve recently argued) that most industry researchers I know aspire to create such profoundly effective medicines, imagine the economic value of a drug that cured Parkinson’s Disease or pancreatic cancer – consider what such a therapy would be worth.

Exhibit A is the explosion of pharmaceutical interest in hepatitis C.  How do you explain the billions of dollars in investment– including an eye-popping $10.8B acquisition — if companies weren’t looking to cure patients?  The entire premise of this field has been coming up with approaches to cure more patients faster.

Of course, progress in HCV has been exceptional; by and large, medicine has seen mostly incremental gains, and has witnessed few transformative therapies.   Why?

The unfortunate truth is that drug companies really want to cure disease, but rarely know how.  Medical science simply isn’t up to the challenge.  Most diseases aren’t well enough understood to enable the rational development of truly transformative treatments.

When high-profile pharma studies fail – such as the slew of recent Phase 3 Alzheimer’s Disease trials – it’s fashionable to characterize them as yet another industry failure.  There’s some truth to this: the proximal cause may well be a poor decision to continue the development of a questionable drug.  But the root cause is likely insufficient understanding of disease pathophysiology.