Archive for August 21, 2019

On the Poor Career Prospects for People with Postgraduate Degrees : 2

August 21, 2019 7 comments

In the previous part of this series, I went into some detail about the careers of those who studied or worked alongside me during my MSc. To make a long story short, the majority are either no longer involved in scientific research or have menial unstable jobs with some vague connection to what they studied or used to do for a living. Some of you might say that this is to be expected since the biomedical sciences produce many times more graduates than the number of available jobs. While that may be true now, it wasn’t always the case. Indeed, until the early 1990s, those who studied or worked in that sector could either find decent to acceptable jobs or simply move into related areas with considerable ease.

Now let us now talk about another sector which, for over 50 years, provided highly stable, well compensated and intellectually engaging employment. I am talking about pharma. From the end of WW2 in 1945 to mid-1990s, pharmaceutical corporations (large and medium) provided some of the best and most interesting jobs and careers in western countries. And it worked both ways, since those who worked in them came up with the most important advances in medicine we have ever seen. There is a very good reason why this period is often referred to as the ‘golden age’ of drug discovery. And then it started going wrong and is now a mere shadow of its former self. Years ago, I linked to a spoof by somebody else about how things went to shit in pharma.

To be fair, this fall was not instantaneous and it was only after 2008 that the whole sector was irreparably damaged. But ya.. things had been on a downward slope since the mid-1990s. In retrospect, the true beginning of end started in late 1980s, when certain large corporations (Pfizer, Merck etc) decided to recruit ivy-league MBAs. The first signs of this rot manifested as gradual consolidation within that sector. While I could write multiple books on why consolidation in the pharma sector was so disastrous, here is the very brief version. Monopolization and oligopolization always results in counterproductive centralization, destruction of real innovation, greatly increased rent-seeking and is bad for everyone other than the upper management of those corporations in addition to their lawyers and bankers.

It should be noted that corporate monopolization has been much more disastrous in the West than Asian countries because corporations in the later are answerable to their governments to an extent unimaginable in the former. But why are we talking about how the pharma sector used to be about 20 years. Well.. because it is relevant to my choice of career. One of the main reasons for me taking the educational path I took was that working in pharma was an excellent career option with long-term stability and a pretty decent work environment. Sure.. nothing is perfect, but for someone with my interest and talents, it was as good a match as realistically possible.

Also, the pharma sector used to be fairly conservative in both hiring and firing people. Until early 2000s, mass layoffs and multiple site closures for the purpose of “corporate reorganization” were unknown in pharma. Many larger corporations even had defined benefit pensions until mid-2000s. Yes.. you heard that right. To make a long story short, those who stayed out of corporate politics and had generally satisfactory job performance could reasonably expect lifetime employment, and this was widely expected by employers and employees right upto early 2000s. You were not expected to work beyond normal work hours unless necessary due to nature of experiments and there was tons of autonomy at the site and group level. And in spite of all this, vast majority of pharma corporations were profitable businesses and remained so over multiple decades.

But how is any of this linked to my story? As it turns out, I ended up working in pharma for a few years and through direct experience and observing the career trajectories of acquaintances had a ringside seat to the beginning of final collapse of employment in pharma sector. Here is a post from 2011 in which they document that almost 300k jobs in that sector were lost between 2001 and 2011. And those layoffs did not stop in 2011, though they have sorta run out of people to fire- especially in past 4 years. The total is now closer to 400-450 k jobs and even if we assume that 60-70% were in sales and administration, it is fair to say that ivy-league MBAs have finally killed the goose which used to lay golden eggs. Far more problematically, it has altered the career course for many who would have otherwise gone into pharma.

In other words, their short-termism not only destroyed decades of institutional knowledge but also their ability to rebuild in future. And it shows! And before I explain you how, it is important to quickly explain the process of drug discovery and approval. It all starts with either the discovery of a new drug target (usually protein) or some effect of a chemical compound in cell-based or animal assays. From there it enters the pre-clinical development phase where chemists make hundreds and thousands of chemical cousins of the initial lead compounds and test them in a number of assays, animal models of some disease and extensive toxicity testing in multiple animal species. Only after it has cleared that phase can it be even considered for human trials. Small phase I trials are usually the first (dozens of people), followed by larger Phase II trials (hundreds) culminating in Phase III (hundreds to thousands and often) over a few years.

To make another long story short, the system was designed such that drugs which entered Phase III trials were unlikely to fail, and this was the case for most of modern history. Sure.. you did encounter situations where testing in larger populations (P III) revealed some rare but nasty side effects or the drug was not as efficacious as previously expected. But outright failures of efficacy in Phase III trials was really rare. Then something changed and nowadays the majority of drugs which enter Phase III trials fail, and they usually do so for lack of efficacy. Curiously, this often occurs when Phase I and Phase II data was either very good or pretty promising. So.. what is going on? While many industry insiders have tried to explain this deeply troubling trend by invoking all sorts of clever sounding bullshit, there is a simpler and more rational explanation.

A large percentage, likely overwhelming majority, of drug development in past two decades has been based in two types of fraud. The first involves manipulating metrics to make something look far better than it is in real life. Examples of such frauds involve cherry-picking patients, burying negative data, changing criteria for success, playing around with data and statistics and other stuff which is not technically illegal. The second type involves falsification of data, deliberately deleting data, kicking non-responders out of trials to improve responses rates etc. But what does any of this have to do with the downward career trajectory of people working in that sector?

Well.. since we have already exceeded 1200 words in this post, I will leave that discussion for the next part of this series. In it, I hope to go into some more detail about how neoliberalization and financialization of pharma destroyed its older and much more successful business model and institutional structure- all to make a handful of people on wall street and upper management far richer than they otherwise would have been. You will also see how stuff such as pushing opioids, antidepressants, antipsychotics etc to doctors and constantly jacking up prices of old and new drugs replaced developing newer ones as the main source of corporate growth. And ya.. I will also go into what happened to all those middle-aged and older people who lost their jobs and, in many cases their entire, careers after decades of relative stability.

What do you think? Comments?