The valley of death: why Australia failed to develop clinically effective drugs in COVID-19

Area of Science:

• Pharmacology and Clinical Therapeutics
• Public Health Policy
• Pandemic Preparedness

Background:

• Limited public discourse on the cost-effectiveness of drug trials during the COVID-19 pandemic.
• Significant public investment in vaccine and drug research yielded no deliverable medicines or vaccines for Australia.
• Australia's reliance on global supply chains and commercial pricing due to insufficient domestic therapeutic development.

Purpose of the Study:

• To analyze the value and public cost of drug trials during the COVID-19 pandemic.
• To identify cognitive biases and systemic failures in Australia's therapeutic development strategy.
• To propose improvements for a national therapeutics and clinical trial strategy for future pandemics.

Main Methods:

• Review of public spending on drug trials and vaccine development during the COVID-19 pandemic.
• Analysis of cognitive biases potentially influencing therapeutic development decisions.
• Assessment of the role of clinical pharmacology expertise in leadership and strategy.

Main Results:

• A lack of transparency regarding the costs and value of COVID-19 drug trials.
• Identification of cognitive biases, including underestimation of development complexities and a lack of systems thinking.
• The absence of clinical pharmacology and translational science expertise in key decision-making teams.

Conclusions:

• Addressing cognitive biases and integrating clinical pharmacology are crucial for effective therapeutic development.
• Australia needs a robust national strategy for therapeutics and clinical trials, integrated with a Centre for Disease Control.
• Improved strategies are essential to enhance national preparedness and reduce reliance on external factors for future pandemics.