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Medicine, Drugs and Clinical Trials

Drug development, preclinical testing and the therapeutic index

  • 3 things to know
  • AS 6

Overview

The stages of drug development and their cost, in vitro and in vivo testing, pharmacology and toxicology, thalidomide, animal ethics, ED50, LD50 and the therapeutic index, and dose calculations.

What you need to know

Answer each one before you reveal it.

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Process

Outline the stages a new medicine passes through from pre-discovery to launch.

Key term

Why does developing a new medicine take so long and cost so much?

Key term

Why do most candidate drugs never reach patients?

Questions from this subtopic

Each one with the model answer underneath.

  1. 1

    Outline the stages a new medicine passes through from pre-discovery to launch.

    Model answer

    Researchers first study the disease to find a target, then discover and optimise a lead compound. Preclinical tests and clinical trial phases I to III follow, and a licence is sought before launch.

  2. 2

    Why does developing a new medicine take so long and cost so much?

    Model answer

    Development typically takes 10 to 15 years because every stage of testing must be completed and reviewed. Most candidate drugs fail along the way, and the successful few must cover those costs.

  3. 3

    Why do most candidate drugs never reach patients?

    Model answer

    Many candidates prove toxic, poorly absorbed or ineffective during testing. Only roughly one in ten drugs entering human trials is eventually licensed.

  4. 4

    What is preclinical in vitro testing, and what are its limitations?

    Model answer

    Preclinical in vitro tests use isolated cells, tissues or enzymes to screen a compound's activity and toxicity. In vitro tests are quick and cheap but cannot show how a whole body handles the drug.

  5. 5

    Why is preclinical in vivo testing carried out in animals before human trials?

    Model answer

    In vivo tests show how a drug is absorbed, distributed, metabolised and excreted in a whole living organism. Regulators usually require testing in two species, typically a rodent and a non-rodent.

  6. 6

    What is the difference between pharmacology testing and toxicology testing?

    Model answer

    Pharmacology testing finds out what the drug does in the body, how it works and at what doses. Toxicology testing looks for harmful effects, such as organ damage, cancer or harm to a developing fetus.

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