![]() ![]() The most recent example is dimethylfumarate, which has widely been used as a mould inhibitor. Similarly, the discoverers of warfarin (( R, S)-4-hydroxy-3-(3-oxo-1-phenylbutyl)-2 H-chromen-2-one) at the University of Wisconsin in 1948 21 would be amazed that at the beginning of the 21st century this rat poison is still the most frequently prescribed anticoagulant in the world. For example, the vasodilation properties of nitroglycerine were only discovered by William Murrell 20 after its invention by Alfred Nobel as the active constituent of dynamite. Not surprisingly therefore, many pharmaceuticals are also used for non-pharmaceutical purposes. This greater role for the state was paralleled on both sides of the Atlantic, with increasing government regulation of medicine production. This produced a major incentive for further commercial investment in research, development and manufacture. After the war, the implementation of state healthcare systems in Europe, such as the UK's National Health Service (NHS), 17 created a much more stable market, both for the prescription of drugs and, much more importantly, their reimbursement. ![]() The Second World War provided a major stimulus to the developing industry, with requirements for the large-scale manufacture of analgesics and antibiotics and increasing demands from governments to undertake research to identify treatments for a wide range of conditions. 16 In the 1920s and 1930s both penicillin and insulin were identified and manufactured, albeit at a modest scale. In 1897, scientists at Bayer demonstrated that a chemically modified version of salicylic acid had much improved efficacy and the product, aspirin, is still in widespread use today. Salicylic acid, a natural constituent of willow bark, had been recorded by Hippocrates as having analgesic properties. However, a number of major advances were made in the early part of the 20th century. 1,2 Despite the acknowledged risks and costs associated with pharmaceutical development, many citizens still believe that pharmaceuticals should be being developed to meet all human needs and that when developed they should be given away to everyone on the basis of need. The major pharma companies rightly promote themselves as being research-based organisations, yet most people believe that they spend more on marketing than on research. It is undoubtedly one of the riskiest businesses in which to invest money, yet it is perceived by the general public to be excessively profitable. It is also an industry replete with contradictions for example, despite the undisputed fact that for over a century the industry has made a major contribution to human wellbeing and the reduction of ill health and suffering, it is still regularly identified by the public in opinion surveys as one of the least trusted industries, often being compared unfavourably to the nuclear industry. The pharmaceutical industry has a number of unusual characteristics that make it very different from what people normally think of as industry. ![]()
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