Illustrating Broken Incentives

Research is fundamentally broken by regulation in much of the world. One facet of this problem is that the cost of obtaining approval for new drugs and technologies is so astronomical that large swathes of the research community are directed towards finding marginal new uses for drugs that are already approved by regulators. This activity is, despite occasional successes like the one linked here, always going to be far less productive and useful than tailoring new technologies to the problem at hand. This is one of many ways in which regulation slows progress to a grinding crawl. Because people only pay attention to the occasional successes, they don't see or much care about the many other potential successes that never happened and were never worked on because of the perverse financial incentives put upon the research community by the regulators: "Bexarotene has been approved for the treatment of cancer by the U.S. Food and Drug Administration for more than a decade. These experiments explored whether the medication might also be used to help patients with Alzheimer's disease, and the results were more than promising. ... the main cholesterol carrier in the brain, Apolipoprotein E (ApoE), facilitated the clearance of the amyloid beta proteins. [Researchers] chose to explore the effectiveness of bexarotene for increasing ApoE expression. The elevation of brain ApoE levels, in turn, speeds the clearance of amyloid beta from the brain. Bexarotene acts by stimulating retinoid X receptors (RXR), which control how much ApoE is produced. ... The present view of the scientific community is that small soluble forms of amyloid beta cause the memory impairments seen in animal models and humans with the disease. Within six hours of administering bexarotene, however, soluble amyloid levels fell by 25 percent; even more impressive, the effect lasted as long as three days. Finally, this shift was correlated with rapid improvement in a broad range of behaviors in three different mouse models of Alzheimer's."



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