Industry critic Dr Marcia Angell has defended her claim that pharmaceutical companies today “do almost no innovation” from a counter-attack asserting that the private-sector contribution to pharmaceutical science is “immense and indispensable”.

The war of words, conducted in The Wall Street Journal, follows an op-ed piece in that newspaper by Benjamin Zycher, co-author of a report for US think-tank the Manhattan Institute. The report and Zycher’s op-ed sought to refute assertions by Angell, former editor-in-chief of the New England Journal of Medicine, that most of the innovation in the drug sector comes from academic research supported or conducted by government agencies – notably the National Institutes of Health (NIH).

The Manhattan Institute report, written by Zycher with Joseph DiMasi, director of economic analysis at the Tufts Center for the Study of Drug Development, and Chistopher-Paul Milne, the Tufts Center’s associate director, cited case studies of 35 drugs and drug classes identified in the scientific literature as important and/or among the most prescribed in the US during 2007.

These showed, the report argued, that while basic research occurs in both the public and private sectors, the applied science of drug development and clinical refinement is conducted almost entirely by the private sector.

Taking up the challenge in a letter to the Journal, Angell says the examples of innovation quoted by Zycher “date back to the 1980s or earlier”. Even then, she adds, Zycher is not telling the whole story.

“For example, Amgen did not work out the synthesis of Epogen [epoetin alfa] on its own; it licensed the basic technique from Columbia University,” Angell comments. “Nearly every top-selling drug today has progenitors dating back many years, often based on NIH-funded research in universities.”

Zycher’s finding that, among the 35 drugs/classes reviewed for the report, private sector research was responsible for ‘central advances in basic science’ in seven cases is “not much of a yield”, Angell writes. “Far from doing scientific innovation, the large drug companies license or otherwise acquire discoveries from universities or small biotech companies, then develop them for commercial production and sponsor the clinical research necessary for FDA approval. That’s expensive but hardly creative in the scientific sense.”

The problem, Angell adds, is that industry “expects to be rewarded as though it were the source of innovation, pricing drugs as high as the traffic will bear and doing everything possible to extend its exclusive marketing rights. The only really innovative thing about this industry is its apologists.”