A “multiple-shots-on-goal” approach is needed to find coronavirus drugs, Cambridge Judge academics say in California Management Review.
A many-shots-on-goal approach – not command and control – will most effectively develop vaccines and treatments for COVID-19 (coronavirus), Cambridge Judge Business School academics say in a new California Management Reviewarticle.
While some have suggested a coronavirus “czar” to coordinate medical responses to the pandemic, the Cambridge Judge team say focusing resources on what seems like the most promising ideas – the natural tendency of a czar – is less likely to succeed.
“Instead, what we need is a multiple-shots-on-goal approach that would allow us to test as many and as diverse ideas as possible, some of which will seem crazy to some experts, at least until they start working (or can unambiguously be ruled out),” says an Insight note in California Management Review by the Cambridge Judge team – Donald Drakeman, Fellow in Operations and Technology Management; Professor Christoph Loch, Dean of the Business School; and Nektarios (Aris) Oraiopoulos, University Lecturer in Operations and Technology Management.
The Insight note refers to an academic study, “The risk of de-risking innovation: optimal R&D strategies in ambiguous environments”, published in the new Spring 2020 issue of California Management Review by Donald Drakeman and Nektarios Oraiopoulos that analyses the most novel medicines of the past 20 years. It shows the “superiority of decentralised parallel searches” – finding that a very large group of small companies created more breakthroughs, at considerably less overall cost, than a much smaller group of very large companies.
“Accordingly, companies that attempt to ‘de-risk’ the innovation portfolio by narrowing their search efforts to minimise failures run the risk of filtering out the next breakthrough,” says the study.
The Insight note underlines how diverse projects by small entrepreneurial biotech companies have outperformed large established companies in developing high-priority drugs over the past two decades, and have done so by “trying many, many things; failing early and often; and eventually discovering genuinely novel and impressively effective medicines.”
Often, such advances are unexpected. When the Nobel committee awarded the 2018 prize to James P. Allison of the University of California, Berkeley, it said his breakthrough on how the immune system can help combat cancer came “despite little interest from the pharmaceutical industry,” and it was eventually developed by a small biotech firm.
The Insight note, “A COVID-19 Manhattan Project?”, discusses at length the Manhattan Project to develop a nuclear bomb. Begun in 1939, it is commonly perceived as a top-down, czar-like initiative focused on hitting milestones – but in fact, the Manhattan Project experimented widely and that was crucial to its success.
“General Leslie Groves soon learned that no one actually knew what was needed” and there was no working design for the bomb, the authors say. Instead of picking a winner, General Groves pushed projects forward in parallel. “Rather than asking for the consensus choice, he provided them with the resources to advance them all simultaneously, and them learning from one another.”
In the coronavirus crisis, we similarly don’t know at this point what a safe and effective treatment will entail: “we don’t yet know whether we want a bomb or a battleship or a missile.”
Given that less than 10 per cent of new drugs succeed, the Insight article says that any coronavirus czar-like figure “needs to resist the temptation to place all our bets on whatever some group of experts thinks is most likely to succeed. Until the clinical data is in, and we can see what will actually defeat the virus in infected patients, the key goal is to get the needed resources to the maximum number of projects and be ready to take advantage of the unknown and unforeseen as it develops.”