title: Medications development for substance-use disorders: contextual influences (dis)incentivizing pharmaceutical-industry positioning.
abstract: BACKGROUND
  The significant contribution of substance-use disorders (SUDs) to the global-disease burden and associated unmet medical needs has not engendered a commensurate level of pharma-industry research and development (R&D) for novel SUD therapeutics invention. Analysis of contextual factors shaping this position suggests potential routes toward incentivizing R&D commitment for that purpose.
  
  
  METHODS
  This article considers multiple primary factors that have consorted to disincentivize pharma industry's operating in the SUD space: ill-understood pathology; variegated treatments and patient profiles; involved clinical trials; and - with particular reference to SUDs-negative cultural/business stigmas and shallow commercial precedent. Industry incentivization for SUD drug innovation requires progress on several fronts, including: translational experimental data and systems; personalized, holistic SUD treatment approaches; interactions among pharma, nonindustry constituencies, and the medical profession with vested interests in countering negative stereotypes and expanding SUD treatment options; and public-private alliances focused on improving SUD pharmacotherapy.
  
  
  CONCLUSIONS
  Given the well-entrenched business stance whereby the prospect of future profits in major markets largely determines drug-company R&D investment trajectory, strategic initiatives offering substantial reductions in the risks and opportunity (i.e., time and money) costs associated with SUD drug discovery are likely to be the most potent drivers for encouraging mainstream industry positioning in this therapeutic area. Such initiatives could originate from front-loaded R&D operational and back-loaded patent, regulatory, marketing and health-care policy reforms. These may be too involved and protracted for the turbulent pharmaceutical industry to entertain amid its recent retrenchment from psychiatric/CNS diseases and intense pressures to increase productivity and shareholder value.
authors.affiliation: Northeastern University, Bouvé College of Health Sciences, Center for Drug Discovery, Department of Pharmaceutical Sciences, Health Sciences Entrepreneurs , 360 Huntington Avenue, 116 Mugar Life Sciences Hall, Boston, MA 02115-5000 , USA +1 617 373 2208 ; +1 617 373 7493 ; d.janero@neu.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Janero
mesh_terms: D000818:Animals; D002493:Central Nervous System Diseases / Q000188:drug therapy; D055808:Drug Discovery / Q000639:trends*; D004345:Drug Industry / Q000639:trends*; D006801:Humans; D055818:Public-Private Sector Partnerships; D012106:Research / Q000639:trends; D019966:Substance-Related Disorders / Q000188:drug therapy*
keywords: CNS; abuse potential; addiction; discovery alliances; drug development; economics; pharmacological intervention; psychobehavioral illness; regulatory requirements; systems biology; therapeutics discovery