Why have so many trials failed, and what should be done better? A drug may be effective and still fail in a trial. One reason is that companies often look for the most broadly applicable drug — for example, 'for all stroke patients' — but disease conditions often differ among patients, resulting in huge variations in treatment responses. Another problem with past trials was that the often crude clinical endpoints missed small but meaningful treatment effects, such as improvements in hand, leg or bladder function. With novel approaches, we can do better.
Neuroscience faculties and medical centres must work together to establish research consortia and networks that unite basic and clinical scientists. On a smaller scale, retreats with select groups of experts from both sides are inexpensive and can jump-start a field. Already, studies of spinal-cord injury are more focused now that the two sides are communicating — some basic researchers have begun using clinical criteria for functional improvement.
In 2011, a report commissioned by the European Brain Council found that, in terms of health-care costs and lost productivity, brain disorders are a greater socio-economic burden than cancer, cardiovascular diseases and diabetes combined1. Yet in 2005, research funding for cancer and neurological diseases was roughly equal (see 'Costs and research funding in Europe'). More than half of that total comprised private funding; now that drug companies have shifted focus, cancer funding is likely to eclipse that of neuroscience.
http://www.nature.com/nature/journal/v483/n7389/full/483267a.html
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