By Peter Allen
BBC Five Live, Drive presenter
Taking part in clinical trials for new drugs is not a pastime with a good reputation.
Volunteer numbers have gone up
Certainly not since the following appeared in the News of the World almost a year ago:
"An anguished victim of the Elephant Man drug trials has broken his silence to tell how doctors discovered the early stages of cancer in his ravaged body."
That victim was one of six who took part in a drugs trial at a site at Northwick Park Hospital in London. All suffered multiple organ failure.
Yet, according to the drugs companies, the number of volunteers for such trials did not fall as a result of all the publicity. Instead, it went up.
BBC Five Live's Drive programme decided to have an in-depth look at the business of drug development, to speak to those who worked in the industry and indeed to some of those who still happily volunteer for trials.
Not so bad as it sounds
Philippe is one such person. I met him in the Pfizer research headquarters, located on the Erasme Hospital campus in Brussels. He is an accountant and apparently a very sane man.
Yet he had agreed to be shut up in what is effectively a high quality prison for two weeks to try out a new drug designed to treat asthma.
It increased his heart beat, made him tremble and made him go to the loo. But he seemed unconcerned.
"The impact itself is not so bad as it sounds, it's minor," he said. "And it passes."
He had been taking part in such trials for ten years, he told me.
They began in university when he needed the money, now he takes part mostly because he thinks it is useful work, and also gives him the chance to watch the 80 DVDs he brings in with him.
"In those studies I've participated in several of the drugs have been further developed and commercialised," he said.
"I do know that several of those drugs are now on the market. And today there are several hundreds, if not thousands, of people who are cured, or at least treated with medication I have helped to develop. Of course my input was very small."
Philippe is one of hundreds of people who happily turn up each week at the research headquarters to try out drugs, admittedly in very small amounts, which have never been given to a person before.
Weighing up the risks
Companies like Pfizer put together thousands of compounds every year in their laboratories.
Ryan Wilson was most badly affected by the failed drug trial
They are tried on animals before being tried on people and only a couple of dozen of those thousands make it from the laboratory to the clinical trial on people.
If Philippe and the others react badly, it goes no further.
If it does make the grade the next phase will be to test it on people with asthma, and finally to large scale clinical trials.
I asked him whether he had been put off participating by the disastrous British trials and the potential risk of things going horribly wrong.
"Of course we have given it a lot of thought, we've read about it and we've made some enquiries and we've also discussed it with a few people in the healthcare industry - but they have assured me that it is impossible for it to happen again."
All that takes money, lots of it: the cost of a drug which makes it is on average more than £500 million.
Of all those thousands of compounds produced each year, probably only one will make it to the chemist's shelf.
That is the company's case, put very forcibly to me in Brussels. That is why, says the company, profits have to be high on the drugs they do sell.
They have decided to open their doors to us at the headquarters in Sandwich so that we can see for ourselves whether their case is a reasonable one.
BBC Five Live's Drive programme, with Peter Allen, is live from Pfizer's research centre on Thursday, 21 June 2007, from 1600 BST.
You can join the debate by email (firstname.lastname@example.org), text (85058) or by telephone (08700 100 500).