Another area in healthcare where IT can be leveraged to obtain a sustainable business model is Drug Discovery.

About Drug Discovery: Drug Discovery is an expensive, difficult and inefficient process which leads to discovery of very few new and effective drugs as the rate of failure is very high. A new drug costs about US$1.8 billion to reach to the market and takes about 15-16 years in the process. Although research based pharmaceutical companies on an average spend about 20% of their sales on research and development (R&D) but still there has been a steady decline in the number of new drugs introduced each year. For eg : It has been over 40 years since a new drug for Tuberculosis (TB) has been developed although it kills 50000 people every week. This is because 90% of all drug development candidates fail to make it to the market and hence there is a need to enhance the drug discovery process and reduce failure rates. The stages in drug discovery are as provided below: 1. Drug Target Identification 2. Target Validation 3. Lead Compound Identification 4. Lead Optimization 5. Preclinical and Clinical Development Now in this paper let me just address the first stage of drug discovery and analyze how IT can play a substantial role in making the process more reliable, fast, efficient & cost effective. Drug Target Identification: The identification of new, clinically relevant, molecular targets is of utmost importance to the discovery of innovative drugs. The complete genome sequences of pathogens has provided a plethora of potential drug targets as these data potentially has all the determinants of hostpathogen interactions and possible drug targets, however computational tools for selecting suitable candidates for further experimental analyses are limited. There were many insilico approaches proposed for finding drug targets but only few has been automated. This is precisely where IT can step in and built an integrated tool based on the new techniques of target identification like a) Genomics (Biotechniques 31: 626-630 2001) b) Bioinformatics (Drug Discovery Today 7:315-323 2002) c) Proteomics (J. Pharmacol. Toxicol. Methods 44:291-300 2000; Biopolymers 60:206-211 2001) The basic algorithm (Taking the example of Drug Target identification in Mycobacterium tuberculosis) could be as illustrated below:

Essential genes need to be found by comparing a bacterial gene set against DEG (Database of Essential Genes) and excluding homologue genes by comparing against a human and human symbiotic organisms protein databases. Insilco comparative analysis of metabolic pathways of the host Homo sapiens and the pathogen M. tuberculosis was performed. Enzymes from the biochemical pathways of M. tuberculosis from the KEGG metabolic pathway database need to be compared with proteins from the host H. sapiens, and later with three symbiotic bacteria by performing a BLASTp search against the non-redundant database restricted to the H. sapiens subset and symbiotic subset Enzymes, which do not show similarity to any of the host proteins, below the set threshold, need to be filtered out as potential drug targets

An attempt has been made to automate the process by a tool T-iDT. As per Singh et al T-iDT, a tool for the identification of drug targets, finds essential genes by comparing a bacterial gene set against DEG (Database of Essential Genes) and excludes homologue genes by comparing against a human protein database. The tool predicts both the set of essential genes as well as potential target genes for the given genome. The tool was tested with Mycobacterium tuberculosis and results were validated. With default parameters, the tool predicted 236 essential genes and 52 genes to encode potential drug targets. The tool is based on the principle of comparative genomics however to make an impact at the industry level there is a need to build an tool integrating all the 3 above mentioned approaches. Only targets which are identified in all the 3 approaches should be considered for rational drug designing. It has been calculated that a 25% reduction in clinical phase lengths would reduce total capitalized drug development costs by 16% (approximately US $129 million). It has also been reported that improving success rates from the current 21.5% to 33.3% would yield a reduction of US $221 million in capitalized cost per NCE (new chemical entities i.e., new drug candidate). Hence the potential impact that an integrated tool can have is clearly visible. The other benefits that an IT company which would take up this project would have are an early mover advantage in the market and large number of clients from the healthcare sector. The model would be highly sustainable since drug discovery is an ongoing process & currently only approximately 483 targets accounted for nearly all drugs currently in market so the software would have tremendous utility and demand.