The Drug Development Process: A Rube Goldberg of Life Sciences?

A Rube Goldberg contraption is an over-engineered machine that uses chain reactions to accomplish the simplest of tasks in the most complicated of fashions, often in a comical way. The idea arose in the 1930s and is named for its creator Rube Goldberg, an engineer and Pulitzer-Prize-winning cartoonist. These devices have become so popular you have probably seen examples of them in well-known movies such as “Back to the Future” and “The Goonies.”

The idea for these inventions came from Goldberg’s curiosity with modern technologies and how some of society became attached to technological solutions for simple problems. A classic example is the depiction of Professor Lucifer Gorgonzola Butt operating a napkin in a very peculiar and overly elaborate way. Who would’ve thought that this would be the beginning of one of the countless ways to make science really, really cool?

The “Self-Operating Napkin” is activated when soup spoon (A) is raised to mouth, pulling string (B) and thereby jerking ladle (C), which throws cracker (D) past parrot (E). Parrot jumps after cracker and perch (F) tilts, upsetting seeds (G) into pail (H). Extra weight in pail pulls cord (I), which opens and lights automatic cigar lighter (J), setting off skyrocket (K) which causes sickle (L) to cut string (M) and allow pendulum with attached napkin to swing back and forth, thereby wiping chin.

Flash forward to modern day, when these machines are still popular. Just last month, Bob Partington—an artist, engineer and inventor—wanted to accomplish the perfect mini-golf hole-in-one in a very stylish way. So with production help from YouTube channel Field Day, Partington created one of the slowest Rube Goldberg machines ever. It is so slow and elaborate, taking a little over six weeks from beginning to end to complete, that Partington actually baptized it as “The Rube Slowberg.”

This Rube Slowberg has everything—a turtle, a molasses river, growing grass, popsicles, and even a DMV waiting line! Take a look at “The World’s Slowest Rube Goldberg” video and enjoy the slow ride set to Kanye West music (don’t worry about it, the video is not that long).

But what does a Rube Goldberg have to do with the drug development process? Actually, a lot. I cannot help but see it as a metaphor for all of the steps that scientists have to go through during the drug development process to have one of their therapeutics finally see the light… in this case approval by the FDA.

The drug development process—as the Rube Goldberg—consist of several stages, five to be precise. Each one of them composed of mini sections of chain reactions. To do the exact opposite of Rube Goldberg’s methodology of over-complicating simple procedures; I will over-simplify the explanation of the complicated procedures of developing a drug. The stages are:

Discovery & Development – This stage involves the screening of several thousand compounds for their potential to treat a condition.
Preclinical Research – The most promising compounds are then selected to understand their pharmacology and behavior.
Clinical Research – It is narrowed to five final compounds and each follow specific protocols to test their efficacy.
FDA Review – The FDA review team examines the data on the drug and makes a decision to approve it or not.
FDA Post-Market Safety Monitoring – After the drug is on the market, FDA reviews reports of problems with the prescriptions, and can decide to add cautions to the usage information.

Translating the drug development process into numbers, it takes an average of 12 years for a drug to travel from the research lab to the patient, and a staggering average of 2.5 billion dollars to finance the complete process.

So a drug has to go through countless contraptions, survive several cuts, and wait for acceptance to finally fulfill its purpose. This sounds to me as a typical Rube Goldberg machine, but at a much bigger and important scale.