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This research has had impact on two linked areas of illicit drug policy. Firstly, pioneering research on the effects of drug decriminalisation in Portugal has shifted the debate on this issue in the UK, US and elsewhere towards an acceptance that decriminalisation is a viable and not harmful approach. Secondly, research on alternatives to imprisonment for drug-dependent offenders has moved debate towards supporting the expansion of treatment for such offenders in the UK and US. These impacts are evidenced in the citation of the research by policy-makers and NGOs (including the British Sentencing Advisory Panel; The All Party Parliamentary Group on Drugs; the Home Affairs Select Committee; UK NGOs, Release and Transform; the US Drug Policy Alliance and the United Nations Office on Drugs and Crime), demonstrating a significant influence on policy-making as well as public debate.
The emergence of new psychoactive substances (NPS) in Europe over the last decade (including performance and image enhancing drugs), poses challenges to policy makers. These are substances which are frequently not controlled under law, and governments have struggled to address potential societal and health harms of use. We have analysed this drugs market, described the potential health harms of NPS, and generated evidence on effective intervention responses for some of these. Our findings have provided the necessary evidence to support the development of robust, responsive and predictive policy making at both national and international levels.
Research at the University of Sheffield developed pharmacokinetic tools that enable prediction of drug absorption, distribution, metabolism and excretion, and potential drug-drug interactions. In 2001 the University created a spinout company, Simcyp Ltd, to commercialise the technology. The impacts are:
A new, more structured way of assessing the various harms done to individuals, families, communities and wider society by a range of legal and illegal drugs was first articulated by Professor David Nutt and colleagues at the University of Bristol. The "rational scale" they developed in the light of their research has stimulated extensive policy debate and informed drug classification in the UK and overseas. The research underpinning the scale has been disseminated through numerous public lectures and discussions and has stimulated worldwide media coverage. As a consequence, public awareness of drug harms has increased and public engagement in important debates about drugs has intensified.
University of Dundee-led research has changed the international approach to illicit drug deaths. Though reducing deaths was a national priority, no systematic research into Scottish deaths had previously occurred. Highlighting the heterogeneity of the deceased, Dundee researchers identified deficits in care processes and multi-agency data sharing, making recommendations regarding monitoring. This directly influenced government response, introducing a standardised mandatory annual review process, enhancing understanding of drug death in Scotland and facilitating targeted prevention approaches. This, and subsequent Dundee-led research, now informs strategy development in the UK via the national programme on Substance Abuse Deaths (np-SAD) and the European Union (European Monitoring Centre for Drugs and Drug Addiction; EMCDDA).
Innovative formulation science to create and develop the commercially successful PowderHale® technology was undertaken within the Department of Pharmacy & Pharmacology at the University of Bath, and subsequently by Vectura. This has directly provided the basis for novel, potentially life-saving treatments for chronic obstructive pulmonary disease (COPD). Seebri® Breezhaler® and Ultibro® Breezhaler® are once-daily, maintenance bronchodilators for the relief of various symptoms due to airways obstruction caused by COPD. Seebri® Breezhaler® was approved in the EU and Japan at the end of 2012 and has now been launched by Novartis. Ultibro® Breezhaler® a first-in-class combination bronchodilator was approved in Japan and the EU in September 2013. Under the terms of the licence agreement with Novartis concerning these products, Vectura has already received $52.5M with an additional >$100M anticipated upon achievement of regulatory and commercialisation targets. These medicines are major advances to treat and manage a disease that, according to the WHO, affects an estimated 210 million people worldwide and was the third leading cause of death in the developed world in 2012.
Research by the School of Pharmacy played a key role in the 2008 regulatory approval of Janssen Pharmaceutica's HIV drug Intelence®. As a poorly soluble drug, Intelence® required specialist formulation and was the first formulation of its type to be approved by the FDA and EMA. Intelence® offers significantly improved clinical outcomes due to its efficacy in patients with HIV resistance. Global Intelence® sales in 2012 were $349M, with additional not-for-profit supplies to resource-limited countries. As a result of this landmark regulatory approval formulation development strategies at Janssen were adapted enabling a further poorly soluble drug to reach the market. Telaprevir, a second-generation Hepatitis C treatment (marketed as Incivek®, Incivo® & Telavic®), gained global regulatory approval in 2011. 2012 sales exceeded $1bn in the US alone.
A routine test to screen for patients genetically disposed to serious side effects from treatment with thiopurine drugs has been widely adopted following research by the Academic Unit of Clinical Pharmacology at the University of Sheffield. The test has spared patients painful and potentially life-threatening sepsis, and saved the considerable associated treatment costs which have been estimated to be over £9,000 per patient for a 17 day hospital stay. It has also led directly to a change in clinical guidelines and recommendations in both the USA and UK.
Research by Professor Abdul Basit's group at the UCL School of Pharmacy is leading to improved treatments for ulcerative colitis and other conditions through increased knowledge of the complex physiology of the gastrointestinal tract. Improved understanding of in vivo drug release and uptake has allowed development of three patent-protected technologies for improved drug delivery: PHLORALTM, for release of drugs in the colon, and DuoCoatTM and ProReleaseTM formulations designed to allow intact transit through the stomach followed by immediate release upon gastric emptying. These technologies are the subject of licences and ongoing development programmes, with PHLORALTM currently in phase III clinical trials. The impact is therefore the introduction of enabling technologies that have positively influenced the drug development programmes of pharmaceutical companies.
Clinical pharmacology studies conducted at Newcastle have led to optimisation of the administration of the chemotherapy drug carboplatin in children with neuroblastoma and other cancers. The research provided the rationale for carboplatin dosing based on patient renal function, with individualised dosing resulting in increased drug efficacy and reduced toxicity. This approach is now in widespread use in national and European treatment protocols, benefitting over 2,500 children. Similar drug monitoring approaches are being implemented for an increasing number of important drugs. Following a recent Newcastle-led national clinical trial, new dosing guidelines for the drug 13-cis retinoic acid have been adopted for high-risk neuroblastoma patients across Europe.