Research and the Economic “Big One”

When I wrote about the EULAR meeting in the September and October issues of The Rheumatologist, I said that times are changing and that rheumatology should be prepared to look carefully at itself and adjust to new realities. In those columns, I focused on the improvement of outcomes in the treatment of rheumatoid arthritis (RA) and how this will change the structure of practice, work force projections, and the research agenda as remission in RA becomes more and more achievable.

By the calendar, the interval between the EULAR meeting in June and the ACR Annual Scientific Meeting, held in October 2008 in San Francisco, is not a long time, but rather a quick blink in history. Those warm and radiant days on the Champs Élysées, however, now seem like the distant past, shrouded in memory as economic uncertainty swept into our country with the force of a hurricane and flailed everything in its path.

The last few months of financial turmoil and uncertainty have probably been the most momentous for our country since the end of the Second World War, and we are only beginning to learn the magnitude of recent events. There is no Richter scale for historical happenings but, if there was, the time since the financial collapse would certainly rate as a Big One, as earthquake-like changes rattled our entire economy. Even though the ACR meeting provided an outstanding menu of science and learning, everyone could feel the afterstocks of Wall Street’s epic plunges.

Revelations at 30,000 Feet

On the first leg of my flight home from San Francisco, I swiped a copy of the Wall Street Journal (WSJ) that had been left abandoned in the first-class section. To skimp on funds, I, of course, booked the cheapest flight and sat crowded in coach, assailed by the cacophony of a man gripped by sleep apnea and stewing over the $15 baggage fee and the $1 I paid the flight attendant for a cup of bitter, lukewarm coffee. The WSJ was a welcome freebie.

Consider the following headlines of the October 29, 2008, WSJ: “Cash-Poor Biotech Firms Cut Research, Seek Aid”; “Wyeth to Focus Research Efforts on Fewer Diseases”; and “Outlook is Cut for U.S. Drug Sales.”

Those headlines don’t sound particularly good, especially at a time when the pharmaceutical industry provides a significant source of funds for both basic and clinical research. Events at the Moscone Center, San Francisco’s convention hall, may have given a different impression of the state of industry’s health. The exhibit area for the companies was huge, blaring, and boisterous, and filled with the newest in upscale computer displays and advertisements for a cornucopia of products. While the company exhibits were far away from the poster viewing area, many attendees made the trek, interested in seeing what industry had that was new, or perhaps attracted by the “lure of the cappuccino,” as one of my friends said.