The Pharmacology of Distributed Experiment – User-generated Drug Innovation

Abstract

It is a commonplace of the critical innovation literature that experiment has replaced mass production as the driving force of accumulation. But while many theorists have explored the politics and dynamics of such economies of experiment under the rubric of ‘immaterial’, cognitive or affective labour, few have examined the intersection of labour, experiment and the speculative in the clinic. Taking the clinic as representative of contemporary transformations in the commodity-form, labour and innovation, this article will look at recent attempts to reform the clinical trial, arguing that these developments represent a far-reaching shift in our understanding of medicine. First, I investigate recent efforts (associated with the discourse of ‘translational medicine’) to rethink the interface between experimental lab-based science and the clinic. I also look at closely associated efforts to reintroduce an element of experimental surprise into the clinical trial process itself, through the adoption of novel trial designs. If the randomized controlled trial was conceived essentially along the lines of a product testing procedure, recent efforts have attempted to reintroduce surprise into the testing process itself – in other words, to invent a trial process capable of producing unexpected events as leads for further innovation. I then move from the experimental clinic to what I call the distributed experiment. Here I focus on efforts to outsource pharmacological innovation to a distributed public of patients through the use of social networking software. These platforms allow drug developers to escape the limits of the conventional clinical trial by tracking the experimental practices taking place in the distributed clinic of unregulated drug consumption.

Big-pharmaceuticalisation: Clinical trials and Contract Research Organisations in India

“…Petryna (2009) describes how when CROs 'go global', they work across national and cultural boundaries, spread the methodologies, skills and ideas of the pharmaceutical sector, and facilitate the increase in clinical trial activity in countries like India, China and Brazil. We agree with other analysts of commercial research and pharmaceuticals that such clinical trials ought not be considered 'science' but rather a mechanistic, pre-defined test (Bachelard, 1953, quoted in Gaudilliere andL€ owy, 1998, p.10;Cooper, 2012).…”

Depression, performativity and the conflicted body: An auto-ethnography of self-medication

“…She particularly refers to a gradual move from traditional trials to forms of 'user-generated innovation' that employ social networking models of data sharing. 3 Although randomised controlled trials work by testing a hypothesis, forms of 'user-generated innovation' reconfigure the 'experimental' element in the development of compounds, by potentially generating unexpected outcomes (Cooper, 2012). As Cooper suggests, this context of 'distributed experiment' implies 'the recognition that a chemical compound has no inherent therapeutic valence' but produces a series of effects that will be then framed as either beneficial or adverse (2012, p. 34).…”

“…Elaborating on clinical research and practices of self-medication in the development of new medical compounds, Melinda Cooper (2012) suggests that the economic value of these compounds is co-created by clinicians, pharmaceutical companies and user-patients. She particularly refers to a gradual move from traditional trials to forms of 'user-generated innovation' that employ social networking models of data sharing.…”

Every participant is a PI. Citizen science and participatory governance in population studies

“…In these projects, decisionmaking and research agenda setting largely rest with the researchers running the projects (they could be described as 'top-down' citizen science projects). However, interest is growing in initiatives where lay volunteers and patients take a more active role and function as part- Some scholars have criticised citizen science, citing worries that due to lack of formal training, results might be of lower quality, or that such initiatives are vulnerable to commercial influences and interests, leading to biased results (17,18). Certainly, not all participatory practices are created equal (11), but if done well, they could indeed provide a tool to support increased and meaningful participation of members of the public with science and research (16).…”