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: It has been a painful life for Paul Bacon. A life in which everything revolves around aches, groans and part-of-the-package side effects of so-called remedies. Bacon, professor in the department of rheumatology at the University of Birmingham, UK, advises people on how to handle pain. Recently, he was in Mumbai to talk about the impacts of analgesics at large, their origin, and how these must be handled. Particularly, Etodolac, a non-steroidal anti-inflammatory drug, is his favourite subject. With a long-standing interest in drug mechanisms and assessing systemic manifestations of connective tissue diseases, Bacon has been working on developing the perfect painkiller. He has created computerised indices for disease activity in systemic lupus erythematosus and vasculitis. His Birmingham Vasculities Activity Score and Vasculities Damage Index serve as standards in European Vasculities trails. “India is using them to document the diversity of vasculities here and has developed new indices to assess Takayasu syndrome,” he says.

With good medical discoveries in store, Bacon returns to the subject he’s here to speak on. Etodolac has good efficacy in postoperative cases and arthritis, high gastric safety with long-term three-year clinical trial. The cardiac safety of the drug has made it acceptable worldwide. He says only one out of 5,000 initial molecules reach the third phase of drug development. Many of these, when launched, face the heat and are rolled back. “That’s why most of the investment (from $800 million to $1.2 billion on any drug) goes into clinical trials. Trials are much cheaper in markets like India and the government is also supporting the patent drive. This could be the land of many cost-effective drugs,” Bacon says. In London, the overall cost of managing arthritis, estimated five years ago, was 1.8 billion pounds. Think of the scale of opportunity in India. “The drug companies can really pick up any chronic painful disease as an opportunity to deliver. Rest of the focus should be on trials,” he says.