Sam Jaffe's article in Technology Review, "A Dip in Time", discusses some well known problems with the pharmaceutical industry.  Namely that it costs a ridiculous amount of money to get a drug into testing, which is just the beginning of the financial gamble because it is so hard to predict how new compounds will behave in a large and complex population.  More interesting for me is the suggestion -- within the first sentence, even -- that, "Some [are speculating] that the way new drugs are financed and brought to market will soon be overhauled".

With venture firms basically gambling that one or two in ten investments will pay for the rest, we certainly can't expect innovation from that direction.  Alas.

The article ends with a note that Millennium Pharmaceuticals is using genetic/genomic screening to choose which patients to include in drug trials.  This will certainly help with the trials, but it is rather a backwards strategy to take what you happen to have on hand and see who benefits.  That said, this is what most companies have to work with, and they are looking out for the bottom line first and foremost.  It is clear some significant effort needs to be put in to changing the whole drug discovery and testing infrastructure, so that it is a bit more rational at the front end.