Billie Piper (Connie), Jonjo O'Neill (Tristan) and Anastasia Hille in The Effect. Photo: Ellie Kurtz.
After 45 minutes of being lost in a bleak industrial estate, I eventually discover Hammersmith Medicines Research at the end of an intersection, just off the Park Royal roundabout, adjacent to a factory building pumping flumes of smoke. The building is exactly what I expect: large, non-specific, stark and cold. I’m feeling a little trepidatious, to say the least.
To my relief, there are no humans being experimented upon in the reception area. Instead there are two friendly, uniformed, ladies at the front desk, who document my arrival and hand us all passes to wear during our visit.
At midday, the deputy ward leader takes us upstairs to a yellow boardroom, where tea and biscuits await. A few moments later, Medical Director Malcolm Boyce arrives: a man who alongside his academic career, has personally participated in 80 drug trials in the past 50 years. He’s obviously a man, who practices what he preaches.
“What people don’t understand is that without trial centres, medicine would be light years behind…so every little helps”, he comments. Indeed, students, the elderly and BBC script writers are just some of the candidates who regularly volunteer to take part in trials. For a few, it’s purely a financial matter. At £150 a day, HMR pay a healthy wage. But many volunteer for personal or altruistic reasons: to honour the memory of a loved one by supporting the development of new treatments or a general desire to contribute to the advancement of medical science.
“Volunteers are treated as guests. We look like a hospital but run like a hotel”, continues Boyce. “There’s a pool table, a 24-hour entertainment centre, a café and laundry service”.
But before we get too comfortable Boyce adds, “now on to the protocol”. The cast and I are intrigued at what is about to follow. While the volunteers may have 24-hour access to an Xbox, PS3 and Sky, they have to adhere to a strict set of rules during their stay. “No caffeine, as it’s a medicine, no sugary foods, as they affect liver function results and you may be asked to wear a red bracelet...which monitors your toilet activity”.
This sparks a deluge of questions from the cast. Are there mixed sex wards? Yes. Do the volunteers behave? Generally. What are the rules on showing affection? Hanky panky is not permissible. Has anyone ever been thrown out? Once - for peeping over a shower cubicle. How long do the trials last? Up to 31 days. How informed are the volunteers? Fully. Is it possible to become institutionalized? Yes. What would the symptoms of this be? Neurosis, twitching, rocking. Have any of the trials ever gone terribly wrong?
Boyce is used to this question. In 2006, medical research company Parexel experienced a media frenzy, after their latest drug TBN1412, left their volunteers with violently swollen heads. He replies calmly, “there have been no adverse reactions to any drug at HMR in the last 40 years”. In actual fact, there have only been three occurrences of volunteers being hospitalized. The first was a heart attack before the trial began. The second was a discovery of a peanut allergy. The third was a bout of acute appendicitis. In all three cases, being surrounded by fully qualified medical staff proved rather useful.
Developing a drug is a long process. Out of 10,000 molecules discovered in the lab, only one of these will ever make it to a medical trial centre. The development process takes ten to twelve years. It includes toxicology tests on rodents, such as rats, and non-rodents, usually dogs. In addition, to this there are tests that thoroughly examine the likely effect of the drug on the human body. This all costs billions of dollars. Only after all of these phases have been satisfactorily completed and the drug company have received ethics committee approval, is the drug is ready to test on volunteers. Even then, only three percent of drugs trialed on human volunteers ever make it to the market.
Big pharma is big business. “There must be a return on pharmaceutical investment” continues Boyce, “the current focus is on degenerative diseases, there is a big market for these”. In most cases, the drugs that are tested are the ones that will make money.
“What about depression?” asks one of the actors, “Ah depression”, sighs Boyce, “unfortunately, it’s one of many psychiatric diseases still not understood”. “After all, how can we test this?” he asks. “How can you give someone depression in order to cure it? This makes grounds for testing healthy patients very difficult”. “Healthy subjects are essential, as they are not on other medication, they tolerate the drugs better…and they have time”.
We are taken up several flights of steps to see the ward. We walk past a series of signs: ‘This door is security locked. Ask ward staff for assistance’; ‘Please keep quiet and peaceful - ECGS are in progress.’ One corridor is decorated with large paintings of nursery rhymes fixed to the corridor walls. “They are from the old children’s hospital” interjects the ward sister, as we walk past little Miss Muffet.
Inside, the ward is pristine. There are several beds, some with their green curtains drawn, some open. The ward is full of male volunteers, mostly plugged in to their laptops and iPods. A couple of them are asleep. It is all remarkably calm and controlled.
We are shown the sluice, the urine lab and the main laboratory. The laboratory is peppered with men and women in white coats. Anastasia Hille and I find ourselves peering at a large glass machine. It seems to be some kind of chemical cleaner. The lab notice boards are covered with diagrams and safety information. There’s an emergency shower in case of chemical spillage.
Leaving the building, I turn back for a final look. It still seems bleak and uninviting in the autumn light. I don’t think that this is a hotel, I’ll be booking into anytime soon, but I feel reassured. It seems a tightly and safely run ship and the work that is done here is vital to the health of us all. It’s not something I’m scared of anymore.