A video game that only a pharmacist could love flushes out drug fraud

Robert Lodder, a professor in the School of Pharmacy at the University of Kentucky and a biopharmaceutical entrepreneur, has long enjoyed a good video game. Now he’s turning his passion for gambling into a powerful tool for identifying faulty and dangerous drugs.

Working with Heather Campbell, a pharmaceutical engineer with a penchant for software coding, Lodder created a video game to help hospitals and pharmacies find shoddy drugs.

The duo have already deployed their game to bring them to a disturbing observation: some pharmaceutical companies can skimp on active ingredients to save money to the detriment of the quality of drugs.

For someone with a headache, it could mean a little extra discomfort. For a patient recovering from heart surgery, a weakened drug could cause serious damage.

Lodder and Campbell are in the early stages of building their game. The idea is to recognize patterns that can report foul play within the pharmaceutical industry. Think of it as a flight simulator more than Super Mario.

“The government has been doing this for a long time,” Lodder said. “It goes back to Rand Corp. and the war games, but nobody did it for the pharmaceutical industry.”

The video game draws on inputs from real-world experiences, including a gleaned from another project Lodder helped develop. In this other project, pharmacy students are performing quality testing of drugs that pass through hospitals and university clinics under the aegis of the University of Kentucky Health System.

Examples of quality measures include whether a medicine contains all of the ingredients claimed by a company and whether it contains impurities that could signal contamination.

The game is still in the early stages of beta, but it will help Lodder pharmacy students prioritize which drugs to test in real life, as it is not possible to analyze everything that goes through the healthcare system. of the University.

Lodder and Campbell hosted a few tournaments played by a dozen University of Kentucky students sitting in rows on high-backed chairs in the school’s rec room. Nuance and reasonableness are layered to create scenarios for players to choose from.

The first screen shows a bird’s eye view of a floor of a drug factory with graphics from the early 2000s. Players choose chemical ingredients from a drop-down screen, then set up production lines.

From there they can “connect” to the factory. From that point on, they step into a part of the game that Campbell designed with cutting edge first-person player mode graphics – meaning players get a realistic view of their actions – as they navigate through. different tasks designed to test their scruples.

Players make several decisions as they advance through new levels of the game. Will they clean an industrial vat to brew the new medicine? Or will they skip this step to save time and money? Should they risk the wrath of the FDA and sell an unapproved version of a drug? Should they throw away a batch of medicine that tests positive for impurities or just mix it into a good product?

The reaction of the players will affect the company’s revenue as well as the quality of the drug. The game is also designed to test player ethics: will they do the right thing for the patients or will they focus more on the outcome? Whoever makes the most money wins.

The university testing program that influenced Lodder and Campbell’s work on video games is one of the few in the country to independently analyze the quality of drugs.

The United States Food and Drug Administration does not regularly test treatments, but rather relies on the drug companies’ own routine tests. Yet the FDA’s spot inspections at drug production plants have revealed issues ranging from the accuracy of test data to sanitation issues, suggesting that relying on industry to control itself. its own quality can be problematic.

The promise of the Lodder and Campbell video game is that it can help hospitals and other big drug buyers recognize the signs of bad behavior long before the FDA has a chance to document it.

During Campbell’s work on the game, she played out a storyline that Lodder’s drug testing project had encountered in real life: a generic drug maker selling a drug at half the price of two of its competitors.

The tests gave a surprise. He determined that the more expensive drugs contained lower levels of a key active ingredient than the cheaper ones – levels low enough that the drugs no longer met FDA standards.

Intuitively, it would seem that the opposite should be true – that the vials that cost more should be of better quality. Campbell therefore played the game, using the same prices and levels of active ingredients as the real-world scenario and found that the bottom lines of companies selling the most expensive, lower-quality drug remained healthy even if they lost shares. market to the benefit of low-cost competition. due to the savings made by reducing the ingredients.

Lodder and Campbell recreated the situation at an April tournament and observed that players regularly used strategy.

Michael Ganio, senior director of pharmacy practice and quality at the American Society of Health-System Pharmacists, called the video game concept fascinating. His association represents hospital pharmacists and welcomes the use of predictive models that can help them understand risk.

“On the front line, it helps us prepare for a vulnerability in a drug’s supply chain,” he said.

Lodder and Campbell still have a long way to go before they can deliver on their promise. Their next step is to get permission from a college review board to host video game tournaments, with cash prizes, as official research essays.

If they get the green light to do so, they can begin reporting their results, providing hospitals with a valuable tool in unearthing potential funny deals from drugmakers. – Bloomberg

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