This thesis addresses how and when British pharmaceutical firms first manufactured synthetic drugs, and how they persuaded doctors to test novel therapies in clinical trials. Edwardian Britain was reliant on Germany for synthetic drugs, so how did British firms meet this challenge in the First World War, and how was this new form of the British pharmaceutical industry nurtured in the interwar period?
Previous studies have covered the industry’s origins in pharmacy roots and dyestuffs, and the growth of the American industry, but without an overall synthesis. There are several good company histories for Britain, and Robson and Quirke compared pharmaceuticals in France and Britain, whilst Tansey examined physiological research at Burroughs Wellcome; but little has appeared on chemical research and synthetic manufacture. I will emphasise the work of Francis Carr who developed synthetic drugs at Burroughs Wellcome, Boots and British Drug Houses. As for testing, the literature covers early statistics and the clinical trials of major biological drugs such as insulin; but these did not originate with industry. With synthetic and other novel drugs, as I show, firms found it difficult to arrange clinical trials and they turned to the MRC for assistance. I examine these negotiations and trials in some detail.
Chapter 1 reviews the historiography of the pharmaceutical industry and the clinical testing of drugs. Chapter 2 examines the varied origins of the industry, contrasting ethical and patent medicines, and comparing Britain with Germany and America. Chapter 3 shows how Burroughs Wellcome combined novel drugs in sophisticated dosage forms, adopting new sales strategies and establishing laboratories to standardise drugs. Their experience in small scale synthesis from 1896 enabled them to prepare German drugs when patents were abrogated in the First World War (chapter 4). The MRC and other firms poached Burroughs Wellcome researchers, and the MRC took standardisation as a central theme, so establishing an international reputation. Chapter 5 addresses the postwar campaigns for tariff protection, and the extension of MRC drug evaluations as British firms strove to remain competitive. Novel vitamin and hormonal drugs allowed them to expand their manufacturing capacity while gaining further experience of drug synthesis. Chapter 6 describes how British firms campaigned for clinical testing of drugs from 1922 – 1930 and explains why a Therapeutic Trials Committee (TTC) was established in 1931. Chapter 7 examines the strategy of Burroughs Wellcome postwar, by analysing the strategic debates within their Scientific and Technical Committee. Chapter 8 examines the TTC, how they favoured British drugs, and how studies complemented their own research interests; it provides insight into the research strategies of British (and foreign) firms, plus an assessment of the TTC as seen by the MRC and by companies. Chapter 9 offers general conclusions and contrasts the position of British manufacturers at the outbreak of the Second World War with their position at the outbreak of the Great War in August 1914. Some opportunities for further work are then identified.