Addressing the pharmaceutical issue specifically, the reason drug companies are awarded patent protection for new drugs -- or at least, the rational justification -- is that they don't just cook up a new chemical compound in a lab and ship it out; it has to go through extensive testing and clinical trials, at astronomical expense, paid f…
Addressing the pharmaceutical issue specifically, the reason drug companies are awarded patent protection for new drugs -- or at least, the rational justification -- is that they don't just cook up a new chemical compound in a lab and ship it out; it has to go through extensive testing and clinical trials, at astronomical expense, paid for out of their own pockets. The patent allows them to recoup those expenses by solely profiting off their investment for a time.
It wasn't clear from your comment, but I take it from "nationalized industry" you mean the Federal government would take over the process, and costs, of drug trials? So the private R&D labs would come up with a new drug they *think* might work, then submit it to the FDA to manage the testing and approval process? I can only imagine that system resulting in slowing the process to a glacial pace (and it's not fast as it is), at massive taxpayer expense, with even greater vulnerability to regulatory capture and political influence over which drugs get the "royal treatment" and which get ignored.
We could have a discussion of ways to address the problems with the current system -- and I don't deny that drug companies can and do use their patents to gouge consumers while they can -- but government takeover of private industries is rarely the best solution. Natural monopolies (e.g. utilities like power and water) come to mind. That is about it.
"they don't just cook up a new chemical compound in a lab and ship it out; it has to go through extensive testing and clinical trials, at astronomical expense, paid for out of their own pockets."
I get that.
I think that the reward for inventing and developing medicines of proven value should go directly to the researchers and developers, not to the owners of drug manufacturing factories and venture capitalists. I think that the mechanism for reward should take a form other than patent protections on chemical compounds and their formulations.
I don't think the FDA should be in the position of relying on studies commissioned by private pharmaceutical companies to determine the safety and efficacy of new drugs. I don't think that drug manufacturers should use commission salespeople to soft-soap physicians into prescribing their product lines. I don't think there's any justification for marketing prescription medications directly to a consumer customer base, in magazines and especially not on television. I question their practice of spending enormous amounts of money on marketing and advertising- for products that arguably shouldn't require marketing at all; we aren't selling toothpaste or TVs here, the product is generic chemicals (and formulations that are typically so basic that they might as well be generic, like time-release dosages.)
There's some controversy over the oft-repeated claim that the largest pharma companies spend more on advertising and marketing than they do on research and development. But even those who claim that's an overstatement admit that the companies don't spend very much less on advertising and marketing than they do on R&D. And my point is that the debate is a distraction anyway, because drug prescription should not be an affair of marketing. The agenda of medicine is to produce the best possible health outcome for all patients; the agenda of profit-making drug companies is to sell as many of their products as possible, for the maximum amount the market will bear. Those priorities are inimical.
I read a recent article by the widow of the patriarch of the Sackler family, claiming that he's being unfairly scapegoated for the opioid epidemic, when his actual innovation was the introduction of marketing techniques that applied to all of the products sold by his companies (a practice taken up in turn by the rest of the industry.) She's missing the point. The emphasis on pitching patented medications to doctors IS the problem. Oxycontin is only the most egregious example.
"So the private R&D labs would come up with a new drug they *think* might work, then submit it to the FDA to manage the testing and approval process?"
I don't see why that would have to be entirely the case; the role of the FDA could be confined to doing end-stage confirmation of tests already done by the research companies. As for the approval process, the FDA is supposed to be managing that already.
As for your concerns about "massive taxpayer expense", we're dealing with exorbitant expenses already, both on an individual basis (that's often widely disparate) and as a pooled expense administered through insurance company premiums and co-pays, with much of the cost related to the unique regulatory capture of prescription drugs by the pharmaceutical industry in this country.
I mean, sure, it's going to cost something if the public sector takes more of a role in the pharmaceutical industry. But I don't have a superstitious aversion to "Taxes", per se- like, compared to what? The bite from drug companies, for drugs that can often be manufactured for pennies a dose? A pharmaceutical industry that conditions doctors- and the medical schools where they learn their profession- with the message that the implicit baseline of modern medicine is to put their patients on as many medications as possible, and keep them on them in perpetuity?
This is issue is destined to loom even larger if it's the case that there are research breakthroughs related to youth extension, biological repair and rejuvenation, the reversal of degenerative disease, etc. If those advances are simply to be exploited as a cash cow with availability restricted to the wealthy- not for lack of supply or due to manufacturing expense, but on account of legal provisions that sequester their availability through regulations like patents- the consequences are liable to be grave, and terribly disruptive.
Ironically, I'm more of a fee-for-service, independent physician guy on a lot of health care issues. I've seen how much more insurance companies get billed by doctors, compared to the patients who simply pay for their own office visits. The same goes for lab tests, and the like. I'm of the mind that public insurance should be primarily concerned with catastrophic health expenses, paying for hospitalizations, and matters related to long-term care and home health care. But the control of drugs by unaccountable private interests primarily concerned with owner/investor/stockholder profit rather than patient interests or due reward for the actual inventors of their products has no place in modern medicine.
Money is a great incentive for invention. Perhaps that's why China can't invent anything. That and the inability to accept failure as It's difficult to develop something on the first try.
I'm fine with researchers being amply rewarded for their creations and innovations. I just don't think that reward should consist of patent-protected medicines. Especially when that proprietary profit goes to people who aren't the inventors, but merely the funders.
That said, I don't necessarily object to having some portion of the profit from successful research and development efforts to develop new medicines going to private funders, either. But, as I said, not through patents, or control over manufacture and distribution. I'd perfer to see a system of outcome-based rewards, because with some medicines it's difficult to determine their actual worth until an expanse of time has passed. Like years.
Chinese people have invented plenty of things over the expanse of human history, of course. And while I agree that the Communist system of education and the control of thought encouraged by a collectivist societal paradigm ends up stifling a lot of individual creative potential, I don't think that it discourages it entirely. The Chinese regime undeniably rely on stealing a lot of foreign patents in order to advance technologically, but I'd bet that there are some scientific and tech realms where their R&D efforts may be out in front of other nations, like advanced nuclear reactor technology and genetic engineering.
O.K. This is my third attempt to reply. If this doesn't work, I give up.
All utilities such as water and electric power should be public. Always. Never private. [Look at Bechtel in Bolivia, for example. At least it LOST the water wars there, in a court of law. They even tried to charge people for rainwater the citizens caught and saved in barrels!] Schools, roads & bridges, libraries, infrastructure, hospitals should all be public and never belong to profit-making entities. Should people like Betsy DeVos be in charge of our children's education? Should schools be military-nationalistic-patriot-building endeavors to produce fodder for endless wars? Should there be profit in healthcare? No. Rob Roy
Addressing the pharmaceutical issue specifically, the reason drug companies are awarded patent protection for new drugs -- or at least, the rational justification -- is that they don't just cook up a new chemical compound in a lab and ship it out; it has to go through extensive testing and clinical trials, at astronomical expense, paid for out of their own pockets. The patent allows them to recoup those expenses by solely profiting off their investment for a time.
It wasn't clear from your comment, but I take it from "nationalized industry" you mean the Federal government would take over the process, and costs, of drug trials? So the private R&D labs would come up with a new drug they *think* might work, then submit it to the FDA to manage the testing and approval process? I can only imagine that system resulting in slowing the process to a glacial pace (and it's not fast as it is), at massive taxpayer expense, with even greater vulnerability to regulatory capture and political influence over which drugs get the "royal treatment" and which get ignored.
We could have a discussion of ways to address the problems with the current system -- and I don't deny that drug companies can and do use their patents to gouge consumers while they can -- but government takeover of private industries is rarely the best solution. Natural monopolies (e.g. utilities like power and water) come to mind. That is about it.
"they don't just cook up a new chemical compound in a lab and ship it out; it has to go through extensive testing and clinical trials, at astronomical expense, paid for out of their own pockets."
I get that.
I think that the reward for inventing and developing medicines of proven value should go directly to the researchers and developers, not to the owners of drug manufacturing factories and venture capitalists. I think that the mechanism for reward should take a form other than patent protections on chemical compounds and their formulations.
I don't think the FDA should be in the position of relying on studies commissioned by private pharmaceutical companies to determine the safety and efficacy of new drugs. I don't think that drug manufacturers should use commission salespeople to soft-soap physicians into prescribing their product lines. I don't think there's any justification for marketing prescription medications directly to a consumer customer base, in magazines and especially not on television. I question their practice of spending enormous amounts of money on marketing and advertising- for products that arguably shouldn't require marketing at all; we aren't selling toothpaste or TVs here, the product is generic chemicals (and formulations that are typically so basic that they might as well be generic, like time-release dosages.)
https://www.pharmacychecker.com/askpc/pharma-marketing-research-development/#!
https://www.raps.org/news-and-articles/news-articles/2019/7/do-biopharma-companies-really-spend-more-on-market
There's some controversy over the oft-repeated claim that the largest pharma companies spend more on advertising and marketing than they do on research and development. But even those who claim that's an overstatement admit that the companies don't spend very much less on advertising and marketing than they do on R&D. And my point is that the debate is a distraction anyway, because drug prescription should not be an affair of marketing. The agenda of medicine is to produce the best possible health outcome for all patients; the agenda of profit-making drug companies is to sell as many of their products as possible, for the maximum amount the market will bear. Those priorities are inimical.
I read a recent article by the widow of the patriarch of the Sackler family, claiming that he's being unfairly scapegoated for the opioid epidemic, when his actual innovation was the introduction of marketing techniques that applied to all of the products sold by his companies (a practice taken up in turn by the rest of the industry.) She's missing the point. The emphasis on pitching patented medications to doctors IS the problem. Oxycontin is only the most egregious example.
"So the private R&D labs would come up with a new drug they *think* might work, then submit it to the FDA to manage the testing and approval process?"
I don't see why that would have to be entirely the case; the role of the FDA could be confined to doing end-stage confirmation of tests already done by the research companies. As for the approval process, the FDA is supposed to be managing that already.
As for your concerns about "massive taxpayer expense", we're dealing with exorbitant expenses already, both on an individual basis (that's often widely disparate) and as a pooled expense administered through insurance company premiums and co-pays, with much of the cost related to the unique regulatory capture of prescription drugs by the pharmaceutical industry in this country.
I mean, sure, it's going to cost something if the public sector takes more of a role in the pharmaceutical industry. But I don't have a superstitious aversion to "Taxes", per se- like, compared to what? The bite from drug companies, for drugs that can often be manufactured for pennies a dose? A pharmaceutical industry that conditions doctors- and the medical schools where they learn their profession- with the message that the implicit baseline of modern medicine is to put their patients on as many medications as possible, and keep them on them in perpetuity?
This is issue is destined to loom even larger if it's the case that there are research breakthroughs related to youth extension, biological repair and rejuvenation, the reversal of degenerative disease, etc. If those advances are simply to be exploited as a cash cow with availability restricted to the wealthy- not for lack of supply or due to manufacturing expense, but on account of legal provisions that sequester their availability through regulations like patents- the consequences are liable to be grave, and terribly disruptive.
Ironically, I'm more of a fee-for-service, independent physician guy on a lot of health care issues. I've seen how much more insurance companies get billed by doctors, compared to the patients who simply pay for their own office visits. The same goes for lab tests, and the like. I'm of the mind that public insurance should be primarily concerned with catastrophic health expenses, paying for hospitalizations, and matters related to long-term care and home health care. But the control of drugs by unaccountable private interests primarily concerned with owner/investor/stockholder profit rather than patient interests or due reward for the actual inventors of their products has no place in modern medicine.
Money is a great incentive for invention. Perhaps that's why China can't invent anything. That and the inability to accept failure as It's difficult to develop something on the first try.
I'm fine with researchers being amply rewarded for their creations and innovations. I just don't think that reward should consist of patent-protected medicines. Especially when that proprietary profit goes to people who aren't the inventors, but merely the funders.
That said, I don't necessarily object to having some portion of the profit from successful research and development efforts to develop new medicines going to private funders, either. But, as I said, not through patents, or control over manufacture and distribution. I'd perfer to see a system of outcome-based rewards, because with some medicines it's difficult to determine their actual worth until an expanse of time has passed. Like years.
Chinese people have invented plenty of things over the expanse of human history, of course. And while I agree that the Communist system of education and the control of thought encouraged by a collectivist societal paradigm ends up stifling a lot of individual creative potential, I don't think that it discourages it entirely. The Chinese regime undeniably rely on stealing a lot of foreign patents in order to advance technologically, but I'd bet that there are some scientific and tech realms where their R&D efforts may be out in front of other nations, like advanced nuclear reactor technology and genetic engineering.
I found you.
O.K. This is my third attempt to reply. If this doesn't work, I give up.
All utilities such as water and electric power should be public. Always. Never private. [Look at Bechtel in Bolivia, for example. At least it LOST the water wars there, in a court of law. They even tried to charge people for rainwater the citizens caught and saved in barrels!] Schools, roads & bridges, libraries, infrastructure, hospitals should all be public and never belong to profit-making entities. Should people like Betsy DeVos be in charge of our children's education? Should schools be military-nationalistic-patriot-building endeavors to produce fodder for endless wars? Should there be profit in healthcare? No. Rob Roy
A portion of R&D is already paid for by the Taxpayers through IRS tax deduction weather we ever use the drug or not!