The drug industry wants us to think Martin Shkreli is a rogue CEO, but he isn't
washingtonpost.com
washingtonpost.com
I think the difference is they didn't raise the price in one fell swoop. Frogs in boiling water, etc, etc.
http://www.bloomberg.com/news/articles/2015-09-23/how-market...
From a quick web search, this site[1] shows:
> To go from inhalers that cost 5 dollars to 60 dollars especially for those who don’t have prescription drug coverage has been awful.
As a consumer, I can either forgo inhalers or use expired ones (instead of spending $$$ to keep them current).
[1] http://www.dailystrength.org/health_blogs/dr-orrange/article...
This carries the risk of fakes, though. I mean fakes are everywhere in the first place, but through mail order the risk significantly increases.
Has that not happened yet? Or did people / insurance companies adapt to the higher prices so that the new generics can charge more than the old ones?
The drugs in Diskus form are typically steroids. Steroids are to prevent attacks, albuterol is to stop attacks that have already started.
Edit: link to picture: http://bloggfiler.no/tcmn.blogg.no/images/441858-8-126583454...
For a long time, asthma medication was not under patent protection. The FDA, however, outlawed all generic asthma medication because it contained CFCs [0] in the late 00's, and the replacement delivery system was newly eligible for patent protection simply due to using a different propellant. [1] This wasn't some amazing new advancement in the drug formula, they just changed how it got into your lungs - ostensibly due to environmental concerns.
This case is a damning indictment of patent law and in how we handle externalities generally. The environmental cost of CFCs was an externality that no drug manufacturer ever had to pay. What's the solution to that problem? Of course it's not to tax or fine manufacturers who continuing to pollute, no: it's to reward some pharma companies with a fresh monopoly for altering the medication such that it doesn't deplete the ozone layer.
Congratulations on the amazing new drug you developed! You're now doing the bare minimum that should be required to be a citizen of the planet by not actively destroying it with pollutants! Here's your reward, a monopoly, with which you can extract money from the (mostly poor) asthma sufferers who no longer have affordable medication.
I don't understand why this wasn't a bigger story.
[0] http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/u...
[1] http://www.nytimes.com/2013/10/13/us/the-soaring-cost-of-a-s...
Of course, what happened next is exactly what you'd expect. Pfizer made a bid for a hostile takeover and the shareholders approved it. What was the first order of business on day 0? Exactly what you'd expect: lay off 90% of the King employees and more than double the price of epipens. Why? Because they could.
I have deep appreciation for pharmaceutical research, but it's folly to imagine any of it's ultimately driven by anything but profits. The exception may be the fewer-every-year small pharmas.
Btw, after Pfizer laid her off, my wife went to work for Salix, another small-but-successful pharma based in Raleigh that specializes in GI drugs. Guess what happened after barely over a year? Valeant bought Salix and laid off 90% of the workforce. Valeant is far worse than Pfizer, too. Their entire business proposition is finding "under-performing" drugs, buying the companies, then cutting costs and doing a better job marketing them. It's working so far, but has cost a lot of good folks their jobs/careers.
I disagree with you. I remain convinced that research is driven by the curious geeks with a passion for solving the problem at hand.
Research is, unfortunately, funded by profiteering assholes.
Would something like demanding (say) at least 20% of the profits should go into research be viable?
In addition, it's simply false that businesses are more efficient than the government. For example, compare overhead in public health care systems (e.g. Medicare) to private insurance systems and you'll find that the overhead is vastly lower in the public systems - something like 3% vs. 15%. Giant businesses are as burdened by bureaucracy as any other large institution, and they're only as efficient as they need to be, which in an industry with monopoly rents is not very efficient (pharma spends as much on research as the government for much less in research outcomes). Government at least has Republicans keeping it trim.
In any case, reform is definitively needed; and complaining without demanding reform is pointless. Discovering new drugs is a scientific endeavor and so it really should be as open as possible. I am a little skeptical of plain massive government research agencies, but maybe it's a good way to go. Maybe patent reform or something else is instead better. If you look at machine learning research the industry is not bad at sharing results because of two factors, apparently: 1) Companies know that progress will be much faster if everyone decides to share 2) To attract to researchers, they need to show they do high caliber research and share.
The reality is that "invest and create more jobs" actually means "fire as many people as you can, cut wages as far as they go, make all hires as at-will as possible, and offshore to save money if you possibly can, even if it hurts the company in the long term."
The rest of the reality is that our political system is an assholeocracy. The people responsible for this kind of idiocy should be nowhere near policy - not just because of some abstract sense of moral wrong, but because it's incredibly toxic to real economic and social development.
70% of wealthy families lose their wealth by the second generation, and a stunning 90% by the third, according to the Williams Group wealth consultancy [1]. So the power seems to naturally defuse without having to "kill them all".
[1] http://time.com/money/3925308/rich-families-lose-wealth/
In addition, why should we empower rich people at all? Why is giving a single person a billion dollars, skillful or not, better than allowing a million people to democratically direct that wealth? Even if those million people simply redistribute that money into their pockets, the outcomes will likely be better for everyone, and it's mathematically far more likely that those people will direct it towards the common good than a single person would.
That's silly, of course some do. There are any number of inventors, entertainers, etc, who've gotten rich largely from their own efforts (and luck).
> The only way to do it is by appropriating the output of others, or having it handed to you.
There would be no output to appropriate without the skill and direction of the rich person who had the idea and took the risk. As for the inheritance angle, who better deserves the money than the children of the original rich guy? They're the ones most likely genetically to share the same traits that enabled the original guy to get rich.
> In addition, why should we empower rich people at all? Why is giving a single person a billion dollars, skillful or not, better than allowing a million people to democratically direct that wealth? Even if those million people simply redistribute that money into their pockets.
Because they've proven to be able to direct capital in a beneficial way. Regular people haven't. Regular people would just buy the same old trinkets and necessities and innovation would halt. It would be a very boring existence with no hope of a better life to strive for.
I think that it is a bit much to suppose that every rich person is benefiting exclusively, or even mainly, from his or her own skills and ideas.
> As for the inheritance angle, who better deserves the money than the children of the original rich guy? They're the ones most likely genetically to share the same traits that enabled the original guy to get rich.
Down this road lies kings!
You'd think so, but as I wrote in another comment, 70% of wealthy families lose their wealth by the second generation, and 90% by the third. Rich kids do a crappy job of holding on to wealth (although I'm sure they're still better than poor kids would be).
Why, exactly?
this is the industry which tries to offshore as many aspects of the process as possible
http://fortune.com/2013/05/15/dirty-medicine/
Is a very interesting and quite frightening take on the potential consequences of such offshoring.
One is a registered nurse. She has seen her overall compensation shrink over the last 5 years as hospitals merge into regional cartels and medical practices consolidate. These cartel entities play rough, breaking unions and shipping in visiting nurses to keep wages low. Fortunately, her husband got a job with better insurance -- her family plan on his insurance costs less than her individual coverage.
The other person is a pharma sales rep. She makes about 2-3x the nurse, gets a car, and usually wins 1-2 vacations to beach resorts or Vegas every year. For awhile it was peddling a viagra competitor, now she has a stable of different drugs to push.
So when I hear about of the money needed for "research", from companies with huge sales forces pulling down $100-150k plus cars, etc... My first thought is "bullshit"
/s
That said, the real world is not that simple.
And how would your budget drop if the salesperson is bringing in more than they cost? Not having salespeople doesn't mean the same money will still be coming in, rather it would be potential market left uncaptured.
The drugs you get prescribed should be based on medical necessity, not which sales chick winks at the doctor, gets the doctor a vacation, or gets the coolest promo into the office.
Ask yourself... Crestor is a multi-billion dollar business. That little yellow pill sells for $5-6/unit. Why are any sold today when generic Lipitor (an identical drug for most uses) is available for 80% less?
Almost. Engineers also bring in so much more than they cost.
The real question is if the money they bring in scales with the amount you're paying them. The reason salesmen can make so much money is because you can just pay them mostly on commission and take on practically zero risk of overpaying them. You can't do that with engineers.
Why not? Salespeople must have rules for assigning proportional commissions from joint sales. Why not assign proportional commissions to the engineers responsible for the product sold?
Engineers who want a bigger piece of the eventual profits start companies.
It's just unwieldy compared to the salespeople case.
Each geographical area had one salesperson and all sales in that area were attributed to that salesperson. It was very easy to calculate commissions.
And sales is usually more important unless it's a highly technical situation. There are plenty of terribly engineered but extremely popular products. The important part of staying in business is getting people to buy it.
Source: I spend over $1k / mo on medical bills, and I have "really good insurance". In the past my plan had been simply to ignore exorbitant medical costs and my credit got pretty disfigured that way. I've been rehabilitating it the last few years, but if I can get to a place where I don't need credit, you can bet that the first thing I'll do is ignore any frivolous medical billing. We have to stop propping up this disgusting system.
I'll never forget her telling me how she felt little more than a hooker, albeit with a much larger list of drugs to peddle, legally and with the backing and support of her company - which expected her to do what it took to get the doctors on their brand. It seems this is not uncommon, either - that pharma-co's hire the youngest, most attractive folks to rep their wares at the front lines of doctors offices.
I think that aspect of the industry has a lot, lot darker side than people are willing to admit. I knew her for a few years, until one day she committed suicide.
(1) Medicine has a very inelastic demand function. If you need substance X to stay alive, you'll pay anything to get it.
(2) Costs are hidden from consumers. If insurance / Medicare is paying for it, it literally makes no difference to the end user if it's $5, $50, or $50,000.
(3) Free-market forces are distorted by patent monopolies and lack of diversity in the supply chain. With a patent, you can crank up the price as high as you want. Ditto if you're the only supplier and it'll take some time for competitors to bring production online, or you can deny them access to samples for the equivalence testing your competitors need to prove to regulators that their drug is the same as your drug.
(4) Broken incentives for developing new drugs. A patient's going to be taking a drug to treat their diabetes / ED / high blood pressure for the rest of their life, whereas something like an antibiotic is only taken for a couple weeks. Guess which one is more profitable, hence attracts more R&D money?
What's the solution? I don't know. Maybe market reforms to align the incentives; perhaps even bounding pharmaceutical companies' profit margin to some multiple of their costs (but of course you'd have to be careful about the wording of the regulation and auditing for compliance, to make sure it can't be gamed by e.g. deliberately inflating the costs). Or perhaps even some kind of socialism where the government tells people what to produce or how much to sell it for (agricultural subsidies might be regarded similarly -- the government is deliberately manipulating the market to push down the price and push up the supply of goods necessary to sustain life, so shocks don't result in lethal shortages).
Bernie Sanders at one point talked about replacing patents for new drugs with prizes, but I think he may have given up on that.
Possible answers. Tighter fiscal policy, patent reform, smarter testing, looser regulations on known compounds, google x prize like gov't or private funding for cures, distributed computing using algorithms to evolve a cure (will be interesting to see what happens with that patent)
[0]http://www.scientificamerican.com/article/cost-to-develop-ne...
I would add to that list "heavy government regulation on medicine prices", they are not a common commodity and should not be left to the markets free whims.
It could be that without the US system, these drugs would not be available in European countries as well.
Mandating lower prices for drugs is unlikely to work as it hasn't worked in the past (Venezuela everything, US gasoline, etc).
See my other comment about the alleged leading of the US in drug development. Or this other article, that explains it better: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1261198/
Not sure if you are saying this generally, or you mean it as a response. I did not mean to indicate this, I believe lowering regulations and dev. costs would be beneficial but not mandating lower prices.
As an aside, I agree with you but would be interested to see if America can continue to compete in the drug market long term. Obviously, it is a big market, but with countries like China and India and their growing middle classes, if they have a more attractive development cycle with less regulation and tighter feedback I wonder if biotech would move overseas. America has really great biotech and science sectors because engineers move out of those countries here. If this stops, other markets become more attractive, and/or the patent system remains broken I would be pretty concerned.
http://www.nature.com/nrd/journal/v6/n4/full/nrd2293.html
The majority of drug research spending is in the US, and the majority of drug consumption is in the US, both per-capita and in aggregate. Once a drug has been researched and FDA-approved and can be sold in an un-price controlled market to recoup fixed costs, it's cost-effective to go ahead with approval hurdles for marginal profits in controlled markets like EU countries.
In effect, high US drug prices subsidize lower prices elsewhere.
[1]: http://content.healthaffairs.org/content/early/2009/08/25/hl...
PS: I have just found this other article that explains it way better: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1261198/
http://emoglen.law.columbia.edu/twiki/pub/LawNetSoc/BahradSo... seems to expound on a criticism of the first paper, which asserts that it muddles the data by classifying drug origin by company headquarters, rather than the market in which the research is done and the drug is first patented in. With that reclassification, their data seems to show that US-based research (though not necessarily US-headquartered companies) substantially outperforms EU-based research both in quantity of NMEs and sales.
> At first glance, the organizations with their headquarters based in European countries are characterized by a higher probability of market launch for compounds entering clinical development. However, when the composition of research portfolios is taken into account, the apparent comparative advantage of European organizations vanishes.
Your second link seems to reinforce this:
> The European Federation of Pharmaceutical Industries and Associations reported that, between 1990 and 2003, its members increased their research and development investments in Europe by 2.6-fold and in the US by fourfold
It's obviously silly to claim that all research has fled Europe (it clearly has not), but it does seem evident that European-based pharma countries are electing to research and bring to market first in the US. I think the question then is "why?" - is it the US's higher effective ceiling on drug prices? Higher per-capita drug spending? Higher probability of success through the FDA versus the EMA? What are the causes, and what are the effects?
Economic wisdom tells us that long-term price controls reliably cause shortages, either by underpricing demand and/or by disincentivizing supply; I don't think it's unreasonable to presume that the same effect would be in play to some degree here. The pharma industry is obviously extremely distorted by regulatory intervention, both in barriers to entry for a new product and barriers to entry for competition on existing products, so conventional wisdom can't be applied across the board, but I can't imagine that the effects of price controls are negligible.
I find both points of view interesting and contributing to the discussion. This is a valid dialectic between two parties. I thought HN did not downvote arguments merely because we disagreed with them, which is one of the reasons it has appeal to me.
As a single datum, I was told I needed to be on statins, and when I balked, my heath care professional said I could try RYR for 3 months and if it didn't work I'd need a prescription for statins. My cholesterol dropped 97 points in 3 months. I said "so I don't need statins?" She said shes never seen that kind of drop with statins, so no.
So yeah, take stuff from nature, patent it, then get the natural version banned, profit!
You might argue what's the difference between a tablet of lovastatin and Red Yeast? Well, I don't know and the FDA doesn't either that's why you can't make medical claims about it.
I'm glad it worked for you! Also, lovastatin went generic a long time ago and it now costs a few hundred dollars (if that) a year to treat a patient.
This is about $10 per year (~3 cents per day) more expensive than cheap red yeast rice.
The tablet of lovastatin has a precise amount of active ingredient. Red yeast rice has some random amount that may or may not be clinically significant.
Wikipedia disagrees with you. It says, if a product has a measurable amount of monacolin K, i.e., lovastatin in it the FDA will stop it's sale even if there aren't any claims of cholesterol reduction.
https://en.wikipedia.org/wiki/Red_yeast_rice#Regulatory_rest...
That is a total mischaracterization of the situation. The patent on lovastatin was not on "stuff from nature"; it was on a way of reproducing "stuff from nature" in a controlled manner to guarantee purity and potency, and to put it in a form that can be made into pills.
The authorities said they had conducted tests on top-selling store brands of
herbal supplements at four national retailers — GNC, Target, Walgreens and
Walmart — and found that four out of five of the products did not contain
any of the herbs on their labels. The tests showed that pills labeled
medicinal herbs often contained little more than cheap fillers like powdered
rice, asparagus and houseplants, and in some cases substances that could be
dangerous to those with allergies.
Apparently some doctors consider statins to be overprescribed and Pfizer has worked hard to drive that - in 2012, Lipitor (Atorvastatin) became the best selling drug ever.
Telling me some random generic has gone up in price means nothing to me . For all I know, that might be an old fashioned drug hardly any doctors prescribe and the price increases is required in order to keep it available for the few people who require it... or it could just as easily mean the company has a monopoly and is price gouging consumers.
There needs to be a weighted index, or multiple indexes, of drugs weighted by how important they are. Not sure how to define importance in this context, but quantity sold would be a good start, maybe another index weighted by average expenditure per patient per year and another weighted by lives saved.
Edit: Downvoters, I did read the article. An unweighted group of any product is not very useful from an economics perspective. That is why the CPI is weighted.
They state that the average price of a group of over 220 drugs has been increasing faster than inflation for some time. That's hardly "some random generic". In fact they say generics tend to drop in price, it's the name brands that are rising.
Unfortunately I can't find it right now, but the Us gov't did a study into generic drug price increases. There is no one reason why they went up. For some drugs it was because a company decided to stop making it and there were shortages. For other companies, they had manufacturing problems and shortages resulted.
I agree with you that to make a distinction between legitimate and illegitimate price increases is needed. But then again, I'd say the fact that healthcare is a for-profit industry has already put the incentives in place necessary for anyone interested in dabbling on the dark side.
"@matthewherper great question, I guess we will find out. I take the pain for my investors"
-Martin Shkreli (@MartinShkreli) September 21, 2015
http://www.independent.co.uk/news/people/hedge-fund-trader-m...
An interesting set of documentaries in that regard may be The Mayfair Set: https://en.wikipedia.org/wiki/The_Mayfair_Set
It recounts, from a British point of view, the rise of a type of finance capitalist that revolved around strip mining established companies.
I think part 3 touched on how by the time the people that started it got cold feet about it all, it had become institutionalized thanks to pension funds and similar.
Anytime I see data that is a subset of the real data set, I have to wonder why they did that. Why not the average annual rate of price increases over all prescription drugs? Why only 227 of them?
Also, I disagree with this quote: "Only when a 46 percent discount was applied to a pricy Hepatitis C treatment, Harvoni, did it become a good health care value -- at about $40,000 per year."
That's patently untrue. Hell, CTAF (California technology assessment forum, which assessed drugs for MediCal) found that Harvoni, at it's full price of almost $90K was cost effective. The real problem is that it would cost too much to treat everyone.
http://member.aarp.org/content/dam/aarp/ppi/2014-11/rx-price...
Also note that the drugs were chosen before they started tracking prices.
I totally understand your skepticism, but rather than just wonder why they chose those, why not find out?
You are correct, I could have done some background reading before my "drive by" post.
Lesson learned!
To be fair, I really wish news organizations would do a better job of linking to their sources. In this case, you have to notice a link in the story, then dig up the link to the actual study from that. There really should be a direct link to the study from the chart's caption, made obvious for all to see.
Given the patents and difficult FDA approval processes, it might make sense to regulate drug prices similarly to public utilities.
I'm all for free markets. But when there's zero competition, you can't still treat things like a free market.
Poor people end up taking that increase in life expectancy and just wasting it on walking and sitting on the bus because it's so expensive to operate a vehicle here in Canada.
It's your mother's place to tell you to wear your seatbelt, not the government's.
Drugs are not comparable, because there's typically only a handful of drugs that are effective for a given condition, and often just one.
The inexpensive prices for drugs cited in the article happened before the US government got heavily involved with running the health care industry. Maybe that's a coincidence, but I doubt it.
The end of famine in America happened around 1800, as the free market and the industrial revolution fixed that problem. Famine persists in other areas that insist on collectivized farms or have other problems that prevent free market agriculture, such as warfare.
Even the Soviet Union had to import wheat from Kansas, and allowed farmers to farm their own plots and sell the results, because the collectivized farms could not produce enough.
In this case, not even due to a patent, but because you can't sell a generic without lengthy, costly FDA approval.
Essentially the government is telling sick people, "you can't take this generic daraprim from India because we haven't approved it, so pay Martin Shkreli $750 a pill or fuck off and die".
It's asinine and it's 100% the government's fault this is happening. If Martin Shkreli hadn't done it, someone else would have.
* the market in the United States is so small, that there is a single manufacturer
* Generic drug manufacturers try to come in the market, the brand-name holder has made it extremely hard for them to do equivalence testing by making the drug available only through a restricted channel that excludes them.
* Even if them manage to get the drug to the market, the brand-name manufacturer can lower prices temporarily, ensuring they exit.
* The same manufacturer can have doctors prescribe the expensive brand-name versions of the drug by buying them off.
Instead of leaving patients in the hands of such natural or almost natural monopolies, the government can fix this situation in a variety of ways - price ceilings, subsidies, even government production of drugs for rare diseases.
You can argue that, some regulation somewhere has given these companies a monopoly, but without any regulation, there would be no market to speak of - the off-NDA drug market isn't one I and assume most patients trust.
I'd think they should require cooperation with the equivalence studies, and possibly foot (part of?) the bill for those studies. Try to minimize the downsides of their (overall important and helpful, if perhaps taken a bit too far) regulations that cause the problem.
Price ceilings for anything with a government-granted monopoly would also probably be good, but that's... not exactly the issue here, since the drugs in question have gone off-patent.
See "Regulation of Pharmaceutical Innovation" by Sam Peltzman.
http://hcrenewal.blogspot.sg/2015/09/turn-that-door-around-p...
Wheeler can't claim credit for net neutrality after attempting to destroy net neutrality and losing.
Colchicine has been used for hundreds (?) of years. It never went through phase 3 trials and it was never officially approved by the FDA. Instead it was grandfathered in.
This made the FDA pretty uncomfortable [1] and I can't blame them. How do you properly regulate a drug where there is little to no data outlining it's efficacy and safety? So, the FDA decide to dangle a carrot in front of drug developers. If you formally take a grandfathered drug through the approval process, you will be awarded with something call "data exclusivity" (it's not a patent). For a period of 3 or 5 years (it depends on the filing), the FDA will not approve another form of the drug. In addition, they will tell/force all the other grandfathered manufacturers to stop selling their versions.
Statement from the FDA: Colcrys is the only FDA-approved single-ingredient oral colchicine product available on the U.S. market. Approved by the FDA in 2009, Colcrys’ prescribing information contains important safety data and recommendations on drug interactions and dosing not available with unapproved products.[2]
Of course this is a pretty attractive carrot for a drug company. Spend $X now and you've got a captive market where you can recoup your R&D spend and make a profit over 5 years. Plus the heavy hand of the FDA will help you get rid of competitors!.
Due to the the FDA regulatory process, it shouldn't be surprising that the cost of colchicine went up, it's pretty much had to in order to pay for the FDA approval. Did it have to go up 5000%? No, probably not. But it did have to go up if the FDA wanted an approved version since producing a grandfathered, unapproved drug is pretty cheap compared to an FDA approved one. What made the colchicine case particularly unfair was that the company didn't actually run any trials. They just collected all the trial data that already existed (mostly published papers) and submitted that data.
Another great example is Mr. Mucus, the cold medicine, it was the exact same play. In fact, a VC firm backed the entire process. The got the active ingredient approved by the FDA (again, it had been grandfathered in) and the FDA forced all other competitors off the market. This blog post has all the details [3]. Suffice to say, Aisling Capital made a 15x return off that investment. And that's why you see Mr. Mucus ads all over the place.
[1]http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulat...
[2]http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/uc... [3]http://biotechtranslated.com/2011/08/09/how-to-make-the-fda-...
I'm confused about this example since guifenesin has been approved by the FDA since the 1950s. But it was the time-release formulation of the molecule that was given data exclusivity to Reckitt in 2002 (after purchasing it from Adams). There was no "unknown efficacy" tag attached to this medicine.
I asked a similar question about Ambroxol a while back (Europeans know this as Mucosolvan). For some reason nobody will take up this one in the USA? I find ambxorol works way better than guifenesin on my kids.
The problem was, all the current time-release products were not FDA approved. You can't just create a time-released version and keep your fingers crossed, you need a clinical trial to actually show how it is time released. You wouldn't want a time-released version to release 24 hours of drug in 5 minutes!
I thought the point was to take old drugs with no clinical data and get them back into the mainstream - this exclusivity was the carrot on the stick. But this seems more like a twist on that idea.
Of course, your new formulation actually has to add some value (1 tablet per day instead of 1 table three times per day).
To your second point, the Mucinex example is "taking an old drug with no clinical data and getting them back into the mainstream". The difference is that instead of it just being the active ingredient, it's a time released version of the active ingredient. Prior to Mucinex being approved, there were unapproved versions of long-acting guifenesin out on the market.
You're right it's not exactly the same as "no one has tested this drug at all", but rather "no one has tested this formulation of this drug".
Money going exclusively towards research that is focused on earning more money might not be ideal, sure.
But in a nationalized drug industry, money will instead go exclusively towards "research" conducted by those who are best at filling out forms and schmoozing with politicians. I think that would arguably be worse.
As for "research" as you put it, I was under the impression that a number of countries already fund medical research. I'm not privy to how much "filling out forms" and "schmoozing with politicians" this involves, but I have a hard time imagining the methods and goals being worse than the "best practices" of the private sector.
My friends reported that their (highly educated and intelligent) supervisors in their university labs spent almost all their time doing funding applications instead of research.
I imagine it's not the same in the private sector, you go to work and spend your day working not running around begging for funding because the company is already rich and has already decided to fund the project.
If the company has a big cash stockpile (e.g., because it is either a well-funded startup or a well-established big player) the likelihood of needing to secure outside funding may be less, but the scientist will still likely have to sell the idea to the business team.
The government has other priorities (diversity, "fairness in procurement", getting some of the money back in political donations, etc.). That's why incompetents like CGI Federal get massive contracts like healthcare.gov. They're clearly bad at writing software and excellent at navigating procurement.
I don't want the pharmaceutical research industry, bad as it is, looking like that.
A free market is generally considered superior because the element of competition keeps the vendor(s) honest. If it were illegal for others to make drugs, I would expect the result to be much like it is now for companies that hold patents on drugs; charge as much as possible for as long as possible, until you're forced to bring the price down by competitors.
Anywhere you find exorbitant prices you'll find high barriers to entry. These are specifically designed to keep competition minimal and make it so once competition does clear the hurdle and enter the market, they won't have much interest in shaking up the existing structure too much. The government saying "only we can make drugs now" is a pretty high barrier to entry.
Why would you expect that? If you take, eg, the French railways, they have for a long time charged reasonable prices for a good service with very good territorial coverage. Similarly, state-owned energy monopolies generally don't gouge out their customers. As for the "honesty" of big pharma, are we talking about the same entities repeatedly caught hiding unfavorable studies or plainly bribing doctors?
[1]http://www.scientificamerican.com/article/cost-to-develop-ne...
So?
> We need to find a way to allow tighter feedback loops, better data flow and less regulation without purpose.
Everybody is all for that. Obviously, the question of what is "without purpose" may depend on whom you ask.
> That would, of course, require elected officials to be qualified in various disciplines, act in the public's best interest and not accept money from lobbyists.
You can't expect politicians to be qualified as everything, but you should expect their cabinets to have a number of specialists.
Everyone agrees with that; all regulation that actually exists or has been proposed has/had a purpose behind it.
Individuals may disagree with whether the purpose is desirable, whether the regulation effectively serves the purpose, and whether (assuming they agree that the purpose is beneficial and it is actually served in effect by the regulation) the beneficial effect of serving the purpose is worth any costs that the regulation creates, but those are different issues than "regulation without purpose".
1)That is logical, and makes sane tradeoffs.
2)Is in the publics interest instead of lobbyists.
3)Is divined using evidence.
We need unbiased medical experts to propose a system that works which has the following charachteristics:
1) Promotes the creation and development of drugs and the advancement of medical science.
2) Allows for a tight feedback loop and quick sceintific evaluation of new drugs, possibly allowing less dangerous drugs quicker feedback cycles.
3) Lowers the cost to get to market.
This is a VERY hard problem to solve as an exercise, but particularly difficult within the current political framework.
Unbiased medical experts are not particularly likely to be experts on three points you suggest are critical, since none of those are actually even remotely medical questions.
Reason is we need a consumer reform, and not a government reform which is a temporary solution.
The entirety of pharmaceutical R&D is $161 B globaly. If half of Americans were contributing $100 monthly to a pool, we could fund it entirely and make every drug available for free.I would love to see this done outside of the government.
We MUST stop depending on government for Health, and Education. While they intend well (I truly believe they do individually as people), as an aggregate they are not able to solve these issues at scale.
Shall I continue?
This idea does not stop at Pharma. Wherever Gov fails, we can try this.
What we need is a direct competitor to government. I am all for government regulating what is safe/unsafe to consume/use/inject in your body. However I would like for us to fund development and have/give free access to the discoveries.
but i grow all my medicine out of the ground.