> if you can't make money off lifesaving drugs, you also won't bother to invent any new ones.
Someone call NIH -- I think they believe that part of the annual $30 billion they hand out in extramural research grants is being used just for that.
Someone call NIH -- I think they believe that part of the annual $30 billion they hand out in extramural research grants is being used just for that.
Moreover, if you're advocating pushing private investment even farther out, there are undesirable side effects. It means that the decision about what to pursue stops being driven by what there's actual demand for, and becomes a matter of political policy.
We can already see the effects of this. Government investment in medical research is not proportional to the number of sufferers, or the expected gain in QALYs (Quality-Adjusted Life Years). It's clear that the investment is strongly slanted toward research on maladies that have distinct demographics - i.e., that are represented by organized voting blocs. Thus, you'll find far more money spent, proportionately, on research for HIV than for something that's pretty widely distributed like colon cancer. I believe it's wrong for politics to drive this so strongly.
My impression is that the cost of the final clinical trials account for a large part of the expense of bringing any single drug to market (but on the other hand a lot of other drugs fail before clinical trials) (some people think clinical trials are even 90%: https://www.manhattan-institute.org/html/stifling-new-cures-... ; see https://news.ycombinator.com/item?id=10752639 for some disagreement with this figure). My impression is that the general tendency is for the government to focus more on funding the less expensive but more risky earlier stages of research, and for companies to focus more on funding the more expensive but less risky (but still rather risky) clinical trials.
So the conclusion is that in order to do without private funding for drug discovery, the government would have to either (a) massively increase government funding for this, or (b) greatly lower the standards for how much evidence is required before permitting a new drug to be sold to patients (that is, to be content with companies selling a drug to patients, and billing patients/insurance companies/the government, without solid evidence that the drug actually works). Imo either or both of those may be a good idea; but those would both be huge systemic reforms and hence are unlikely to occur, and in the meantime we do in fact rely a lot on industrial funding to bring new drugs to market.