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Comment by hueving | Hacker News Reader

So the question that comes up with this, if there is no free market like the US medical system, would it kill the incentive for biomedical startups and pharmaceutical research in general (which is largely based on the US now).

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Is the R&D largely based in the US?

Also, it's important to distinguish between true R&D aimed at developing actual cures and iterative R&D aimed at developing medicine that will get you hooked on long-term courses that maximise profits.

And R&D aimed at developing replacements for perfectly-fine drugs that are soon to go out of patent, or R&D that is put on a back burner until some other drug is about to go out of patent etc.

>Is the R&D largely based in the US?

As far as I understand it, yes. http://www.xconomy.com/seattle/2014/09/02/which-countries-ex...

As far as your claim about most drugs being a scam, I can't speak to that as I'm not familiar enough with the industry.

I think its clear that the US medical system is specifically not a free market. It has become (and is continuing to become) increasingly subjected to regulatory capture.

Corporate capture, not regulatory. Plain old corruption. Regulation just increases the barrier to enter for competition, which is beneficial to the status quo who can afford it.

>Regulation just increases the barrier to enter for competition, which is beneficial to the status quo who can afford it.

Uh, that's precisely the point of regulatory capture. Ensure nobody else can compete but you.

Just to clarify, the medical system in the US is far from a free market... the pharmaceutical industry itself is the opposite of a free market, inundated with incumbents and very strong patent protections without anything to force open generic production and licensing at a reasonable cost.

Beyond the pharmaceuticals, is that the most expensive healthcare services are provided by hospitals that are mostly locked in by proximity.

GlaxoSmithKline spent 15 percent of revenue last year on R and D, 40 percent on marketing and sales. This is a myth.

http://www.bizjournals.com/triangle/news/2016/07/19/where-gs...

My question is similar...is the US fitting most of the bill for R&D currently, since apparently we get ripped off for prescription drugs? (or are we getting ripped off? maybe it costs that much to develop the drugs dunno)

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