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Comment by rayiner | Hacker News Reader

The system is always subject to market forces. The government can budge the market around, but it's like pushing on one part of a balloon--it'll just have an effect somewhere else. When you set prices, you drive investment and talent out of the industry. Why spend years getting a PhD in biochemistry when you can go make $400k/year with just a BS at Google? It's precisely because people need drugs to survive that it's counterproductive to take measures that make pharmaceuticals a less attractive market to invest in, which fixing prices would do.

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Almost all other developed economies use this approach and it works for them. Many Of these very companies are based on those very countries. We need a reasonable price for these medications. The market isn't delivering them. The scandal here isn't the pay these companies researchers receive. I'm happy to have them paid more for their work. To me the scandal is how much profit is being taken while many people go without due to the price. What do you say to those people who might die for lack of funds?

How much are you willing to pay the nine teams of scientists whose experimentation fails to yield any useful medications for every one that works?

The problem is that most people only want to pay for the ones that work.

Thankfully there are companies that manage that market risk taking on our behalf and take a fee for the service.

"How much are you willing to pay the nine teams of scientists whose experimentation fails to yield any useful medications for every one that works?"

The same yearly salary that the folks on the "success" team make. I don't see why success is the issue here. I'd just make sure the failure is public information so that others can learn from it. After all, the things that don't work aren't valueless and the drug may be effective for something else.

Should we have two teams or twenty researching drugs? How should we prioritize them? Focus on a couple diseases that are extraordinarily hard technically, but impact a small number of highly sympathetic, photogenic victims as with rare childhood diseases? Or problems that treat low intensity pains that could also be treated with behavior change like heartburn drugs and Type II diabetes meds?

What should we do if we find out that a heart disease is ineffective at reducing heart attacks, but seems to help treat erectile dysfunction as was the case with Viagra? Do we divert funds to commercialize that "breakthrough" or redeploy those research dollars back to primary research on heart health?

"Big Pharma" might not be optimal, and I have eaten in their mahogany-paneled executive dining rooms so I know there are healthy profits. But at the end of the day, they have turned death sentences like Leukemia into highly curable conditions. Are there examples of similarly impactful breakthroughs coming out of centrally-planned economies? Until then, I'm happy to pay high insurance premiums and deductibles for methotrexate, vincristine, dexamethasone, and the dozen other drugs I give my daughter to keep her alive.

As many as possible, with international cooperation so that there is diversity. I'm not the best to know how to prioritize them because all have their benefits. I'm guessing there are different folks working on different aspects, and I hope this stuff continues.

I think the proper thing to do with things such as viagra would be to move them over to the proper research team once they become specialized: Viagra would be moved either to a men's health specialist or a sexual health specialist. Viagra can be commercialized, sure, but it can also make a huge difference in mental health - possibly for more than one person. And I do think we should sell them for recreational use as well, if there is that sort of use and use the profits to reinvest or let those be big pharma profits. Possibly in heart health, since lots of folks need that sort of thing.

Contrary to what my post says, I don't mind big pharma in itself. Sure, there are issues, but I don't mind them making profit. I just wish we'd do more - including making sure you don't have unaffordable premiums and deductibles just to live (as in my view, life is a human right if we can prevent the death).

In any labour market, the minimum you pay is what it takes to keep the worker, and the workforce capability, viable. That's straight out of Adam Smith, Wealth of Nations (Book 1, Chapter 8, "Wages of Labour").

You'll want to consider additional premia for the expenses of education and risk. Again, as a minimum.

The question of whether or not to reward successful teams on top of that really comes down to whether or not success is based on characteristics of the workers or is some random chance attribute. Giving high rewards for what are effectively spins of the roulette wheel doesn't strike me as particularly valid. Rewarding effective methodology and procedure, however, does.

WHAAAAAAT?!

You don't hang around scientists much, do you? The people researching and making these drugs do not make a very good living. Not caring about your salary is seen as a mark of a good scientist, I've heard it from many, many people I work under. Most scientists make absolutely crap, even the ones in the pharma sector.

The majority of the pharma profits go straight to the business people that make all sorts of weird deals, jack up prices after cornering the market, get certain chemicals/processes banned so they can re-patent the same drug under a new mechanism, etc.

>Why spend years getting a PhD in biochemistry when you can go make $400k/year with just a BS at Google?

Because they like the work and find it interesting, go ask literally any scientist today. Reducing the profitability of pharma companies will hardly move the salaries for scientists because they are not at all tied to profits.

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