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Comment by nudge | Hacker News Reader

Please just explain how it is that you think we would get new, expensive-to-develop drugs, if there were no guarantee of a limited monopoly for the inventor.

Forget the abstract arguments about corporations being "encouraged" or whatever you think I think. Just tell me how it would work.

If it helps, imagine that you run a pharmaceutical firm, and you have the choice to spend hundreds of millions of dollars researching a drug which, once perfected by your researchers, is not owned in any sense (even temporarily) by you, but rather immediately becomes a generic commodity worth fractions of a cent per unit, and which cannot possibly earn you back the money you spent developing it. In that situation, would you start the research? And if not, where will the new drugs come from?

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> Just tell me how it would work.

Ha ha, that's the beauty of it: I don't know. I just know it works. I know it from a source[1] which I consider reliable. And that source presented empirical observations which strongly support my view.

You keep talking about how it would work, doing what's amounts to a thought experiment. That's valuable, but not nearly as good as actual observations in assessing how the world works.

From the dawn of humanity, the Sun has been observed to rise from a direction and set to a roughly opposite direction. Why? How? For a very long time, no one knew. But only a fool would contradict that observation just because what he thinks of the sun doesn't fit what everybody sees.

In short, when your view of the world doesn't fit the observations, update your view of the world.

Now, I see very few ways in which you could still disagree with me: (1) You think I misreported my source. (2) You don't trust my source. (3) You know of very strong evidence which support your view and not mine. So which it is?

[1]: Against Intellectual Monopoly

Alright, if you don't know how it would work, but you do know how it does work, tell me how it does work.

What countries are you talking about, what years, what drugs? How did the companies cover the cost of research? What was in it for them? Why did they do it?

I am perfectly willing to amend my views but so far you have done nothing but say you have evidence. Show me! I don't have time to read your source but I am happy to read what you quote as relevant.

> I am happy to read what you quote as relevant.

Ah, now we're talking. So, chapter 9, page 247 http://levine.sscnet.ucla.edu/papers/imbookfinal09.pdf

""" You may wonder why we are offering all these details about specific countries, patenting of chemical processes, and pharmaceutical products. For a very simple reason: if patents were a necessary requirement for pharmaceutical innovation as claimed by their supporters, the large historical and cross country variations in the patent protection of medical products should have had a dramatic impact on national pharmaceutical industries. In particular, at least between 1850 and 1980, most drugs and medical products should have been invented and produced in the United States and the United Kingdom, and very little if anything in continental Europe. Further, countries such as Italy, Switzerland and, to a lesser extent, Germany, should have been the laggards of the pharmaceutical industry until recently. Instead the opposite was true for longer than a century."""

I fear you would have to read "all these details about specific countries" if you want anything more substantial. That's 7 pages (from 241 to 247).

Interesting, but not very convincing. The argument concerns historical periods when the costs of research were not nearly as high as they are now. As your own source rightly points out:

"the total cost of bringing a new drug to market [is] around $800 million, in year 2000 dollars... [T]his figure suggests a spectacular increase in the cost of innovating. This increase is due, mostly, to the capitalization of the longer and more expensive clinical trials the FDA requires."

It may well be that patents were not always necessary for drug development. It is lazy thinking to conclude from this that they are not necessary now.

> It is lazy thinking to conclude from this that they are not necessary now.

Correct. We may want to test for that, if at all possible. Also, if we manage to reduce the costs of clinical trials, we may make that point moot. But in the end, I fear we will have to set priorities, and make compromises. I just hope that it will be based on rational judgements, instead of political stances alone.

Simple explanation: patents and the FDA represent barriers to entry for new competitors. Costs going up just means more money spent within the industry, and more profit to be taken later. Costs (and profits) going up are a consequence of patents and regulation, not the other way around. Remove patents and regulation and watch costs plummet.

Well, we could remove patents, but removing (or lightening) regulation may be a bit more tricky: you wouldn't want Big Pharma to release something that's more a poison than a medication.

And how has regulation changed this? What extra laws do we need in place to make sure companies don't kill people other than "dont kill people"?

> And how has regulation changed this?

I don't know. Nor am I aware of any study which shows regulation's effects, or lack thereof. I'm just saying that if regulation has benefits, they should be compared to the drawbacks before we forfeit them. If it has no benefit, of course get rid of it.

Anyway, as I said, I don't know a thing about pharmaceutical regulations. If you do, a few pointers would be welcome.

Somebody mentioned having prizes for the drug developer. This would especially help medication where there wouldn't be much profit incentive but would do lots of good (e.g. Malaria).

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