I'd be interested in seeing someone think these issues through more deeply. For example I know a reasonable amount about the development of next-gen DNA sequencers. How would developments like this have played out in a world without patents?
It doesn't seem feasible to say that academics would be willing to prepay to fund the development of a life science tool that might help their research and appear in 10 years time or might just fail and not get developed at all. Research markets were the initial markets for these instruments.
Same goes for drug discovery, perhaps they need some new analytical tool. So do they directly fund multiple high risk approaches to develop this tool? In our current scenario VCs/startups take on this risk, in exchange for a time limited monopoly.
It doesn't seem reasonable to expect individual drug development companies to take on this risk. Do they ask prospective users of the drug to pay these downstream development costs? Do they take out a loan to cover the development costs?