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Comment by jmyeet | Hacker News Reader

The only "innovation" of capitalism is intermediation, otherwise called "rent-seeking". One of the big lies Big Pharma tells you is that R&D is expensive but the actual R&D is done primarily by government funding and research at colleges. Big Pharma spends WAAY more on marketing.

The only real R&D Big Pharma does is patent extension. Patents have a life so companies will make minor changes to the molecule or the delivery mechanism to reset that patent protection period.

What makes Big Pharma particularly evil is it's one of those industries that profits from inelastic demand (ie people will die without some product) and buying the government to build a moat and make themselves a monopoly. The prices US consumers pay for pharmaceuticals is absolutely criminal.

This is capitalism working as intended: taking a captive market (eg diabetics that cannot live without insulin) and extracting wealth from them to the hands of a very few.

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>One of the big lies Big Pharma tells you is that R&D is expensive but the actual R&D is done primarily by government funding and research at colleges

Not an expert, but my understanding is that the kind of basic science R&D done by the government and academia is the simplest and easiest type of research to do by far. As it was explained to me- anyone can invent new compounds, the really really really hard low-percentage stuff is trialing that those new compounds are A) medically effective in people, and B) actually safe for people and don't have strong side effects.

Also, I believe that if academia actually does invent something novel & useful, they license it out to pharma companies for a % of the profits. Big universities are not shy at all about licensing their IP

> Not an expert, but my understanding is that the kind of basic science R&D done by the government and academia is the simplest and easiest type of research to do by far.

Yeah it is easy to come up with stuff that works in a lab. For example, just see the HN submissions for new battery technology.

This is entirely correct.

Oh good, then the government and academia can stop spending $70b a year in basic R&D research. Since it's "simple and easy" then pharma can pay for it. Big brain move here.

Pretty close. Without getting into what is “cheaper and easier”, the work you need to do to publish is a bit different from the amount of work you need to do to: identify targets, set up screening assays, screen hundreds of thousands of compounds, find/optimize a hit, set up secondary assays, optimize the lead compound, do all kinds of physchem/tox/safety studies, select an indication, test in animal models if good ones exist, try and find a suitable dose range, and put all that into a package to support a phase 1 trial. This is part what I’ve seen on the biology side of things, and it only scratches the surface of what the chemistry (small-batch synthesis and the scale-up), pharmacology, and associated people contribute.

Lots of people can synthesize and test a compound in vitro. Doing the above is another challenge because it needs to work reliably in humans.

And yes, from my understanding, universities are getting better at patenting and licensing their IP. Some even do some basic drug discovery IIRC.

Don't know about the US, but in other countries a phase 1 trial might very well get done by academia, sometimes even phase 2.

> The only "innovation" of capitalism is intermediation, otherwise called "rent-seeking". One of the big lies Big Pharma tells you is that R&D is expensive but the actual R&D is done primarily by government funding and research at colleges. Big Pharma spends WAAY more on marketing.

Yet when shit hit the fan with a global pandemic, it was US Pharma companies that were both able to develop and produce and distribute at scale effective vaccines in a very short amount of time.

This actually makes my point. mRNA vaccines were researched in academic institutions for decades. The Covid 19 vaccines just took those vaccines and ran them through clinical trials.

This isn't hard to verify. Just this week researchers were awarded the Nobel Prize for Medicine for their work on mRNA vaccines. Did they work for Pfizer? Johnson and Johnson? Some other company? Or was it an academic institution?

“The Covid 19 vaccines just took those vaccines and ran them through clinical trials.”

“Just” that, and figuring out manufacturing and distribution at massive scale. Combined that’s billions.

Gotta love the word “just” in that first paragraph.

The majority of the research money behind most (if not all) drugs, is spent well after academia’s contribution. Clinical trials are very costly, they usually fail, and yet they’re quite important!

> The majority of the research money behind most (if not all) drugs, is spent well after academia’s contribution

[citation needed]

Just look at the timeline for Covid 19 [1] and how late in the piece you get before a company like Moderna gets involved. What huge investment was made by Big Pharma here?

Even this was funded by Operation Warp Speed, another $10 billion in Federal money.

[1]: https://covid19.nih.gov/nih-strategic-response-covid-19/deca...

Well, for one, if Moderna et al didn’t actually provide much value above the public research, why didn’t the Chinese quickly create their own highly effective mRNA vaccines?

Building the platform to turn research into practical drugs is hard, not to mention expensive and hardly guaranteed to succeed.

> This is capitalism working as intended: taking a captive market (eg diabetics that cannot live without insulin) and extracting wealth from them to the hands of a very few.

People can't live without food, either, but every historical attempt at government agriculture has resulted in famine. With swinish capitalists engaging in food production, we're all the fattest people in history.

As for the "very few", anyone can buy stock in Big Pharma and get their fair share of the wealth.

> ... but every historical attempt at government agriculture has resulted in famine

So famine has been eliminated then? A quick Google search shows that ~9 million people die of hunger every year. There's no communism to blame that on, much as people like to talk about, say, famine in the USSR, but 9M deaths per year from intentionally withholding food under the auspices of capitalism doesn't get a second thought? Why is that?

> As for the "very few", anyone can buy stock ...

Things like 401ks have convinced people that they are participants. But owning 20 shares in Amazon doesn't make you a capital owner. Something like the wealth of the 8 richest people on Earth is about the same as the bottom 4 billion.