As long as there is more than one pharma company, there's an incentive to cure chronic conditions because you'll take all of your competitor's business away and can charge a price equal to the lifetime costs of the chronic treatment.
You have conflated your incentive (a cure) with people who make and sell treatments (maximize profits).
As long as there are Pharma companies, there is incentive to make slightly better treatments. That is same effect lower production cost, or same cost and better effect.
It kind of sad that treatements have gone from prescription to subscription.
This is of course complicated further by the sheer pigheadedness of CEOs with a career half life of 3 years who come in, _revolutionize_ something by destroying it and antagonizing the workers, bloat HR a bit more and drive sales through something illegal; and finally move on, tallying that one a success.
https://www.propublica.org/article/how-big-pharma-company-st...
Two vaccine candidates use the same adjuvant. One demonstrates high efficacy at curing a disease killing over a million people per year in poorer countries, one demonstrates high efficacy in preventing shingles. Guess which one was prioritized for the adjuvant.
Also shingles can be a serious disease. Doesn’t change the calculus of prevalence, but no need to be quite so dismissive.
Regardless, it makes you wonder why they went forward with that particular adjuvant for the TB trial in the first case.
I'm not dismissing shingles, just triaging it relative to the seriousness of TB.
Well sometimes you select an excipient or adjuvant because some other one you might have chosen has some interaction with your API (active pharmaceutical ingredient -- the thing you're actually trying to deliver). More often though they are pretty arbitrary: the program lead or someone on the team had used that compund before and knew how to handle it or already had all the literature needed for a regulatory submission (had an older submission) or perhaps the division you're submitting to is already quite familiar with that one so you use it.
And of course once you're approved for and done an initial trial (phase 1) with one formulation you don't want to go back and redo all the safety studies, especially for something that isn't the API itself, if you don't have to.
Note, I have not worked in vaccines, only in anti-infectives, so their can always be cultural and technical differences that I'm not aware of! Consider this the equivalent of "experienced Lisp, C++ and assembly programmer reads article written by a layperson about a problem with a Java program, and is dubious about the layperson's diagnosis".
I don't know to what extent the ProPublica writer was informed by their sources, but they're typically pretty good journalists. Still, I get your point.
The patent is actually an argument for the cure. Because if you have a lifetime treatment, as the patent expires, anyone will be able to copy your treatment. It is called generic drugs and it is done all the time. If you have a cure, during the time you have the patent, you will be able to treat everyone, both existing and new cases, and make tons of money while your competitors will have nothing. After the patent expires and your competitors will be able to copy your cure, only new cases will remain. Still valuable, but far less than when you had the patent and there were plenty of people to cure.
https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patie...