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> R&D is one thing, but most drugs fail at the clinical trial stage. This money (hundreds of millions per drug) is just gone, unlike R&D which might result in new tech or at least a patent.

Are you saying the clinical trial stage is somehow not part of R&D spending? It sounds like quite obviously research to me, but I'm not familiar with how it's actually reported.

>This money (hundreds of millions per drug) is just gone,

Is it completely wasted? we learn something doesn't work. It's not fantastic like it would be to find drugs that cure things , but we still learn.

The industry may learn from failures, but the shareholders of private companies want a return on their investment. I sure as heck don't want my 401k tied to oncology.

>Personally, I think its inevitable that there is going to be some form of nationalization for a protected class of life-saving medication.

Wouldn't it make sense for governments to just run their own drug manufacturing company? All the drugs from expired parents are free game.

It might do if they had a chance of running them efficiently.

Yea its a shame that public services get undermined and underfunded at every turn

Patents are a monopoly. Efficient resource allocation is therefore impossible.

You could concentrate on patent expired drugs that cost the most on an annual usage basis. Yeah, that leaves out the newest meds, but you'd still make a dent, and every year, you get cooler stuff to make that's already been market tested.

No, because patients deserve the best or most effective drug, not the cheapest. Unless you'd like to put a price on human life that is. Also, meds don't hit the market before they are tested... Testing meds is part of the resource allocation problems because cheap & effective off-label use won't be researched & tested because there is not enough money to be made...

Tell that to the insurance companies that keep denying my meds

Migrate...

To somewhere with a nationalized health system? Why can't we just have that here

> Unless you'd like to put a price on human life that is.

If you have some magical formula that would avoid doing I'm sure that NICE would love to hear from you.

https://www.nice.org.uk/

The best or most effective isn't always in consideration. At least outside of the US, you get what has been approved for care and only if it's not too cost prohibitive.

If governments were making their own generic drugs and sold them at cost then it would help avoid situations like Martin Shkreli. The drug wasn't protected by a patent, it's just that nobody else produced that drug. In my opinion this seems like a reasonable thing for governments to do.

Also, the best treatments aren't always available in this first place. Eg (at least a few years ago, don't know today) Adderall was illegal as a treatment here. Some EU countries, until recently, even treated methylphenidate like that.

> Unless you'd like to put a price on human life that is.

It's been put at about $10 million, for the purposes of EPA regulations. Insurance companies have their own formula, from a couple hundred thousand into the millions, and healthcare users QUALYs - quality-adjusted life years, and those are priced at $50,000-$150,000.

I'd say non-optimized government corporation running on cca 0 profit churning out safe generics is still a massive good for all mankind, its type of inefficiency we can all somehow live with, compared to usual governmental fubars left and right.

Triple that in places like US (not for fubars but the costs).

The WTO/TRIPS treaty already allows for governments to issue compulsory licenses in case of a national emergency. This also explains why some firms where so "nice" during the pandemic, as they feared it. See https://www.wto.org/english/tratop_e/trips_e/public_health_f... for details. Obviously, it does not suffice but at least it's something.

And now it would be a political issue which drugs get manufactured for cheap and for whom. You can probably see how that would go in corrupted countries (i.e. all of them)

Maybe you could set in place criteria based on how much the drugs are used and how many competing manufacturers there are and go based on that.

So now the politicians families own drug corporations and get preferential treatment. We have reached USA levels of corruption.

I might be mistaken, but don't c-corporations split out R&D (money invested back into the company) from profit?

I'll admit I'm not as well read on the day-to-day reporting as I'd like to be.

Profit is what is left over after R&D - they can choose to invest those profits into future R&D, or far more frequently, just pay out the profits to owners as share buybacks or dividends.

Much of the early development of novel new treatments is funded by venture capital and early IPOs. The big players buy them out when most of the risk is gone and it’s time to scale up.