1) OK... maybe we should stop, then? Like, that seems like a terrible deal? How is that a justification at all? It seems like just a description of something very stupid we're doing.
2) This would be a good deal if we were getting other countries to also pay high prices and bringing that money "home", but basically the exact opposite is happening. WTF.
3) More often than not, the side of the issue that raises this as a good thing is also the side full of folks who think we should e.g. reduce spending on foreign aid, so it's especially weird that they're bringing it up.
Plus, I'm very skeptical that the idea that drug development would dramatically slow down if the US stopped over-spending to the tune of 2x-100x on lots of drugs is even true. But setting that aside, it's still just a bizarre line of argument, to me.
If you move faster than the science and the lawsuits, then you can keep selling deadly crap to a naïve and trusting populace.
https://en.wikipedia.org/wiki/Reye_syndrome
https://en.wikipedia.org/wiki/Thalidomide
The US pays for drug development and then the rest of the world caps prices and gets the drugs cheaper. If the US stops then the money for drug development goes down, which is not great. What you really want is to get the other countries to pay their share, but how do you propose to do that?
Price caps set a very explicit bar and then ask a company to think very carefully if they truly think the drug can't be sold at that price (and surprise: turns out when motivated a ton of them discover that yes, it can be).
1. An expectation of profit at the end. 2. A highly desired outcome from a motivated pool of Investors.
Price caps can dampen #1. Which can put more of the burden on #2 as a source of funding. Whether you think that is an improvement or not probably depends on your particular ideological position around markets and healthcare.
But there is definitely an objective argument to be made that this might decrease the speed of improvements in healthcare technology.
Every American posts about "healthcare improvements" like they're a millionaire and that cancer wouldn't bankrupt them (and then also get them fired from their job when their insurer casually mentions the "bad risk" they've got which is driving up the cost right now).
A slower pace for rare ailments seems like an obviously acceptable trade off.
Then subsidize, on purpose and directly, not by some lopsided roundabout more-expensive-than-it-needs-to-be scheme, if problems arise.
Quite a bit of the high pricing for Americans is also by companies who _don’t even do_ R&D to any significant extent; companies who only make generic price them dramatically higher in the US than elsewhere.
They cannot pay with money, but honestly speaking they could "pay" with risk taking, I mean trying drugs that the FDA is too risk averse to approve . For example the risk profile of basically every day activity is much much higher in India or Nigeria compared to the U.S. and so the same should be for drugs, medicine is an extremely risk averse field as it is, but with the FDA being the world authority over medicine safety basically the risk profile of the US is being transferred over to the rest of the world which is nuts. Consider for example the risk profile of daily driving in the U.S. vs India or Thailand where everybody goes around in scooters without helmets, it works for them, their economy would collapse if they tried to have the safety of the U.S. drivers going around with 20ft long 7500lbs cars.
The unfortunate thing is that the whole world relies not only on the U.S. for drug research but also drug approval. If the FDA says no to something then not even Lesotho would try it , even though maybe from a risk reward standpoint it would make so much sense for Lesotho to try it .
Between 2019 and 2022 there were like 88 biotech IPO lockup expirations and only 3 were trading higher than post lockup for any period of time.
Macro determines the rate of risk taking. Not “details.” You simply 100% cannot have drug discovery without risk, and risk wants returns.
Should we have low rates and high inflation for the sake of more “discovery of medical techniques?” Inflation and high costs: dude, they are exactly the same thing!
The majority of basic research is done in academic research laboratories which are predominantly funded by government research grants. If one of these studies pans out and something can be patented, a business or investor group may license the patent and fund an applied R&D program with the goal of getting through FDA trials. This effort is either funded by investor capital or internal company funds (likely from revenues from the sales of FDA approved medications or other products). Presumably if a business or investor group has a track record of bringing treatments to market (e.g. having a revenue stream from a previously economically successful product) they are entitled with the option to invest more funds, etc.
I am currently prescribed a medication that is over $30,000 per injection every 12 weeks.
Because we have absolutely atrocious health organization. Pharmaceutical companies can set their prices regardless of anything but their profit.
This should apply to food, water, housing, health care, transportation, internet; all those good things that you can't do without and are extremely vulnerable to market manipulation.
Price controls are Hobson's choice: Would you prefer expensive bread, or no bread?
And, to many, the difference between "expensive bread" and "no bread" in the case of drugs is entirely academic.
This obviously kind of sucks when the drug is the difference between life and death, but those are also the drugs we most want a large incentive to develop, and that's why the patents eventually expire.
> Consider the example of a Taylor Swift concert. Are scalpers creating more supply by raising the prices of tickets or is it pure rent seeking?
Scalpers are trading time for money. You want tickets that would otherwise sell out but you don't want to wait in line, so you pay someone to wait in line for you. It causes tickets to be available at the higher price instead of being sold out and unavailable at any price. The way to prevent the rent seeking is to auction off the tickets to begin with so the money goes to the artist instead of the scalpers.
* A little extra space in your dwelling * Internet * Access to nature * Hot water * Some means of transportation that grants you access to work, home, and recreation * Leisure time beyond that needed to cook, clean, sleep, and exercise * Some dietary variety * Any functioning smartphone * Access to community * A modest amount of extra money for recreation * Any vacation time * Access to heat/cooling beyond the bare minimum * Access to education * More than one choice in a job * A bed that doesn't hurt you
The list could likely be trimmed or made narrower, and there are likely things I'm not thinking of, but you get the idea. Nothing extravegent or necessarily expensive, just a few things beyond the absolute bare minimum a human needs to survive. Basically, I think everyone should have access to three major things: 1. The necessities of survival 2. A few extras to allow the unmotivated and unambitious to be sustainably content and not truly miserable from true deprivation (so, like, evaluate human needs the way a modern ethical zoo evaluates animal needs rather than a historical abusive menagerie would). 3. Access to tools and resources for the sufficiently ambitious to reasonably improve their situation without making excessive sacrifices from point 1 or 2.
Does any of that strike you as unreasonable or unachievable?
How does this determine how much the license fee should be?
The way Trump touted an invention from the German company BioNTech as "Invented in America".
"Nothing is purely German or American nowadays."
I know that, not everyone seems to though:
"I've heard it quipped that Americans are subsidizing the discovery of new medical techniques for the rest of the world."
And not even nowadays. Like with the Wright Brothers, who used data from Otto Lilienthal.
But the Wikipedia article could not stop trying to minimize his impact,
"Lilienthal's research was well known to the Wright brothers, and they credited him as a major inspiration for their decision to pursue manned flight."
where someone felt the need to add
"They abandoned his aeronautical data after two seasons of gliding and began using their own wind tunnel data."
and make it all about the Wright Brothers. In an article about "Otto Lilienthal" not the Wright Brothers.
That said, I wouldn't dismiss Karikó's and Weissman's discovery of replacement of uridine with pseudouridine as merely "writing a paper". It was a pretty crucial technological stepping stone that made mRNA treatment orders of magnitude less dangerous to humans. Same with their discovery of the way how to deliver mRNA into cells (using lipid nanoparticles).
The recent "negotiated prices" for Medicare drugs could be the beginning of the end for this system though.