It's a longer read than I have time for (at work), but thanks for the link. I'm curious to see how they resolve the problem of the major upfront cost of R&D that is usually (so far as I know) recouped only via temporary monopoly.

That chapter is very silly.

It compares British and German chemical companies and explains the difference with patent laws. But any company can build a chemical factory wherever the patent laws are favorsble. In reality the difference was cultural: Germans have had a kick-ass chemistry culture since alchemy turned into chemistry.

The chapter explains dye manufacturing changes with patent laws. To anyone with chemistry knowledge, this is ludicrous to the point of deliberate dishonesty. Dyes are embarrasingly easy to discover. If you take an existing dye structure and make a tiny chemical change, the new material is probably colorful and is not covered by the patent on the original dye.

In fact, a lot of early pharmaceutical work was done by taking chemical libraries from dye companies and screening their thousands of structures for biological activity.

The argument against patents on the basis of "me too" drugs is also ludicrous. The chapter actually says that patents are damaging because they give patients too many choices: there is no need to waste the money on having all those alternatives. In reality, there is huge variation between similar drugs. Many variants turn out to work better for different people, and some variants turn out to have unacceptable side effects. The only way to find out is to make a bunch of alternatives and try them all out.

The chapter becomes even more ludicrous by saying thst the COX-2 inhibitors are just a wasteful duplicate of cheap ibuprofen. Folks, ibuprofen and related drugs kill probably a few hundred thousand people a year with side effects. They're more dangerous than Al Qaeda. (Although by bad luck it turned out that the aCOX-2 inhibitors were worse, but in a different way.)

The chapter makes the absurd claim that patents hurt drug discovery and patients, ignoring the elephant in the room of generics manufacturers. If patents were so harmful to innovation, the the generic companies would be leading they way with new drugs. They are most emphatically NOT. Except for a few minor formulation chsnges, they do nothing of their own.