Right now the NIH's budget is $30.1B. US pharmaceutical companies invest $48.5B in 2012. Note, that's only R&D expenditure, not all the capital costs (e.g. Pfizer spent $1B for a manufacturing unit in Ireland; the drug failed due to safety).
Same place it does now - the end user. But the money would cover research, development, trials, data mining, treatment, etc. It would not be used to mislead medical practitioners, patients, or government officials.
> Right now the NIH's budget is $30.1B. US pharmaceutical companies invest $48.5B in 2012. Note, that's only R&D expenditure, not all the capital costs ...
US-centric may not be the best way to come at a discussion about health costs (no disrespect - just it's not typical in the world stage, and you'd be hard pressed to find someone that considers it best practice).
How does that R&D component stack up against the industry's Sales and Marketing budget? (Hint - less than admirably.)
To answer your first point, you're saying that the cost of R&D would still be born by the end-user (patient). What's the benefit then if it's not saving money?
If you think a gov't run company would not pull some of the same stuff the private ones do, I'd have you take a look at some of the corruption that goes on at public companies. A gov't run company might not be for-profit, but someone there has budgets and revenue numbers to meet. The motive to cut corners doesn't disappear when it's run by the gov't.
And why shouldn't a pharma company have a sales and marketing budget? Do you think your doctor has time to sit down and analyze all of the clinical trial data? Getting in front of a doctor and touting the benefits of your drug sounds like a good thing to me. Sure, some sales reps use slimy tactics, but overall educating physicians doesn't sound like a bad thing.
Also if it were open (globally) countries could be the checks and balances for each other.
And no, pharma don't need marketing. Marketing is always used to trick people into buying things, or to create brand awareness, it's never about the good of the recipient. Dr's could simply have a database where they look up drugs and supporting material (i.e pull information rather than push marketing).
If marketing didn't exist, this need could easily be fulfilled by organizations acting on behalf of the buyers. Consumer buying guides and professional industry-specific journalists publishing reviews are examples.
Much R&D may be billed back to the US, or at least billed in USD, but I'd suggest it's been quite some years since even a sizeable minority of actual R&D work has been done within the borders of the US.
Quoting Ben Goldacre in "Bad Pharma" (2012)
"In the past, only 15 per cent of clinical trials were conducted outside the USA. Now it’s more than half. The average rate of growth in the number of trials in India is 20 per cent a year, in China 47 per cent, in Argentina 27 per cent, and so on, simply because they are better at attracting CRO business, at lower cost. At the same time, trials in the US are falling by 6 per cent a year (and in the UK by 10 per cent a year). As a result of these trends, many trials are now being conducted in developing countries, where regulatory oversight is poorer, as is the normal standard of clinical care."
* CRO = Clinical Research Organisation. Precisely as disarmingly harmless as it sounds.
> To answer your first point, you're saying that the cost of R&D would still be born by the end-user (patient). What's the benefit then if it's not saving money?
I wasn't suggesting that money won't be saved.
To the contrary - the cost of R&D is a relatively small component of the current pharma mechanism. Once you eradicate the need to (expensively) mislead and befuddle regulators, medicos, patients, there's a lot more to spend on actual R&D.
> If you think a gov't run company would not pull some of the same stuff the private ones do, I'd have you take a look at some of the corruption that goes on at public companies. A gov't run company might not be for-profit, but someone there has budgets and revenue numbers to meet. The motive to cut corners doesn't disappear when it's run by the gov't.
Rest assured my idealistic interpretation of this impossible world precludes this kind of corruption. :)
> And why shouldn't a pharma company have a sales and marketing budget? Do you think your doctor has time to sit down and analyze all of the clinical trial data? Getting in front of a doctor and touting the benefits of your drug sounds like a good thing to me. Sure, some sales reps use slimy tactics, but overall educating physicians doesn't sound like a bad thing.
Oh my. I'd strongly recommend you spend a few hours to read through Goldacre, B.'s book (ref above). The idea that the pharma industry is 'helping' doctors in their on-going education is ... worrisome, at best.
(Hint: overall .. it's a horrendously bad arrangement for everyone involved apart from the shareholders in the relevant big pharma org)
Medicare alone spends something like $50B per year on drugs, add also Medicaid and other agencies (VA and such), and there you have an ability to invest comparable numbers as the pharma companies do currently.
Could you quantify this? Is it because they're tackling the very difficult diseases and not the low-hanging (profitable) fruit?
The polio vaccine was developed with federal money and was provided for free as a result. There is no way the polio vaccine could have been done more efficiently if the private sector did it.