The Best Fix for American Drug Prices Is Already on the Books

Through reading up on the 'opioid epidemic' you realise that a lot of this 'innovation' is not that great. Slow release tablets? There is no big deal there. Furthermore a lot of this 'research' is backwards, i.e. create a molecule that can be patented, see how much of it kills rats and then try and find some medical benefit for this 'new molecule'. If it treats cancer then is that because it kind of prolonged someone's life by a week even if the others in the trial were essentially killed by the 'new molecule'?

This went on with AMGEN and Johnson + Johnson with the EPO drug that Lance Armstrong so enjoyed. They sold this drug into many, many 'off label' side markets - could the same molecule be good for stroke victims too? No trial data, but with profits to be made this sort of thing happens.

You can market a drug a dozen ways even if it is only paracetemol. Back pain? You can buy this tablet. Hangover? This one mixed with caffeine. Kids version? Brightly coloured with a lower dose per pill. Easy.

Then there are those drugs sold with the 'dating website' business model. The 'dating website' business model is to have a few success stories but have everyone else paying their subscription as long as possible. Statins are sold like this, the Big Pharma scam is to have people on these things for life.

The rest of the world - Canada included - care about healthcare more than money. In the UK healthcare is a service, not a business first and foremost. The NHS has to balance the books but not be putting profit before people. In the US it is backwards.

The rest of the world would do better without U.S. Big Pharma stifling innovation and sponging off their citizens.

This doesn't pass my sniff test. The original article's point isn't that companies are marketing just so they can flush money down the toilet. Of course it's profitable. The article's point is that we as a society want them to spend more money on R&D; and our current strategy seems not to be working.

Companies would prefer to spend no money at all. If they could recoup their investment by spending no money on marketing, research, development, or production, they would. So a good company does the next best thing: they find the least costly, most efficient way to make money and prioritize that.

If companies are investing the majority of their resources into marketing, that at least suggests that they view marketing as the most efficient way to make money. Since we as a society would prefer that R&D be the most efficient way for them to make money, it may very well be reasonable to look for ways to decrease the cost of R&D and/or to increase the cost of marketing.

Shortening the exclusivity period of a patent might be an effective way to decrease the value of marketing, since marketing returns likely benefit from exclusivity.

The marketing expense isn't necessarily avoidable.

Suppose it costs $50M to research a drug and patients will pay $1000 for a course of treatment. If you do no marketing then you get forty thousand customers and can't recover your R&D. If you spend $100M on marketing then you get two hundred thousand customers and more than recover both your R&D and your marketing expense.

Spending more on marketing can allow them to do R&D they otherwise couldn't by providing more customers to spread the R&D costs over.

"But this will disincentive research!" Maybe. Or, tax people more in order to fund the research. The tax revenue would go directly to researcher salary, equipment, expenses. Even a large tax increase can't be worse than today, where people have to pay huge $$$ anyway, of which a large cut goes to executives, shareholders, the marketing machine, etc.

I believe by and large, people that go into pharma research do it because they're interested in the science and the cause, not because of any privatized profit motivation. Which is to say, people will still go to grad school in the same fields and continue carrying on the research work (so long as the facilities and equipment is available, which we can solve). The downside is that many senior executives would be displaced or be forced to accept lower compensation.

Someday in the distant future, people will look back and be as shocked that private companies profited from medicine, as we're shocked today about the for-profit firefighters in ancient Rome.