8 ms·

I'm sure a lot of folks will pile in here about evil, etc. But I do appreciate the fact that some market incentives (profits) exist to encourage greedy companie

I'm sure a lot of folks will pile in here about evil, etc. But I do appreciate the fact that some market incentives (profits) exist to encourage greedy companies to come out with new drugs. I fear lower innovation in its absence. THAT SAID...obviously a big problem (like software) with the way we handle intellectual property. Just like IBM/x86, there's no philosophical reason why one shouldn't be able to derive a generic and produce it. That's the real issue. We issue "king's crown" (gov't) monopolies on these products. The ONLY advantage I am okay with is first mover advantage. Similar corollary to toll road and broadband concessions...stop protecting these giants and allow REAL PvP competition!

spullara 7y ago
We issue these monopolies because discovering new drugs and putting them through patient trials is expensive and actually manufacturing the drugs after you discover them is cheap. Not sure how you can solve the pricing problem without reducing innovation in the space.
Alex3917 7y ago
> But I do appreciate the fact that some market incentives (profits) exist to encourage greedy companies to come out with new drugs. I fear lower innovation in its absence. There were more new drugs released before Bayh-Dole. If anything, the fact that you can now make a lot of money creating new drugs is probably reducing innovation.
_edo 7y ago
Governmental regulations (safety, etc.) make the cost of developing a new drug extraordinary. Without exclusive patents on the back end companies won't have a reason to foot the bill on the front end. Even without regulations developing and testing a new drug wouldn't be economical if somebody else could steal your formula the moment you figure out that it works.
- entee 7y ago
  This dynamic already exists in diagnostics. There's a huge second mover advantage in diagnostics because it's relatively hard to patent a diagnostic effectively. I know a few people in diagnostic companies that have very much soured on the industry as a result.
- brightball 7y ago
  Yep. These realities exist in so many other industries too. Entire businesses are setup as fast followers.
- breck 7y ago
  It turns out that most of these new drugs have done more harm than good. See Purdue, for example. With very few exceptions, new drugs != better health. Our healthcare industry is a disaster and intellectual monopoly laws are a big reason why. We need to ditch those and focus on good outcomes, which does not mean focusing on giving vast rewards to some novelty regardless of efficacy.
  - entee 7y ago
    Purdue's new delivery mechanisms were actually a huge benefit to the right patients. The problem is they abused it and actively sold the drug to the wrong patients repeatedly and worked hard to push back oversight.
    - breck 7y ago
      The problem was you could make unnatural "lottery-winnings" money selling OxyContin, and people respond to incentives. Ditch the incentives for selling novelties and the boring businesses focused on the actual health outcomes of the patient will thrive.
  - _edo 7y ago
    If a new drug isn't useful it doesn't matter if the manufacturer has exclusive rights to it. If people are buying/being prescribed drugs that don't improve their health that's a different problem that won't be solved by changing intellectual property law.
    - breck 7y ago
      The problem is it does in practice. Almost all of the profitable drugs turn out to be useless (often harmful actually). I agree there is another problem here: medical science is laughable bad (and that’s a problem of tooling and poor data science tools, which I work on), as the combinatorics are much larger than our tools are currently capable of handling. But in the meantime, while people are still allowed to pitch junk science as fact, and medical decisions are based on junk science, the least we can do is stop rewarding monopoly profits to drugs with scant real evidence of support.
thaumaturgy 7y ago
> But I do appreciate the fact that some market incentives (profits) exist to encourage greedy companies to come out with new drugs. I fear lower innovation in its absence. I think of this as a "prayer to innovation", in the cargo-cultism sense. Like tax relief for the wealthy, the prayer goes that "if we can just give these people more money, they'll improve our lives". Multiple studies have found links between drug pricing and the development of new drugs, but it doesn't work in the obvious way. Large pharmaceutical companies often rely on purchasing smaller startups who do the actual research into developing new drugs [1] but don't have the expertise in bringing the new drug to market and making it successful. The larger pharma companies need financial capacity for this, but since the patents have expired on a lot of other successful drugs before the companies recovered the profits they wanted, they're relying on captive markets for the monopolies they still have in niche pharmaceuticals [2]. These companies are profit-motivated. They aren't working for the public interest. They have no particular desire to "innovate"; their business model instead relies on identifying innovators, buying them, and then selling the product of their research at high prices for as long as possible. Price controls for pharmaceuticals would ultimately reduce the funding available for the R&D startups, which would limit the creation of new drugs. But it's not clear that allowing big pharma companies to continue charging extortionate rates for life-saving medicines is a good solution to this, nor is it a guarantee for future innovation. It seems like single-payer insurance and more federal funding for pharmaceutical R&D would be a far better solution than defending predatory drug pricing. [1]: https://www.forbes.com/sites/stanfleming/2019/06/20/the-relationship-between-drug-prices-and-innovation/ https://www.forbes.com/sites/stanfleming/2019/06/20/the-rela... [2]: https://www.healthaffairs.org/do/10.1377/hblog20190228.636555/full/ https://www.healthaffairs.org/do/10.1377/hblog20190228.63655...
- rayiner 7y ago
  > They have no particular desire to "innovate"; their business model instead relies on identifying innovators, buying them, and then selling the product of their research at high prices for as long as possible. Isn't that to a great degree how Silicon Valley works too? Google didn't develop Android, for example. It acquired Android, Inc. and then plugged it into the Google ecosystem. Such acquisitions are a fundamental pillar of R&D. They enable startups to do what they do best, and allow big companies to take over when it is time to try and bring a product to market.
breck 7y ago
We need to stop using the phrase IP. It’s an illogical euphemistic marketing term invented by the industry. More accurate phrases are intellectual monopoly laws or intellectual slavery laws. They have done horrible things for the drug industry. The root cause of the opioid crisis is patent law. You made 100x+ more money selling patented drugs, even if the patented drug is worse for the patient. We need to ditch these laws. Perhaps you could switch the system to where you get a bonus check for a novel patent; but we gotta ditch the monopoly rights aspect of these laws as they are horrible for 99% of the population.
- rhino369 7y ago
  All property is a monopoly. Is it slavery that I can't grow some crops on your lawn.
  - breck 7y ago
    No, because if you were to do that you preclude me from using my lawn. It is intellectual slavery that you are telling me I can’t copy your book that i bought from you on my lawn, even though you are not affected.
    - tathougies 7y ago
      You are allowed to copy other's books. You just can't derive a revenue from them.
      - breck 7y ago
        > You just can't derive a revenue from them. I wish this were the case, but you cannot distribute them either. I would love to collaborate with a team on an app that let's you instantly query all books ever published and revenue from that is the least of my concerns and it would be easy to do if we weren't forbidden from doing that by intellectual slavery laws.
        tathougies 7y ago
rhino369 7y ago
First mover advantage isn't worth much for generic drug manufacturing. The product is a commodity at that point. It wouldn't be worth much in tech either if you were allowed to clone a product 100%. Intellectual property even protects things that copyright and patents don't. Like you can't commit industrial espionage and steal the secret codebase of a SAAS company that keeps its software on its own servers. That's just as artificial as a patent. Even real estate property is artificial. You didn't make the land that your house is on. Why should you have a monopoly on it? Because someone government issued someone else a piece of paper 300 years before either one of us were born?

spullara 7y ago

We issue these monopolies because discovering new drugs and putting them through patient trials is expensive and actually manufacturing the drugs after you discover them is cheap. Not sure how you can solve the pricing problem without reducing innovation in the space.

Alex3917 7y ago

> But I do appreciate the fact that some market incentives (profits) exist to encourage greedy companies to come out with new drugs. I fear lower innovation in its absence. There were more new drugs released before Bayh-Dole. If anything, the fact that you can now make a lot of money creating new drugs is probably reducing innovation.

_edo 7y ago

Governmental regulations (safety, etc.) make the cost of developing a new drug extraordinary. Without exclusive patents on the back end companies won't have a reason to foot the bill on the front end. Even without regulations developing and testing a new drug wouldn't be economical if somebody else could steal your formula the moment you figure out that it works.

entee 7y ago
This dynamic already exists in diagnostics. There's a huge second mover advantage in diagnostics because it's relatively hard to patent a diagnostic effectively. I know a few people in diagnostic companies that have very much soured on the industry as a result.
brightball 7y ago
Yep. These realities exist in so many other industries too. Entire businesses are setup as fast followers.
breck 7y ago
It turns out that most of these new drugs have done more harm than good. See Purdue, for example. With very few exceptions, new drugs != better health. Our healthcare industry is a disaster and intellectual monopoly laws are a big reason why. We need to ditch those and focus on good outcomes, which does not mean focusing on giving vast rewards to some novelty regardless of efficacy.
- entee 7y ago
  Purdue's new delivery mechanisms were actually a huge benefit to the right patients. The problem is they abused it and actively sold the drug to the wrong patients repeatedly and worked hard to push back oversight.
  - breck 7y ago
    The problem was you could make unnatural "lottery-winnings" money selling OxyContin, and people respond to incentives. Ditch the incentives for selling novelties and the boring businesses focused on the actual health outcomes of the patient will thrive.
- _edo 7y ago
  If a new drug isn't useful it doesn't matter if the manufacturer has exclusive rights to it. If people are buying/being prescribed drugs that don't improve their health that's a different problem that won't be solved by changing intellectual property law.
  - breck 7y ago
    The problem is it does in practice. Almost all of the profitable drugs turn out to be useless (often harmful actually). I agree there is another problem here: medical science is laughable bad (and that’s a problem of tooling and poor data science tools, which I work on), as the combinatorics are much larger than our tools are currently capable of handling. But in the meantime, while people are still allowed to pitch junk science as fact, and medical decisions are based on junk science, the least we can do is stop rewarding monopoly profits to drugs with scant real evidence of support.

thaumaturgy 7y ago

> But I do appreciate the fact that some market incentives (profits) exist to encourage greedy companies to come out with new drugs. I fear lower innovation in its absence. I think of this as a "prayer to innovation", in the cargo-cultism sense. Like tax relief for the wealthy, the prayer goes that "if we can just give these people more money, they'll improve our lives". Multiple studies have found links between drug pricing and the development of new drugs, but it doesn't work in the obvious way. Large pharmaceutical companies often rely on purchasing smaller startups who do the actual research into developing new drugs [1] but don't have the expertise in bringing the new drug to market and making it successful. The larger pharma companies need financial capacity for this, but since the patents have expired on a lot of other successful drugs before the companies recovered the profits they wanted, they're relying on captive markets for the monopolies they still have in niche pharmaceuticals [2]. These companies are profit-motivated. They aren't working for the public interest. They have no particular desire to "innovate"; their business model instead relies on identifying innovators, buying them, and then selling the product of their research at high prices for as long as possible. Price controls for pharmaceuticals would ultimately reduce the funding available for the R&D startups, which would limit the creation of new drugs. But it's not clear that allowing big pharma companies to continue charging extortionate rates for life-saving medicines is a good solution to this, nor is it a guarantee for future innovation. It seems like single-payer insurance and more federal funding for pharmaceutical R&D would be a far better solution than defending predatory drug pricing. [1]: https://www.forbes.com/sites/stanfleming/2019/06/20/the-relationship-between-drug-prices-and-innovation/ https://www.forbes.com/sites/stanfleming/2019/06/20/the-rela... [2]: https://www.healthaffairs.org/do/10.1377/hblog20190228.636555/full/ https://www.healthaffairs.org/do/10.1377/hblog20190228.63655...

rayiner 7y ago
> They have no particular desire to "innovate"; their business model instead relies on identifying innovators, buying them, and then selling the product of their research at high prices for as long as possible. Isn't that to a great degree how Silicon Valley works too? Google didn't develop Android, for example. It acquired Android, Inc. and then plugged it into the Google ecosystem. Such acquisitions are a fundamental pillar of R&D. They enable startups to do what they do best, and allow big companies to take over when it is time to try and bring a product to market.

breck 7y ago

We need to stop using the phrase IP. It’s an illogical euphemistic marketing term invented by the industry. More accurate phrases are intellectual monopoly laws or intellectual slavery laws. They have done horrible things for the drug industry. The root cause of the opioid crisis is patent law. You made 100x+ more money selling patented drugs, even if the patented drug is worse for the patient. We need to ditch these laws. Perhaps you could switch the system to where you get a bonus check for a novel patent; but we gotta ditch the monopoly rights aspect of these laws as they are horrible for 99% of the population.

rhino369 7y ago
All property is a monopoly. Is it slavery that I can't grow some crops on your lawn.
- breck 7y ago
  No, because if you were to do that you preclude me from using my lawn. It is intellectual slavery that you are telling me I can’t copy your book that i bought from you on my lawn, even though you are not affected.
  - tathougies 7y ago
    You are allowed to copy other's books. You just can't derive a revenue from them.
    - breck 7y ago
      > You just can't derive a revenue from them. I wish this were the case, but you cannot distribute them either. I would love to collaborate with a team on an app that let's you instantly query all books ever published and revenue from that is the least of my concerns and it would be easy to do if we weren't forbidden from doing that by intellectual slavery laws.
      - tathougies 7y ago

rhino369 7y ago

First mover advantage isn't worth much for generic drug manufacturing. The product is a commodity at that point. It wouldn't be worth much in tech either if you were allowed to clone a product 100%. Intellectual property even protects things that copyright and patents don't. Like you can't commit industrial espionage and steal the secret codebase of a SAAS company that keeps its software on its own servers. That's just as artificial as a patent. Even real estate property is artificial. You didn't make the land that your house is on. Why should you have a monopoly on it? Because someone government issued someone else a piece of paper 300 years before either one of us were born?