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The FDA approves ~40 drugs a year. If you want 40 new drugs a year, it unfortunately will cost somebody something to coordinate the large number of professional

by peytn 6y ago

The FDA approves ~40 drugs a year. If you want 40 new drugs a year, it unfortunately will cost somebody something to coordinate the large number of professionals over many years required by a modern development effort. Few drugs have been developed successfully on good intentions. I find excitement in the fact that we have found a way to get new treatments and cures. Other systems have been tried that weren’t so successful at pumping out new tech.

m12k 6y ago
Could you elaborate a bit about which other systems have been tried, that weren't as successful?
- peytn 6y ago
  I’m not familiar and it’s a complex topic. My knowledge comes from following the reforms in China and picking up bits and pieces of history. The overarching impression I’ve gotten is that a lot of ideas you can think of have been tried before in some capacity. The USSR had a Ministry of Medical Industry and I think Japan might have gone with a bounty model? You can probably find more info. Where everything falls over is that it’s just such a long journey from point A to B, where A is “a chemist has found something” and B is “an entire patient population is taking the drug.” There are a lot more steps than you’d think, and any alternative system needs to do well at each step due to the wildly varying incentives between participants. As a toy thought experiment not based on real-world events, suppose the government has just paid a $500 million bounty for new Drug X that otherwise wouldn’t have been developed. The government now owns Drug X. Okay, great. But doctors aren’t prescribing it. So the government creates a Ministry for Doctor Education that tells clinicians what to prescribe. But the Ministry for Doctor Education develops its own goals and forgets that it’s supposed to help out the pharma bounty program in marketing new drugs. In the meantime, the government is outbid in manufacturing Drug X, and its contracted manufacturers are exporting Drug X overseas, so the government nationalizes the manufacturers. But then the manufacturers forget that they’re supposed to work on novel drugs and decide only to take on low-risk work. Etc. etc. It just empirically works to have a tech transfer model where a set of entities gets rich by taking a drug on the entire journey into the bodies of thousands/millions of patients.

by peytn 6y ago

m12k 6y ago

Could you elaborate a bit about which other systems have been tried, that weren't as successful?

peytn 6y ago
I’m not familiar and it’s a complex topic. My knowledge comes from following the reforms in China and picking up bits and pieces of history. The overarching impression I’ve gotten is that a lot of ideas you can think of have been tried before in some capacity. The USSR had a Ministry of Medical Industry and I think Japan might have gone with a bounty model? You can probably find more info. Where everything falls over is that it’s just such a long journey from point A to B, where A is “a chemist has found something” and B is “an entire patient population is taking the drug.” There are a lot more steps than you’d think, and any alternative system needs to do well at each step due to the wildly varying incentives between participants. As a toy thought experiment not based on real-world events, suppose the government has just paid a $500 million bounty for new Drug X that otherwise wouldn’t have been developed. The government now owns Drug X. Okay, great. But doctors aren’t prescribing it. So the government creates a Ministry for Doctor Education that tells clinicians what to prescribe. But the Ministry for Doctor Education develops its own goals and forgets that it’s supposed to help out the pharma bounty program in marketing new drugs. In the meantime, the government is outbid in manufacturing Drug X, and its contracted manufacturers are exporting Drug X overseas, so the government nationalizes the manufacturers. But then the manufacturers forget that they’re supposed to work on novel drugs and decide only to take on low-risk work. Etc. etc. It just empirically works to have a tech transfer model where a set of entities gets rich by taking a drug on the entire journey into the bodies of thousands/millions of patients.