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Comment by amyjess | Hacker News Reader

Ideally, the government should just straight-up pay companies to do drug discovery using something similar to cost-plus defense contracts (and establish DCAA-style auditing practices to keep them honest).

Establish strict price controls, ban drug patents, and make production volume guarantees a hard condition of receiving federal drug discovery money. And the money should be large enough to be worth it. Ideally, 90%+ of a drug company's income should be from federal contracts and not from sales.

And if that turns out to not be feasible, just nationalize them. The federal government can hire drug-discovery chemists and manufacture the drugs themselves.

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That's a very left-wing view of things - I don't necessarily disagree with it, but I think there are far less drastic changes that can be made to achieve a comparable result.

You'll have a hard time selling a plan like that to anyone even slightly right leaning - think about it politically for a second. The government decides what drug development gets priority? Remember the death panels talk from a few years ago?

It's viable, but involves a lot of trust in government, so much that even as a fairly left-leaning person myself I'd have to think twice about it.

We're already well down that road via NIH and DOD funding decisions.

I agree that trusting the government is out of the question, perhaps we could try an open source solution. Publish drug data, studies, manufacturing knowledge, and all of the usual pages of warnings, indications, contraindications, pharmacokinetics, etc. GitDrugs.org? I think India might have the right strategy with prioritizing human need over economic factors, at least in the short term. I think the problem with funding is a multidisciplinary one, unrelated to how much they can charge for the product. If we can figure out how to match problems->researchers->funding efficiently and effectively, finding drugs and researching existing ones won't be a problem.

It depends if you think it would stop other funding of drug development.

> The government decides what drug development gets priority?

This might become necessary if we're to avoid an antibiotic crisis. Bacteria are becoming resistant to antibiotics at a greater rate than antibiotics are being developed. The problem isn't that we've tapped out what antibiotics can do, but rather that drug companies have little to no interest in developing antibiotics because there's very little money in it. Antibiotics are un-sexy drugs that don't make for good marketing campaigns.

Ultimately, if we want to continue to have effective antibiotics, a large entity with no profit motive, nigh infinite money, and a monopoly on force (i.e. the government) will have to get involved.

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