Hacker News Reader

Comment by gumby | Hacker News Reader

This is good fodder for a case that a public utility should produce these drugs. Of course that would freak various interests out so won't happen, at least in the US or EU.

A hybrid approach in the US has been fairly useful for orphan indications and, somewhat differently for vaccines, but of course jerks found ways to exploit that too. Still it points to a possibility.

But I favor a single utility making some small-molecule and biologic underserved drugs because of the economy of scale it could bring. A small NIH facility in some otherwise underserved part of the country could make a big difference at a relatively low cost.

View on HN

Why are these drugs underserved though? If, as another commenter suggested, the core reason for the shortages is because the government is such a large purchaser and they're keeping prices too low to encourage investment in new supply, wouldn't it make more sense to just pay a bit more to create some oversupply to cope with shocks to the system and long-term growth?

If this was a viable model, I strongly suspect you would've already seen this happen in one of the many countries with socialized health care. I suspect you're assessment of the approach as "relatively low cost" is faulty. Biologic production is extremely difficult and expensive.

Biologic production is extremely difficult and expensive

It's not that bad. Brewers developed the knowledge how to work with microorganisms centuries ago. Most antibiotics are biologics, and they are dirt-cheap. Insulin isn't monoclonal antibodies, it's grown in bacteria, in the simplest expression system, and how to isolate it from the fermentation batch is well-understood and involves no problematic steps.

It's true that my work experience with manufacturing and approval is with small-molecule pharma, but as insulin was one of the very first biologic drugs and is one of the simpler ones to produce, I suspect this is reasonable.

I agree that France or Brazil are better candidates for this approach.

My prediction is that this will happen. Not necessarily in the US, though, more in China, India and Brazil.

It is absolutely mind-boggling that you're being downvoted for saying this.

There are some things that should not be subject to capitalism

You can't build better medical helicopters by saying "there are some things that should not be subject to gravity."

You posted this comment using a network whose fundamental tech was developed in a government project. You posted it using a device descended from an original which was built as part of a government project, based on theories developed with no immediate profit motive.

Would you like to re-think whether it's possible to invent and develop important new things without immediate profit motive?

Government funding happens within an economy subject to market forces. DARPA, in particular, had an intimate cooperation with for-profit companies. BBN and RAND were instrumental to creation of the Internet. BBN won the contract to actually build ARPANet. Bob Kahn and Vint Cerf both went through the “revolving doors” between government and industry. Kahn was involved in the implementation of ARPANet at BBN, and then went to work for DARPA in 1973. Cerf was a program manager at DARPA then went to go work for MCI in 1972.

Government funding isn’t an alternative to the market; it’s a different kind of market partipant. Government funding competes with private investment, and government agencies compete with the private sector for talant, etc.

Reply on news.ycombinator.com