> This is such a fucked up incentive structure [..]
It may well be(!), so let's assume you're right, what better incentive structure should we put in place instead?
Increase general taxation and use that to fund more pharamaceutical R&D?
It may well be(!), so let's assume you're right, what better incentive structure should we put in place instead?
Increase general taxation and use that to fund more pharamaceutical R&D?
For many politicians that would be seen as a "courageous decision" (hat-tip: Sir Humphrey Appleby)
> and let them only be at-cost (!) manufacturers
Won't it be hard to find investors if you do that?
> move all R&D off to universities
I think the "D" in "R&D" might be the problem in this approach. Universities are great at many things, including research, but based on my experiences (science PhD two decades ago in a research group which worked on anti-infectives) the scientists there aren't necessarily very good - or even actually interested - in development as such. We partnered fairly closely with $bigPharma at the time, and they funded a fair chunk of our work.
Better that than paying negative interest for German 20 year bonds, if you ask me.
> Universities are great at many things, including research, but based on my experiences (science PhD two decades ago in a research group which worked on anti-infectives) the scientists there aren't necessarily very good - or even actually interested - in development as such. We partnered fairly closely with $bigPharma at the time, and they funded a fair chunk of our work.
Agreed, universities have historically not been involved into the development part. But that is not a given dogma that can't be changed - the government could fund the establishment of development departments.
Alternatively, international governments could establish cooperative efforts to develop pharmaceutical compounds. Rare diseases and the decline of available reserve antibiotics are a global problem affecting every country on Earth just the same.
Development = taking a lot of candidate compounds and evaluating them in the classic three-stage procedure - phase 1: determine how the compound is processed in actual human bodies to check if it is actually safe to ingest and what side effects can already be observed (n ~ 20-80), phase 2: determine effective dosage (n ~ 100-500), phase 3: check effectivity in a double-blind trial (n ~ 1k-10k), as well as the fourth phase (after-license monitoring) [1][2].
The more a compound progresses, the more expensive the trials get to conduct, not just because the participants usually get some compensation for their risk, but also because all the data has to be tracked and processed. And a lot of candidate compounds fail somewhere along the path (either because they are ineffective or because the side effects are too severe), which makes the money invested effectively wasted (from a capitalist point of view, not from a scientific!).
[1]: https://en.wikipedia.org/wiki/Clinical_trial
[2]: https://studienteilnehmergesucht.de/ratgeber/die-vier-phasen...
At least one $bigPharma defines "research" as being everything up to and including the first proof of concept in a human [Phase I] trial. After that would be "development".
My grandmother had rheumatoid arthritis, and it made her life utterly miserable for her last 10 years. Recently, Enbrel was developed by a biotech for profit company, it is the first effective treatment for rheumatoid arthritis.
No university or government came up with it. A for profit company did.
Take the US military budget and give it to life saving research instead of life taking.
Edit: Also implement a wealth tax instead of income tax. Discourage hoarding of wealth and concentration of power in the hands of top 1%.
Not in % of gdp. The only metric that matters. The US economy is massive in size so of course the budget is a big number.
> one of which is china manages to defend itself with a tenth of the budget.
Everything is cheaper in China. You can do a lot more with one million there than in the US.
edit: BTW, is there any actual proof that this whole military budget dissuades Russia and China in any way?