Good luck with the ambulance chasing lawyers in the US. Also, India's drugs are cheaper.
If every country adopts that policy, which is the direction things are headed because it's the dominant strategy, the rate of medical advancement will be much lower. To quantify, about 58% of US medical funding is provided by private industry. Pharmaceuticals alone spend more than the NIH. NIH in the US spends 29 times more than NHS in the UK on health research, despite having only 6 times more people. The US spends 4 times more per capita than Australia on medical research. This is one of the two gigantic elephants in the healthcare debate auditorium, the other being patient outcomes for comparable patients. Of course US aggregate data is skewed because of the general health of the population (fatness), and those without insurance, but what happens when comparing patient outcomes between people with insurance in the US, with people that are comparably healthy (i.e. fatness and related issues) in other countries. The whole thing is basically a health-and-wealth transfer scheme from the insured to the uninsured.
We see basically the same thing whenever space research is discussed. Pompous Europeans bash US progress and "meager space funding", while the US outspends the entire world combined over 3 to 1 on space research. In the end, the "solution" to both is to cut spending to both medical and space research to global per-capita levels, and let the advanced research go undone, unless other countries choose to start contributing. Of course, that would be a true tragedy of the commons.
What's the use of medical advancement that can't help more than 10% of humanity?
It's far more important that we move to a world in which all human beings have access to basic sanitation and healthcare than it is to spend billions of dollars attacking statistically rare diseases producing medicines that will help only a few rich people.
In fact, I'd go one step further and argue that your statement is actually false in the long term. A world where all humans have access to good healthcare and education would actually be a world in which more people contribute to research and development of new drugs and one in which knowledge would advance faster.
When the patent expires everybody benefits. Until then, it's available to everyone, but they must help pay for the drugs development. If nobody pays, the drug isn't developed, and nobody gets any benefit.
It's far more important that we move to a world in which all human beings have access to basic sanitation and healthcare than it is to spend billions of dollars attacking statistically rare diseases producing medicines that will help only a few rich people.
Would you die for that? You expect others to, no? That's kind of totalitarian. At the same time, this argument is fallacious in the sense that it assumes we should address no problem until the lowest level problem is solved for everyone. That's undesirable for a large number of obvious reasons I will not bother enumerating.
Do the "few rich people" that are helped not end up paying for the R&D of the treatment for everyone else in perpetuity?
In fact, I'd go one step further and argue that your statement is actually false in the long term. A world where all humans have access to good healthcare and education would actually be a world in which more people contribute to research and development of new drugs and one in which knowledge would advance faster.
That's a nice thought. Unfortunately, there is a huge advantage to not paying development costs, in that you can externalize them to others and reap the benefits, which is what many countries, including India and the UK, have chosen to do. In India it's ignoring the patent, in the UK it's setting a price ceiling, which effectively shifts the burden to the US since the profit maximizing strategy is still to sell the drug in the UK because marginal revenue exceeds marginal cost. If the US stops paying, the drug never gets produced, or gets produced much later because there is no private incentive to produce.
All I said was that your hypothesis of a slower rate of medical advancement in the short term might be acceptable if it ensures that (a) more people have access to critical drugs and (b) more human beings have access to basic necessities of life that are taken for granted in most of the western world. Might be good if you respond to this claim instead of setting up a whole bunch of poorly thought out strawmen.
When the patent expires everybody benefits.
You do realize that drug patents are full legal in India, don't you? And the only thing that isn't allowed anymore is evergreening, which is of dubious benefit to society anyway. Further, India has issued exactly ONE compulsory licence (for an expensive cancer drug) ever. There is no evidence for your initial claim that India ignores patents.
I'm now going to ignore the strawman you've put about totalitarianism but I will make one remark about this statement.
Do the "few rich people" that are helped not end up paying for the R&D of the treatment for everyone else in perpetuity?
What is wrong with this? Don't we all benefit from inventions and ideas of many other humans, most of whom aren't rewarded financially from our successes?
If the US stops paying, the drug never gets produced, or gets produced much later because there is no private incentive to produce.
I would like to see citations on your claim that private capital (i.e., not money from the NIH, HHMI etc.) is responsible for the high rate of drug discovery in the US.
A drug under patent might be accessible to 10% of the population now, but considering the number of people who will be able to access it in the future the total percentage looks very different. 50 years from now, long after the drug has gone generic, what percentage of the population who lived over that time would have had access? It would be far more than 50%.
Except for when the company makes a tiny modification to the drug that doesn't change its effectiveness and files for a renewed patent, like in the Novartis suit that India's Supreme Court recently (and rightfully) rejected.
Their actions seem to suggest that they do believe the modification increases the drugs effectiveness, but they don't want to pay for any of the R&D behind that.
http://www.rsc.org/chemistryworld/2013/01/india-supreme-cour... http://healthcare.blogs.ihs.com/2012/11/26/clinical-trial-co... http://www.ahrp.org/cms/content/view/898/84/
Edit: No need for downvoting. This behaviour even has a Wikipedia article. I am ashamed living on a planet where such things occur.
The story has more to do with suing someone for the personal injury that landed the patient in the hospital in the first place, but it's meant to refer to lawyers going out of their way to recruit clients who might not have even wanted to file suit in the first place, or to unethical, enterprising lawyers in general.
The Indian supreme court recently rejected Novartis' patent on Glivec, because the formulation wasn't different enough to merit a new patent (I don't know enough to know whether that was the right decision; just pointing out that the patent situation is different). The Indian government also has pricing restrictions on ~350 drugs deemed "essential".
On top of this, compared to the US, there's little to no drug marketing in India (yet). Plus lower labor/capital costs, etc.
It's just that it doesn't grant a patent on A because the patent of C expired and the company decided to call it A or if rejected then applied again by calling it B.
jm2c.