EE / CS double BS degree here.
0 medical patents though.
I'm not saying you should recieve no reward. I'm also saying you should not recieve unlimited reward for it. ESPECIALLY for something that is not really new nor innovative.
No one is receiving an unlimited reward. They are receiving some finite amount of money based on what the procedure is worth to the person having the procedure (or their insurance provider). No one is holding a gun to the patient's head, nor to the head of the insurance provider, making them get the procedure with one device or the other. They can choose to have the procedure or not to have the procedure. The fact that almost no one will decline the procedure due to cost indicates to me that this device is worth every penny. Who are you to set an arbitrary limit on what the device is worth?
The FIRST generation of devices, be they pacemakers or MRI or whatever, should fairly be pretty expensive, as they need to cover experimental R&D on something they didn't know would work. And manufacturing costs will likely be high as it's a first cut, and needs to be way-over-engineered to make sure that it works correctly and therefore remains on the market.
But 5-6-7 generations down the line, there hasn't been much new "true innovation", only evolution on the original innovation, and the initial R&D should be covered many times over. The R&D is no longer experimental, as the general principle is known to work, it's now only validating that specific minor differences in the model work as expected. Costs should also have gone down by this point as technology and manufacturing techniques have likely advanced.
How do you know? How much do you know about pacemakers? Obviously not much. You're also obviously not a researcher, or you would know what the R in R&D stands for: research. In this case, the D costs are probably the lion's share of R&D expenditures, simply because of all of the regulatory testing and validation that must take place with every change to the device design. Either way, the company has to pay for it before it is legally allowed to sell you a product, so it has to hire people who are qualified to do this sort of thing, pay for the government oversight, and everything else involved. This slows down the development process considerably and makes it very expensive. Again, how can you arbitrarily say costs should have gone down? If it's so simple to produce these things at low cost, despite getting FDA approval and all of the other hoops the company must jump through, then start your own company and do it. You're nothing but an armchair quarterback throwing out idle commentary at this point. If the company can keep its costs down while meeting all of these requirements, then it will make a higher profit than its competitors. If its costs rise due to technical issues, as in the case of Medtronic apparently, then this will necessarily impact their profit margin. Either way, the company should make as much money as it can while meeting all of the safety and performance standards of the device, and you have no basis to tell them that they shouldn't.
Over time, the price paid by the end-user for manufactured devices should trend downwards toward cost of manufacturing, and exactly the opposite is happening. Can you explain that?
Yes, easily. Manufacturing isn't the primary cost of the device: meeting regulatory standards is. The costs associated with this keep rising. Therefore, the costs of the devices will rise accordingly.
Also, more generally, Assumption is the mother of all fuckups, and everyone should avoid making assumptions about anything.
If no one made assumptions about anything, then no engineering problem would ever be solved. I make assumptions based on my analysis of the situation, experience, and deductions. In this case, it is difficult for me to understand how someone who claims to be an engineer thinks that his own income should be arbitrarily limited based on the whim of someone in another industry. Or do you only apply this logic to those working in other industries, while you think your own income should be unlimited by arbitrary standards?
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