http://www.theatlantic.com/doc/201002u/drug-development
There's a pretty simple idea. We accumulate our knowledge of drugs, and apply our best knowledge for treatment, while coming up with some system for researching new, better drugs, gradually improving care.
That's how we'd like to think it works.
Pieces of the system make sense. For example, companies who spendto research new drugs are rewarded patents for them to profit for a period of time to recoup their investment; balanced by this being temporary so eventually, the drug becomes public domain, allowing for inexpensive production in a competitive market of generics.
So far, so good.
But the law of unintended consequences plays a big role. For example, as the article above notes, drugs long since public domain don't make much profit for drug sellers - while they are compelled to make big bucks on the drugs they have patent protection for. And so the healthcare is skewed for the commercial, as money pushes the choices in drugs to change to meet the needs of wealth rather than healthcare.
A drug company might have a patent on drug 1, and drug 2 might be in the public domain. Each might cost $1 - but drug 1 can be sold for $100, $20, $5 - some big markup in big profit since there is no competition, the sky the limit as far as marketig to create demand for the drug can take the price, because no one else can sell it, compete, and lower the price. Meanwhile, drug 2 might get the manufacturer $1.25, and retail for $2.50 on the market, makin gvery little profit.
And so in this system, there can be enormous pressure - based on profit - for the drug companies to get drug 1 used - and that may well mean instead of drug 2 even if drug 2 is better.
In a perfect world, drug 2 would get full use for the good of the patient - but when, when there are such huge economic distortions to incent the wrong choice, has the perfect world not had corruption?
"Ask your doctor about" is one way. With huge marketing budgets, drug companies can build demand directly among the public to 'ask their doctor', who typically have competitive pressure not to say no to their patients too much where they're allowed to say yes, and the use of the drug increases. Everyone's happy - the patient has his manufactured desire met, the doctor has his patient, and the drug company gets more sales.
Now, the government would be a natural for regulating this issue - in finding ways to ensure the real medical needs of the nation are met withyout the bias of profit. So who is spending big bucks to sell the public an ideology against the government playing a role, for 'small government', that 'government is incompetent'? Big Pharma was Republicans' #1 donor the election before the Republicans passed Medicare Part D.
THey give heavily to Democrats as well.
Indeed, under the Republicans, regulatory agencies, typically run by former industry lobbyists, were told to view the companies they regulated as the companies they served the needs of. Saying no was discouraged; negative regulation because overruled on appeal; rules became optional guidelines. None of which served the public, all of which served the industry, who had paid for it, with money for slick ads to persuade the public that that guy claimed he invented the internet so don't vote for him.
What does work? 'Good government', with neutral experts who serve the public interest regulating the industries in ways that work for everyone, and cut out the corruption of policy by profit motives.
There's a pretty simple idea. We accumulate our knowledge of drugs, and apply our best knowledge for treatment, while coming up with some system for researching new, better drugs, gradually improving care.
That's how we'd like to think it works.
Pieces of the system make sense. For example, companies who spendto research new drugs are rewarded patents for them to profit for a period of time to recoup their investment; balanced by this being temporary so eventually, the drug becomes public domain, allowing for inexpensive production in a competitive market of generics.
So far, so good.
But the law of unintended consequences plays a big role. For example, as the article above notes, drugs long since public domain don't make much profit for drug sellers - while they are compelled to make big bucks on the drugs they have patent protection for. And so the healthcare is skewed for the commercial, as money pushes the choices in drugs to change to meet the needs of wealth rather than healthcare.
A drug company might have a patent on drug 1, and drug 2 might be in the public domain. Each might cost $1 - but drug 1 can be sold for $100, $20, $5 - some big markup in big profit since there is no competition, the sky the limit as far as marketig to create demand for the drug can take the price, because no one else can sell it, compete, and lower the price. Meanwhile, drug 2 might get the manufacturer $1.25, and retail for $2.50 on the market, makin gvery little profit.
And so in this system, there can be enormous pressure - based on profit - for the drug companies to get drug 1 used - and that may well mean instead of drug 2 even if drug 2 is better.
In a perfect world, drug 2 would get full use for the good of the patient - but when, when there are such huge economic distortions to incent the wrong choice, has the perfect world not had corruption?
"Ask your doctor about" is one way. With huge marketing budgets, drug companies can build demand directly among the public to 'ask their doctor', who typically have competitive pressure not to say no to their patients too much where they're allowed to say yes, and the use of the drug increases. Everyone's happy - the patient has his manufactured desire met, the doctor has his patient, and the drug company gets more sales.
Now, the government would be a natural for regulating this issue - in finding ways to ensure the real medical needs of the nation are met withyout the bias of profit. So who is spending big bucks to sell the public an ideology against the government playing a role, for 'small government', that 'government is incompetent'? Big Pharma was Republicans' #1 donor the election before the Republicans passed Medicare Part D.
THey give heavily to Democrats as well.
Indeed, under the Republicans, regulatory agencies, typically run by former industry lobbyists, were told to view the companies they regulated as the companies they served the needs of. Saying no was discouraged; negative regulation because overruled on appeal; rules became optional guidelines. None of which served the public, all of which served the industry, who had paid for it, with money for slick ads to persuade the public that that guy claimed he invented the internet so don't vote for him.
What does work? 'Good government', with neutral experts who serve the public interest regulating the industries in ways that work for everyone, and cut out the corruption of policy by profit motives.
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