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Your taxes already do pay for research - through NIH grants, tax breaks for pharmaceutical companies, and then after the drug is almost fully developed the government often gives the patent to an industry 'partner' to bring to market. A good example is AZT, the first ever anti-HIV medicine. The lion's share of the cost for developing AZT was paid by our tax dollars. Then Glaxo-Wellcome stepped in for the last bit and viola, they have an exclusive right to sell a life saving drug for whatever the market will bear.

From Physicians for a National Health Program's website: "15. Taxpayers pay for most research costs, and many clinical trials as well. In 2000, for example, industry spent 18% of its $13 billion for R&D on basic research, or $2.3 billion in gross costs (National Science Foundation 2003). All of that money was subsidized by taxpayers through deductions and tax credits. Taxpayers also paid for all $18 billion in NIH funds, as well as for R&D funds in the Department of Defense and other public budgets. Most of that money went for basic research to discover breakthrough drugs, and public money also supports more than 5000 clinical trials (Bassand, Martin, Ryden et al. 2002). Taxpayer contributions are similar in more recent years, only larger." http://www.pnhp.org/news/2004/february/will_lower_drug_pric.php

So they paid 2.3 billion (tax subsidized), and we kicked in 18 billion. Then they get to charge us for access to the drugs for which we paid 95% of the basic research costs.

Though you may say that PNHP is a bunch of hippies, so if you prefer a more grandfatherly source the AARP do a decent job too: http://www.aarp.org/bulletin/prescription/double_taxation.html

Of course that is the reason that while you may not trust the government, they could be a much better steward of medical research than market forces. Market based R&D is inherently morally corrupt. It can't be otherwise. If its not obvious because of the fact that more R&D is spent developing drugs to give octogenarians a hard-on and a full head of hair than to offer effective treatment for malaria that kills millions each year in the developing world, MSF gives a great summary of the reasons that market based R&D is wrong: http://www.accessmed-msf.org/main/medical-innovation/introduction-to-medical-innovation/what-is-wrong-with-r-d-today/

Though I do agree with you that at present I don't trust the government. Not that they do bad research... the NIH and the researchers they fund are amazing. But I don't trust the corrupt system that gives the breakthrough drugs that the government develops into the hands of private industry so that they can extort millions of Americans for the price that the 'market will bear' for drugs they may need to survive.

I don't buy it. There is no doubt that big pharma has not been as cooperative as they could have been in the past, but in the present, the biggest roadblock is not getting pills at a low marginal cost, it's the fact that many countries don't have the basic health infrastructure to manage the use of anti-retrovirals in real HIV treatment programs.

Brazil managed to wrangle deals on antiretroviral drugs by threatening complete patent revocation and compulsory licensing. They now have cheap antiretroviral drugs that the government makes available for free to everyone.

Read some articles like this. It seems like many people think sub-Saharan African countries could have access to cheap antitretrovirals through the programs drug companies run, or through compulsory licensing and big Indian generic companies.

The issue is a lack of political will and interest by governments in supporting these programs, and the lack of a modern health infrastructure to distribute, monitor and manage usage of these drugs (although even countries like South Africa that have a reasonable health infrastructure seem to not have the interest in pushing these programs through).

While I agree that the multinational drug companies were terrible about this, everything I see indicates that the roadblocks in place now to comprehensive HIV/AIDS treatment in the developing world are more nuanced than you suggest.

For example, in a recent press release they write:

The case of AIDS illustrates the trend. While fierce generic competition has helped prices for first-line AIDS drug regimen to fall by 99% from $10,000 to roughly $130 per patient per year since 2000, prices for second-line drugs - which patients need as resistance develops naturally - remain high due to increased patent barriers in key generics producing countries like India.

The standard argument for allowing the pharma companies to charge whatever they want for patented drugs, is that they spend the excess revenues on research for new drugs. But that is not true.

We can look at the numbers for Novartis, Pfizer or AstraZeneca.

They all spend around 15% of their revenues on research. The number is typical for the industry. The other 85% go to other things, according to their own figures. More than half their revenues are spent on marketing an profits.

So there are clearly better ways to finance drug research than to hand out patent monopolies to the big pharma companies, and hope that they will spend the money they make on research. Because clearly, they don't.

The Swedish Pirate Party has one proposal for an alternative system. Many others have suggested other alternatives.

But at least it is time for us to start discussing the problem in earnest. Today's situation is expensive, wasteful and completely immoral. There must be a better way.

Making the US healthcare industry and supporting industries a private, for profit enterprise was an epic disaster, particularly in the department of research and IP. Companies will only pursue solutions to medical problems they think they will be able to have exclusive control over, in order to ensure they can profit from them. PROFIT??? This is people's HEALTH we are talking about here! Profit shouldn't even be part of this discussion. It's about the people you are trying to help, period. End of discussion. Motivation problem solved. The only questions should be 1) what holds the best promise for helping people 2) how do we produce it safely and 3) how do we produce it inexpensively. National ownership and public right to all medical information should be an absolute no brainer. Don't give them the excuse of needing to make up research costs to have high prices. Fund all medical research Federally, and base it solely on potential healing merit and educational benefit. Peoples' health should not have a price tag on it - people are the only reason a society exists at all. That's like saying its not cost effective to evacuate poor people from a potential disaster area, since they aren't important to the economy and are easily replaced. (Note to the hysterical - that's an example of an argument as wrong on as many levels as I could make it wrong, not an actual argument I'm making.) We don't stand for that, and I don't think we should stand for medical research and production costs being dictated by profit potential analysis.

I have heard the arguments before that medical research moves faster because of the profit motive, but I don't believe it and would have to see hard evidence to believe it. Medical research is like anything else - individuals are motivated by a paycheck and perhaps the chances to help people/do interesting work. COMPANIES are motivated by profits, and I don't believe corporate thinking has been a net positive to the medical world in any sense. Quite the reverse, actually.

I don't know how I could sleep nights knowing I ran a company that had (for example) decided to pursue less promising but potentially profitable cures instead of building off of public domain but very promising work. As a human being it would haunt me.

Here are some examples of profit-motive-as-only-motive issues (I'm sure many more could be found in a few minutes):

http://news.yahoo.com/s/acs/20050928/hl_acs/resear ch_near_standstill_for_childhood_cancer_drugs
http://www.accessmed-msf.org/prod/publications.asp ?scntid=31720021644339&contenttype=PARA&

And now patenting genes. Great. In case there weren't enough issues out there slowing things up, we now add potential patent litigation as yet another reason not to pursue ideas. Because, thanks to the profit motive we know that barring enormous financial resources people will avoid these areas rather than risk having to fork out for patent licensing fees. What a messed up system. Personally I think the nation's system needs to be totally ripped out, all the way from the admistrative system to the drug companies, and redone with one and ONLY one focus - how can they help those who need it. Individuals working in the system can still be paid well - individual incentive is fine since it draws smart people, but the companies contribute nothing beneficial to the people needing help and should be cut out of the loop.

Let's look at the options here.

Collectively bargin with drug companies, or let the drug companies charge whatever they want. Either put a gun up to their head, or let them have the gun.

On-line pharmacies' 15 Billion dollars in sales this year tells me that there are a lot of americans who wouldn't mind having some ammunition against the drug companies for once.

As for the patent breaking, it's not being used as leverage(we had cheaper drugs long before that piece of legislation was introduced), it's specificlally to send drugs to developing nations which can't afford what drug companies have to offer. You could argue that they don't deserve medicine if they can't afford it, which is a completely legitimate arguement, just like me arguing that I HAD to shoot that hobo in the face, because he was just going to apply for welfare or leech off of productive members of society by begging anyway!

source

I don't think you understand how this works. If I, as a third-world country, want to make antibiotics, I don't have to wait for a native version of Alexander Fleming to spring up, and then start from scratch - I just have to read the literature thoughtfully provided by the real Alexander Fleming and his first-world successors. Nothing truly groundbreaking is going to stay secret for long, patent or not.

Having been a chemist for a major drug maker, I understand *exactly* how this works.

Yes, I can read the literature. Yes, this will give me ideas. *Every* *single* *one* of those ideas developed by industry (and lately academia as well) will be patented up the wazoo. Pretty much every commercially viable idea is these days. I now have three options

1. Pay $$$$ to use this idea
2. Wait until the patent runs out. (And unlike copyright, they do, despite many tricks used by companies to extend their life- look at what's happened with generic drugs after patent expiration)
3. Ignore the patent. If I'm in a first world state (US/Canada/Japan/Europe) I'm going to get squished like a bug under an army of patent lawyers. If I'm in Outer Elbownia and start using this idea to get around the high prices of stuff developed elsewhere, expect that nation to get a visit from the various trade representatives of the country holding the patent. You can get away with this a few times if you're big enough, but it's not going to endear you to anyone. (Unless, of course, you're the United States and badly need Cipro during an anthrax scare.)

Public funding is responsible for more R&D into AIDS than private corporations.

Monetary incentives brings out the greed in people. That's not a side of humanity that I would particularly want to nourish.

On a personal note, the sheer number of Slashdot posters that have reduced the very real AIDS problem into another version of "gubmit vs. freedom" is frightening to me. For the love of Jesus H. fuckin' Christ, people are dying, and we don't need rich uncle Pharm as a drain on resources. We can't fight a PANDEMIC half-heartedly. Nobody can.

I guess I shouldn't be suprised, this sort of shit is not new; adolescent-minded White people have always had a reason for their abominations. Read your history.

British Medical Journal 2000;321:833, Letter from Michael Schull, president, MSF-Canada

EDITOR: Do drug patents kill? If they do the risk is felt overwhelmingly by the poor. AIDS will soon become the leading cause of death worldwide, and 95% of people infected with HIV worldwide live in the world's poorest countries. Effective treatments are mostly patent protected, with the result that the annual cost to treat a single patient with AIDS is up to 100 times the average gross domestic product per capita in developing countries.1

These staggering facts have led to a campaign to increase access to essential AIDS medicines in poorer countries, including a loosening of patent protections on medicines.2

Opposition comes mainly from pharmaceutical companies, which argue that without patent protection profits will dry up, eliminating the incentive to conduct research into new drugs. But who really pays for AIDS research? The reality is that taxpayers, not shareholders, have borne most of the cost. Publicly funded research councils have contributed hundreds of millions of taxpayers' dollars to AIDS drug research. Indeed, the Pharmaceutical Research and Manufacturers of America, an industry lobby group, estimates that private industry finances only about 43% of drug development.1 Five commonly used drugs against AIDS -- didanosine, lamivudine, nevirapine, stavudine, and zidovudine -- were developed largely as a result of public funds.