so, the fear is that, if we try negotiating, then the pharma companies are going to negotiate themselves out of business ? if they're that stupid, they don't deserve to be in business.

Can Pelosi add to her legislative agenda some sort of law that bars TNR from commenting on anything that happens outside of the US border?

Kevin,

Nothing is more important than Iraq! I've tried to forgive the misguided HAWKS (spit) who wanted this war of choice, but every time I read articles like this my anger at you and your ilk flares anew. You were dead wrong, Kevin.

You ruined a country; you’ve set generations of people against each other because you wanted vengeance. I know you've apologized and you've got your excuses (misled, bad execution, etc.) but that and a shovel have helped you bury a generation.

I can never forgive you HAWKS (spit) who wanted this war.

So you mean the Democrats really are FOR big government spending programs??

actually, nitwit, they're trying to reduce the cost of the plan the Republicans created.

Or, bringing up Articles of Impeachment when they said that was off the table ; )

cleek nailed in on the first post.

Besides, these guys spend more on advertising than they do on R&D, so what exactly is their beef?

and Reid's got some good ideas, too... like, criminalizing deceptive robocalls and misleading campaign literature.

goodbye GOP.

No, no, Kevin! Just as a rise in the minimum wage will increase unemployment, a loss of profits will prevent big pharma from finding a cure for dandruff. This is so because conservatives say it's so.

As for Down goes Frazier:

Disgruntled, are we? Well, maybe you should try winning some elections.

I must admit that I find the argument, that pharmaceutical companies really don't do the important research, hard to reconcile with the notion that government must buy pharma's products for people. In other words, if what pharma R&D does is really so unimportant, then why all the fuss over the prices they charge? Just don't buy the products.

Haven't read the linked article yet, but I went through this in exhausting detail with Sebastian at Obsidian Wings about 6 months ago, and it's just another zombie argument.

It's true that a lot of the high-risk work is done with taxpayer dollars -- that was, after all, the idea when Vannevar Bush proposed, and the government adopted, the whole government-academia partnership thing way back in 1947 -- but a lot of the EXPENSIVE work is done by the pharmacos. That basically includes all the late-phase clinical testing, which is (or should be) much lower-risk from the point of view of the potential drug, but is very expensive because it's being done on large numbers of human beings, so that sufficient data can be collected to be reasonably sure that the drug should be licensed for sale. For a typical drug, that process costs on the order of, say, one to three hundred million dollars, oh yes, and that's serious money.

But of course, a successful drug makes that money and much more back again, so it's a good business risk.

And importantly -- and here's the kicker -- the pharmacos spend that much or more MARKETING the drug once it's licensed. That is, a big part of the money that the pharmacos claim they need for "basic research" they actually spend on TV and magazine ads that show people running through fields of flowers, or flying kites, or flying kites in fields of flowers. That type of spending has ballooned extravagantly in recent years, and it's part of the reason pharmacos are in financial trouble.

So ... no terrible tears for cutting the poor dears' profit margins. They'll just have to cut back on the TV ads (and the doctors' "conferences" in places like Maui and Aruba). But they won't go out of business. There's still too much money to be made.

Just don't buy the products

the research we pay for often leads to medicines they patent, thus bottling-up that research. if a good drug comes out of research we paid for, but we don't buy it from the only company legally allowed to make it... nobody benefits.

bleh,

Why, do you suppose, any company spends on marketing? Why not just book the entire costs to profits and be done with it?

cleek,

Then you would agree that the R&D the pharmas do really is important, just as important as the government supported research.

However, even with this position, it is still possible not to buy the products until they come off patent. Almost every drug under patent today will be generic within ten years. Another option is to simply buy out the rights to drugs under patent, if it is deemed important enough. Believe me, pharmas are perfectly willing to sell the rights-all it takes is negotiation.

Kevin's trying to play "Bad Cop, Good Cop" with The New Republic all by himself today.

"The most important basic medical and scientific research that leads to major medical breakthroughs usually takes place under government auspices — typically, through grants from the National Institutes of Health."

This pretty much shows zero understanding about the path from 'discovery' to 'treatment'. The most important basic medical and scientific research that leads to major medical breakthroughs tends to get you sort of close to a first step toward getting a remedy. For instance when an NIH doctor discovers a "chemical pathway" of the sort that gets hyped in Newsweek, we aren't anywhere near a therapy. The ratio of promising pathways or targets at the NIH level that get absolutely nowhere at the clinical level is (and I'm not exaggerating at all) 1:1000. The path from the kind of discovery that Cohn writes about to actual therapy involves quite probably dozens of failed start up pharma companies, and hundreds of failed trials. All paid for by the drugs that do make it through the pipeline.

I know I say this every time the issue comes up, but please read Derek Lowe on the subject. I specifically reccomend going to his right-hand sidebar and clicking on:

Me Too Drugs
Academia vs. Industry
Drug Prices
Who Discovers and Why
and if you have lots of time:

Drug Development
Patents and IP

You will find that he is not a reflexive defender of the pharma industry (he sees its warts and identifies them--see especially the Claritin/Clarinex issue) and that he is respectful of government research, but you won't find him agreeing with the silly NIH primacy stuff that Cohen and Angell are spreading around.

From a "Church of the Invisible Hand" standpoint, it's a totally bogus argument that "removing drug company's ability to profit will destroy drug R&D".

This is because the Government already meddles in the Free Market by providing a monopoly in the form of a drug patent. In fact - large pharmaceutical companies have been major players in the extensions of copyright from the original Constitutional definition of "a limited time" (7 years) to all the ridiculous extensions and special stipulations copyright and patent law has today.

There's also the argument to be made, that if a company is sucking off the government teat (ie. a government-sanctioned Monopoly), they have no incentive to compete with other companies (in terms of R&D for new products, or expanding capacity). And in the long run, this makes these companies LESS healthy, less competitive, and ripe for takeover by foreign interests.

In any case - you can't make a "Free Market" argument because there is no such thing anymore. The government has already intervened.

If you want a cure for cancer, fund the NIH. If you want a 6 hour boner, fund Big Pharma. Hmmm, maybe that's not going to help the argument...

Believe me, pharmas are perfectly willing to sell the rights-all it takes is negotiation.
Posted by: Yancey Ward on November 16, 2006 at 6:08 PM | PERMALINK

The government can take away my driver's license if I abuse my driving privileges by driving recklessly.

Why doesn't the government ever revoke a patent?

And here's a little secret for y'all.

Rummy's "resignation" didn't have a damn thing at all to do with the election.

It had to do with the FACT that he was supposed to go to Germany this week - and Germany has recorded a suit filed against Rummy for war crimes.

Would it not have been pretty embarrassing if our SecDef had to cancel a meeting because we were afraid he'd be jailed?

That's why Bush fired Rummy. Had nothing to do with the election. Or even the job he's been doing.

I must admit that I find the argument, that pharmaceutical companies really don't do the important research, hard to reconcile with the notion that government must buy pharma's products for people. In other words, if what pharma R&D does is really so unimportant, then why all the fuss over the prices they charge? Just don't buy the products.

Apparently Yancy believes that R&D is synonymous with production. It's this kind of muddled thinking that we voted out of power on Nov 7th.

The federal government spends $27 billion a year buying research services from major medical drug and device vendors.

How do these contracts work? Are they open bidding? Do the taxpayers keep a portion of the royalties?

And if we let oil companies form cartels then their profits will go up which would allow for us to pretend there was more oil in the ground. Gotta give those dinosaurs better incentives!

Disputo,

Are you saying that the production can proceed without the R&D? Or are you one of the idiots that believes most drugs are discovered in university laboratories?

If you answer yes to either question, then it is unfortunate that you weren't up for election last week.

Impeach...etal,

Sure, government can revoke patents if it wishes-no more problem in prices for drugs. Unfortunately, if you want new drugs, the government will then have to foot the entire research bill. I am sure many here think government could do it better anyway, so that should be no obstacle.

LMAO @ Yancy trying to walk back from his/her ridiculous comment equating R&D and Production by setting up ridiculous strawmen.

You're funny.

I am not asking these questions for snark. If someone has a way that these can be answered please respond.

What about the costs involved in testing? University research may lead to some promising new cures, but who is going to pay for the double blind studies needed. Will this also be taken out of the federal budget.

Who will the people sue when the next Universtiy derived VIOXX causes a heart attack?

If everyone starts negotiating prices, someone is going to have to pick up the slack somewhere.

Our policy should be to buy the drugs at the same price that other industrialized countries pay for the same drugs. That way, drug prices in Canada/Europe/Japan/Australia will rise, and ours will be lower. We'll still be paying monopoly prices for patented drugs (so the drug companies will still be making a good profit), but we won't be providing a subsidy for the rest of th world's American drug habit. And we'll get to listen to Europeans whine about how we're screwing them over. It'll be awesome.

Sure, government can revoke patents if it wishes-no more problem in prices for drugs. Unfortunately, if you want new drugs, the government will then have to foot the entire research bill.

This overstates the case; patents, of course, increase the barriers to entry and reduce competition, and therefore increase the potential payoff for research, OTOH, because someone who beats you may seal off whole broad areas of application, it also increases the risk of investments in basic research, which is why big companies generally don't do much basic research, they work very hard to comb through the basic research done publicly and find something that shows some promise of being quickly converted into some proprietary commercializable technology. Or, often, keep an eye out for small firms that do a good job of doing that, and buy them up when they seem about to strike gold.

Let's just remember that drug companies are looking out for us. God bless these saints who work so hard to sure our diseases out of the goodness of their hearts. I dare anyone to look into the eyes of Pfizer and not see a kind, caring sould staring back at you.

Give them all the money they need, their hearts are pure!

If the democrats use their majority to bully through a prescription drug bill, then within 10 years our country's standard of living will be reduced to Canada's.

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The most important basic medical and scientific research that leads to major medical breakthroughs usually takes place under government auspices — typically, through grants from the National Institutes of Health. In other words, taxpayers — not drug companies — are the ones financing the most important drug research today.

This indicates a fundemental misunderstanding of how new drugs are developed. While it's true that much of the biological research that uncovers the causes of disease is done under government auspices, virtually no development of new chemicals (some tiny fraction of which become drugs) is done in the academia.

Just because we've discovered the gene which causes breast cancer doesn't mean that we have a molecule which can, without horribly adverse side-effects, cure the disease. Going from a known and validated target gene (or more typically pathway, but people seem to understand "gene" better), to a safe, effective molecule is a very big step, and one which is several orders of magnitude more expensive than identifying the gene in the first place. This is what pharmaceutical companies do, and academia doesn't--in any capacity. You can see here, here , or particularly here for more details on this.

The fact is that if drug companies do indeed start making less money, they will devote less money to developing and testing new molecules, and development of new drugs will be slowed.

However, the drugs which have already been developed will be more readily available. This may very well be a good trade off (I think it is), but we should be clear that it is indeed a trade off.

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The fact is that if drug companies do indeed start making less money, they will devote less money to developing and testing new molecules, and development of new drugs will be slowed.

Hard to say what each company will do. With less capital to work with they may decide to scale back R&D, but they may try to implement other cost-savings. For instance, are their supply chains fully optimized? Can their production sites be moved to cheaper labor markets? Would they cut back on advertising? Finally, they might be able to gain efficiencies in their R&D programs by being more careful about what they fund, while still bringing as many products to market as they did before.

In business, it's often beneficial to put a little pressure on the system to see what creative ways the organization can find to compensate with. No business I have ever worked in made the hard choices without a little external pressure.

Okay, this is how new drugs get on the market. The basic work is done in laboratories under NIH auspices. It is big stars who get the money, but the work is very, very labor intensive and mostly done by graduate students and post docs (who often times can't get jobs anywhere else). As soon as the University makes a discovery, the University patents it, because liscensing agreements is the big money maker in universities today. The University then takes the patent and markets it to drug companies, who buy the rights to it and become co-owners with the principal investigators and universities (if it is a money maker they will buy them out in a very corrupt way). The drug is refined in other university laboratories, but this time funded by the drug companies, not NIH. But the drug companies pay relatively little because the infrastructure is already there and the graduate students and post docs make slave wages. Really the drug companies are paying little for what they get.

Once the drug is ready for clinical trials the drug companies approach university hospitals to run the trials. The doctors they approach here are not researchers but clinicians. There is big money in clinical trials. The major reason for this is the drug companies want the university hospitals to get addicted to the money, so that they get the results they want for approval and advertisements, but still not that big because again - infrastructure is already there.

Cutting prescription drug prices wouldn't cut down on research one iota. But if you are really worried then a much more economically intelligent thing to do is invest money directly in university laboratories and hospitals (and it will also get us better, more reliable drugs with fewer side effects).

Will our health care ba as good as Canada's? That would be awesome.

FYI, My company, a fortune 500 whose name is commonly used as a verb is in the process of moving thousands of jobs to Canada because... while the wages are the same, the cost of employing a Canadian is 1/3 less than an American employee because... the employer doesn't pay for health care.

Can we get some of that so my co-workers can keep their jobs? And pay taxes? And put food on their families?

If the democrats use their majority to bully through a prescription drug bill, then within 10 years our country's standard of living will be reduced to Canada's.
Posted by: Al on November 16, 2006 at 7:46 PM | PERMALINK

If the cheap-labor conservatives keep shipping our jobs to other countries, then within 10 years, our country's standard of living will be reduced to Mexico's.

Gosh, Kevin, if you folks think that private capital is so unimportant to drug technology innovation, why waste time with the whole process of negotiating lower prices with companies which hold patents? Why not just do away with the patents completely, or shorten them to just a very few years?

Somehow, I don't think you really believe what you profess to believe.

Okay, this is how new drugs get on the market. The basic work is done in laboratories under NIH auspices. It is big stars who get the money, but the work is very, very labor intensive and mostly done by graduate students and post docs (who often times can't get jobs anywhere else). As soon as the University makes a discovery, the University patents it, because liscensing agreements is the big money maker in universities today. The University then takes the patent and markets it to drug companies, who buy the rights to it and become co-owners with the principal investigators and universities (if it is a money maker they will buy them out in a very corrupt way). The drug is refined in other university laboratories, but this time funded by the drug companies, not NIH. But the drug companies pay relatively little because the infrastructure is already there and the graduate students and post docs make slave wages. Really the drug companies are paying little for what they get.

Uh, no this is not how a new drug gets on the market. Very little (I would go so far as to say effectively no) pre-clical development of chemical entities is done in university labratories. University labs do research which helps untangle the biology of a disease. Pharma/biotech, which also do a significant amount of their own biological research, takes some of this understanding to develop models of the disease which can then be used to test chemicals.

They then test literally millions of different compounds to find some which are active in the models. After a lengthly testing, winnowing and optimization process which can last years, you might have a candidate for clinical trials. But in most cases, you don't, and you try again.

Cutting drug prices absolutely will reduce the amount which is spent on drug development (at least across the industry--as cyntax mentioned, it's hard to know what any given company will do). However, the drugs we have will be cheaper. That might be a good trade off, but no one should pretend that it's not one that we'd be making should we either cap drug prices or otherwise significantly reduce the revenue of pharmaceutical companies without otherwise subsidizing research.

Is everyone starts negotiating prices, someone is going to have to pick up the slack somewhere.

in other words: free markets can never work.

right?

TW, don't even try to reason with what has become a matter of Faith, in this case Faith that central planners can deliver the same amount of innovation for life-saving drugs, without the need for private capital. Like I said above, if people really intellectually believed this, they would be advocating that patents no longer be issued. However, they actually don't intellectually believe this, but instead have Faith that if a government central planner bargains for lower prices with patent holders, the resulting reduced flows in private capital won't affect innovation.

They may as well be advocating that Holy Water be regularly sprayed on research facilities via government helicopters.

Please don't curtail pharmaceutical R&D until after the drug companies come up with a third drug for male urinary disorders, and a fourth for erectile disfunction. There clearly aren't enough options on the market yet for either problem, and certainly not enough ads on TV to let men know that these medicines exist.

It's a shame that Milton Friedman left us last night, but at least he is no longer subjected to this sort of inanity.

Cutting drug prices absolutely will reduce the amount which is spent on drug development

or, it will make R&D more efficient. or, it will drive production or into cheaper markets. or it will reduce profitability. or it will do any number of things.

either the market works, in which case negotiating prices is a given -- because that's how markets work -- or the market doesn't work and that's a problem that needs to be fixed, too.

Dwight, what is it about people like you who so resent consumers having a myriad of options to select from? Look, if you think patents are bad for the American consumer of health technology, why not be honest about it and just advocate that they no longer be issued?

Cleek, I'll ask you: if you think the market power that patent holders have is damaging, why do you want to fool around with the government negotiating regime? Why not just do away with, or greatly reduce the length of, the patents?

"Uh, no this is not how a new drug gets on the market. Very little (I would go so far as to say effectively no) pre-clical development of chemical entities is done in university labratories. University labs do research which helps untangle the biology of a disease. Pharma/biotech, which also do a significant amount of their own biological research, takes some of this understanding to develop models of the disease which can then be used to test chemicals.

They then test literally millions of different compounds to find some which are active in the models. After a lengthly testing, winnowing and optimization process which can last years, you might have a candidate for clinical trials. But in most cases, you don't, and you try again."

Uh, no, you are wrong. The majority of patents come from university laboratories. It is not trial and error. If you have a thousand monkeys typing for a thousand years you still will not find the right drug. Uhm, there's a little thing involved called the scientific method. Have you ever heard of that? Have you ever heard of developing a hypothesis? Have you ever heard of narrowing your range through statistical analysis? I guess not. I have witnessed all three levels of the process I described and know researchers who are involved. By the way, they do this not because they are going to make a fortune from this, but because they have to - that is how productive research occurs - it is in people's souls. The money men do more damage than good. I feel sorry for you and our society if what you describe is what people have come to believe so drug companies can charge exorbitant prices. Meanwhile maybe you need to pick up an intellectual biography of somebody like Pastuer because the way you think is dangerous to science.

TW, don't even try to reason with what has become a matter of Faith, in this case Faith that central planners can deliver the same amount of innovation for life-saving drugs, without the need for private capital. Like I said above, if people really intellectually believed this, they would be advocating that patents no longer be issued. However, they actually don't intellectually believe this, but instead have Faith that if a government central planner bargains for lower prices with patent holders, the resulting reduced flows in private capital won't affect innovation.

There are definitely some of those, but I think most of the "The NIH pays for most pharmecutical research" just comes from basic misunderstanding of how drugs are discovered. To be honest, I'm not entirely satisfied with how the drug industry works--there are *lots* of inefficiencies which I witness on a day-to-day basis. And I'm not particularly against letting the government or other big buyers negotiate prices, but given the structure of the industry, a significant cut in revenue will impact the money spent on research, of which the number of new drugs and how quickly they get to market is a function will be impacted.

That's probably not the only effect it will have. But it is one of them.

Will,

Where did I say anything about patents? If you stopped building strawmen for a moment, it may actually occur to you that I was referring to the fact that the drug industry spends more on marketing than it does on R&D. I don't think developing new options for consumers is a priority for them.

Look, I realize it's been a rough time for you, what with your hero passing away last night and the Flomax failing to help, but the stress is starting to affect your cognitive skills.

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What evidence is there that the drug companies are even making new and better drugs with their huge profits? Are they even using those profits to reduce production and unit costs?

Don't real innovations come from the smaller companies or public financed research or non-profit labs? Do all of the 'new' advertised drugs really improve the quality of popular healthcare or is Restless Leg Syndrome (RLS) so serious a risk to society's health that tax credits and guaranteed profits are necessary to find habitual treatments for RLS and ED?

As for the argument that if drug prices fall R&D will necessarily suffer--

It would appear that R&D is the # 3 expense of drug companies, after Advertising and Lobbying. And this in an industry in which the average annual return on investment exceeds 20%. If there were a linear relationship between gross income and R&D, it would mean that the companies would never, ever spend any less than they currently do on advertising and lobbying, nor would they reduce dividends or stock options even if it meant that they would have no new product when their current patents expire.

While I never took microeconomics, it seems to me that in such an environment a contrarian firm would spend nothing on lobbying and reduce current dividends in order to pursue R&D even more aggressively. It would make for a few uncomfortable board meetings, but in a few years' time, the benefits would be undeniable.

Of course that analysis presumes that pharmaceutical companies are independent, competing enterprises.

As someone who makes his living doing drug discovery research in the pharmaceutical industry, I have to chime in here. Unless you've been involved in the business, you probably have no idea how ridiculous the "NIH does most of the discovery" idea sounds to us. My fellow researchers stare at me in disbelief when I try that idea out on them.

Academic labs make many fundamental discoveries. They do not, though, except in very rare cases, discover drugs. And the fact that most people don't realize the size of the gap that needs to be crossed there is tremendously frustrating to me.

Some of the details are explained in this post from my own blog. (There's a lot more where that came from, if anyone's interested).

I agree completely with TW Andrews in his comments above - he sounds like a colleague of mine, and someone who's been through preclinical and clinical research. I've been doing it for seventeen years now, and I *still* haven't made anything that's ever gone into a sick patient's mouth. Maybe I should hang around more universities, eh?

Uh, no, you are wrong. The majority of patents come from university laboratories. It is not trial and error. If you have a thousand monkeys typing for a thousand years you still will not find the right drug. Uhm, there's a little thing involved called the scientific method. Have you ever heard of that? Have you ever heard of developing a hypothesis? Have you ever heard of narrowing your range through statistical analysis? I guess not. I have witnessed all three levels of the process I described and know researchers who are involved. By the way, they do this not because they are going to make a fortune from this, but because they have to - that is how productive research occurs - it is in people's souls. The money men do more damage than good. I feel sorry for you and our society if what you describe is what people have come to believe so drug companies can charge exorbitant prices. Meanwhile maybe you need to pick up an intellectual biography of somebody like Pastuer because the way you think is dangerous to science.

The million monkeys approach is, in fact, precisely how pharmaceutical companies discover new drugs in this day and age (I guess Pasteur didn't have the necessary robotics to set up an automated lab). The process is called High-Throughput Screening, and if you'd like me to explain it to you in exhausting detail, I'd be happy to given that it's how I am gainfully employed, along with so many others that we even have our own scientific society, a number of journals and half a dozen major conferences every year. It is in use in every pharmaceutical company small and large as well as any biotech which is trying to develop therapeutics, rather than focusing on developing biological knowledge (which is almost all of them, these days).

The process of finding a treatment is remarkably hypothesis free. The hypothesis is that the model well represents the disease you'd like to treat, and that your method of detecting activity works. But beyond that, finding initially active compounds is more an engineering task than real science (optimizing them is another story--that's almost an art).

In any case, the research which is done in universities is mostly not running assays. They do some, but it's simply nothing like the scale or scope of what's done in the pharmaceutical industry, and I'd check your numbers on the patents, since practically all the patents for the new molecular entites submitted to the FDA are held by industry.

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Uh, no, Dwight you objected to the fact that drug companies offer different patented options to consumers for the same conditon. If you find this objectionable, advocate that patents be no longer issued, and if you prevail, then the total atrocity of consumers having multiple treatment options for conditions that you deem too unimportant (really, we are SO lucky to have you around as the arbiter of these things!)to have multiple treatment options for, will be greatly reduced, and the world will be so,so,so,so,so much better, especially for dime-store Mussolinis like yourself!

Cleek, I'll ask you: if you think the market power that patent holders have is damaging...

WTF are you talking about?

i never said anything like that.

This is one of the problems of the left. They would do well to listen to Milton Friedman on this issue.

The government has no business negotiating prices for drugs from pharma companies.

Cohn is largely mistaken about the importance of government subsidies for drug research. Government does fund basic biosciences, often finding target genes or cellular interactions, but the task of actually finding drug molecules that work on these sites (and are safe in humans) is left to the pharma companies. This work is huge compared to the basic research that found the original target or mechanism.

PS - How about that nut in the third comment? Obviously whatever you say about anything is utterly unimportant compared to what you said about Iraq several years ago!

if people could negotiate car prices, auto manufacturers would stop designing new cars! if people could negotiate house prices, homebuilders would stop building and designing new houses! if WalMart could negotiate prices with its suppliers, nobody would invent new toasters or new ways to package air fresheners and aspirin! if hospitals (besides VA hospitals) could negotiate prices, drug companies wouldn't make new drugs!

OMG!

it's fucking amazing watching pseudo-libertarians defend the idea that the government should be forbidden to act as an agent in the free market. instead they demand that the government must pay whatever drug companies ask -- for a $400,000,000,000 program. and the litany of bullshit excuses! my god, are you all drug company employees defending your jobs? i hope so, otherwise, you're fucking crazy. talk about "a matter of Faith".

The pharmaceutical companies that are members of the PhRMA spent $39.4 billion on R&D in 2005. If you include contributions made by companies associated with the PhRMA companies but not members, that number goes up to $51.3 billion. This includes pure research, and the research required to approve the drugs. The companies pick all of this cost up, whether a drug is approved or not.

The 2005 total budget for the NIH was about $29 billion.

In 2004, DTC (Direct to Consumer) pharmaceutical advertising was about $4 billion.

TW, there are no doubt inefficiencies in the industry, and it is theoretically possible that the profit potential in drug technology innovation is so much greater, relative to other opportunities for capital, that reducing revenues will not affect rates of innovation, due to reduced private capital flows, but it is a damned tricky thing to pin down.

At it's core, this is about how well intellectual property rights should be protected in order to strike the right balance between innovation and lower prices via competition. It is an exraordinarily hard question, and there likely is a Nobel Prize in Economics to be awarded to somebody who provides a breakthorugh in determining a good answer. There is certainly nothing sacred about the current state of patent law, and it well could be that reducing the protection now granted to intllectual property would provide better results. The search for the right answer, however, is not aided by the sort of nonsense as has been displayed in kevin's post, or in this thread.

In 2004, DTC (Direct to Consumer) pharmaceutical advertising was about $4 billion.

cite please

cleek, when a customer the size of the Federal Government "negotiates" prices, we aren't talking "negotiation" any more. We're talking price controls. Let's at least be honest about it.

Cleek, does EVERYTHING need to be explained in the most basic fashion? The reason you want the government to negotiate a lower price is because you think the patent holder has too much market power, and can thus charge excessively high prices, compared to what would be charged if the government negotiated a lower price. Instead of fooling around with negotiations, why not just stop the patent protection, especially since, as the author argues, private capital is uneeded to maintain rates of innovation?

if people could negotiate car prices, auto manufacturers would stop designing new cars! if people could negotiate house prices, homebuilders would stop building and designing new houses! if WalMart could negotiate prices with its suppliers, nobody would invent new toasters or new ways to package air fresheners and aspirin! if hospitals (besides VA hospitals) could negotiate prices, drug companies wouldn't make new drugs!

The point isn't that drug research is going to stop if pharmaceutical revenues drop, only that there will be some impact from policies like reimporting drugs, capping prices or having the government negotiate prices.

As I've already said, I'm for letting buyers (including the government) negotiate. And that I think the global effect of having the drugs which we've already got be cheaper at the expense of getting new ones faster is probably worth it (in spite of the adverse impact that reduced R&D budgets would have on me and my coworkers).

But let's not pretend that we're going to get new drugs fast if we want to have them cheap.

Really, Will? My post was about whether patents should be issued? Your stress is worse than I thought.

Read it again, Sherlock. R&D (not just for new drugs, but on improving existing ones as well) is not a priority for these companies. Flooding the market with direct-to-patient advertising is, and the very thing that you claim to covet, i.e. more and better choices for the consumer in the future, suffers.

Oh wait, I forgot, doctors don't have time to keep up with all the new prescription options that are available. They need patients to come in and tell them what drugs are out there for the problem they have.

Go ahead, Will, ask your doctor if he/she has anything for the bullshit you're dropping.

Cleek, does EVERYTHING need to be explained in the most basic fashion? The reason you want the government to negotiate a lower price is because you think the patent holder has too much market power, and can thus charge excessively high prices, compared to what would be charged if the government negotiated a lower price. Instead of fooling around with negotiations, why not just stop the patent protection, especially since, as the author argues, private capital is uneeded to maintain rates of innovation?
Posted by: Will Allen on November 16, 2006 at 10:10 PM | PERMALINK

That *is* essentially my point, Will.

But contrary to what most people might believe about me - I do not hate corporations. I work for a corporation. I likely owe my livelihood to a corporation. And Intellectual Property Law.

However, I think that the fundamental question here is: How much should Government meddle in the market? The bottom line is - it's already meddling. And a zero-meddling would be disastrous.

Should a government use it's Bullying Power against Big Pharma X?

It should not have to - because the drug patent already amounts to Government Bullying Power against Big Pharma Y, Z, W, U, V, and everyone else.

I may *say* that patents should be abolished, but don't take that at face value. It's a silly absolutist way of saying; patents can, and SHOULD be modulated, and when a company uses them like a club against consumers (or competitors), the consumers should be able to fight back by taking that club away, or at least put some safety foam-padding around it.

cleek, when a customer the size of the Federal Government "negotiates" prices, we aren't talking "negotiation" any more. We're talking price controls. Let's at least be honest about it.
Posted by: veritas on November 16, 2006 at 10:09 PM | PERMALINK

When there's a patent, you've already GOT price-controls. Let's at least be honest about that.

Big Pharma spends more on marketing than on research.

It's not that I don't understand the fact that the government heavily subsidizes the most fundamental aspect of the prescription drug process; it’s that I am a garden-variety corporate socialist – socialize the risk, privatize the profits. Sure, the government subsidies are a distortion of the free market, sure intellectual property rights are too, but that doesn’t matter. What matters is that the government not be able to act as the informed consumer assumed by my Econ 101 class (C+, the second time I took it – choke on that you commies).

If the gov't was not purchasing the drugs as a benefit to the citizens, encouraging their welfare, they would not bother about negotiating prices. The branch of the gov't doing the negotiating would be Medicare, not the FTC or some other regulating agency.

Perhaps instead of paying for older and less well off citizens, pharma would prefer all aid for pharmeceuticals be ended and the market stop receiving this revenue input from the public. I am pretty certain pharma would prefer to keep that segment of revenue, but they cry like Rand Capitalists that they are for less regulation and more public spending, but without negotiated prices from their subsidized clients.

Wait a minute, Kev. You forgot a few elements in the Republican Chain of Free Market Causation. Here's how it works:

If government negotiates for lower drug prices and succeeds then pharmaceutical companies will have less money to spend on lobbyists and Republican Congressional campaigns, which will lead to more Democrats in Congress and ultimately mean recissions of corporate tax breaks.

This, in turn, will lower pharmaceutical company profits and increase claims they can't afford to invest in new life saving drugs. Many learned medical studies will emerge signed by learned doctors and medical professionals across the country attesting to the fact that thousands of babies and old people are dying AS YOU READ THIS because DEMOCRATS don't really want you to have these life-saving drugs that can only be developed if the tax breaks are reinstated. Understated yet alarming ad copy will appear in full page ads in the Wall Street Journal under pitiful pictures of dying grandparents and their crying grandchildren.

Around this time US pharmaceutical companies will begin to get serious competition from British and Canadian companies who CAN bring new drugs to market more cheaply. Then Dems will be accused of lax oversight & corruption for allowing cheap & dangerous drugs to flood the US market where pharmaceutical companies support true free market practices and have higher quality standards that PROTECT AMERICANS.

I predict that John McCain will use this as one of the themes of his 2008 campaign.

How can TNR be so wrong on Iraq, yet on the ball when it comes to Big Pharma?

What life saving drugs has pharma made recently? What percentage of their R & D is spent on life saving drugs? What percentage of their R & D is spent on developing habitual treatments for advertised ailments that are of little consequence to improving overall health?

What is the percentage of revenues pharma obtains from publicly subsidized purchases?

Big Pharma spends more on marketing than on research.
Posted by: bakho on November 16, 2006 at 10:35 PM | PERMALINK

Not true, when you count "Marketing Research"!

It's simple - if other large orginizations, such as HMO's, can negotiate for lower prices, then why can't the government? We're not asking to subsidize anything, or interfere with the free market - if the companies don't like the price pojnt, they can refuse to sell, and the government will have to look for an alternative that may be less desireable. If the elderly want brand x, but the government doesn't offer it, then some ambitious public official can run on a platform in an attempt to get the government to pay the drug company's requested price. Our Democratic process is part of the free market - a balance will be struck. By refusing to allow the government to negotiate prices, you are creating artificial price floors, in effect undermining the free market that Republican claim to hold so dear.

Campus storm troopers torture UCLA student:

http://www.youtube.com/watch?v=AyvrqcxNIFs&eurl=

I am so freaking tired of the Big Pharma apologists. These same SOBs cry "free market" on every union job they send to China, but bitch like banshees if we allow Canadian drugs to be purchased. STFU. The fact is, no industry has more protection and does more harm than drug companies today. Some very cheap and basic medicines are unaffordable to a great number of the dying poor worldwide. I am willing to let Darwin prevent Jeffrey's erections if Flemming can save lives.

"Give us all your money or we won't do basic research!"
To Hell with extortion. Most drug companies are looking at smiling bob, hair restorers, and acne cream. I would nationalize medicine and let altruism steer our best and brightest back to the lab rather than the golf course.

I see the coward is back, and illiterate as ever, cannot grasp that I clearly wrote that reducing intellectual property protection may provide more optimum results.

Cleek, why do you want to fool around with foam padding? Why not just take away the club, especially if you agree with the author when he says private capital is not needed to maintain current rates of innovation? If the author is correct when he says...

"So, even if the pharmaceutical industry did reduce its research and development investment because of declining revenues, what we'd lose probably wouldn't be the next cure for cancer — it would be the next treatment for seasonal allergies, and likely no better than the ones we have already."

...then it is logically inescapable that patents are no longer needed, or at least patents anywhere near as strong as those that exist now are no longer needed, to innovate in the area of cancer drugs. Do you agree with this or not?

Dwight, you wrote, sarcastically....

"Please don't curtail pharmaceutical R&D until after the drug companies come up with a third drug for male urinary disorders, and a fourth for erectile disfunction. There clearly aren't enough options on the market yet for either problem...."

...thus objecting to the system which produces a third drug for make urinary disorders and a fourth for erectile disfunction. The system which produces that, Einstein, is patent law, which makes it profitable for drug companies to do so. Must I now explain to you the meaning of a post that you wrote yourself, you ol' dime store
Mussolini?

What is the percentage of revenues pharma obtains from hillbilly heroin? How much revenue does the black market provide to pharma? Valium, oxycontin, etc. are all in 'high' demand.

Does pharma still make qualudes? Mmmmmm, methaqualone ruined many peoples lives, yet it also enriched a few pharma executives lives.

Vincent: the UCLA Taser incident is the Milgram electrocution experiment writ large on America. It is already known that most people will torture and harm others who have no recourse at progressively higher levels if they think they are acting for some authority figure who they come to represent. Scary we would allow Tasers anywhere at all knowing this propensity. They are killing more and more people with them, just as Milgram would have predicted. Fascism? It is here.

I am so freaking tired of the Big Pharma apologists.