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A Case For Scrapping Drug Patent Monopolies As Incentive For R&D

by on Monday, August 8, 2011 at 2:59 pm EDT in Healthcare, Politics

It is widely accepted across the gamut of economic ideologies that when a monopoly exists a free marketplace becomes inefficient and fails. It fails, because without competition, a monopolist is all but guaranteed to price-gauge consumers. So it’s no wonder that US anti-trust laws were written to safeguard the marketplace from monopolistic (anti-competitive) behavior.

Yet, for over half-a-century, the idea that the pharmaceutical industry should somehow remain exempt from this monopolistic prohibition, has largely gone unquestioned. By being permitted to patent its medicines, BigPharma enjoys a monopoly in the marketplace for a fixed period (20 years or more per drug), where they are free to price-gauge consumers. 

The rationale behind drug patent monopolies rests upon the idea that without huge profits assured by this 20+ year price-gauging period, these pharmaceuticals would lack the incentive to invest in costly research and development. In addition, the actual manufacturing of medication tends to be cheap, so without patent-protection would-be-competitors, unburdened by R&D investments, could easily sell many generics for as low as $10 per prescription. 

And thus, the drug patent has been widely accepted as a necessary evil.

But by choosing patenting as the preferred incentive for private R&D investment, the government is knowingly handing ‘for-profit’ corporations monopolistic licenses over vital consumer products. 

We are not talking about discretionary goods, here — music downloads, books, or software — which people can live without. We’re talking about medicines that often keep people alive, or help to lessen their pain and suffering. In other words, the consumer CANNOT DO WITHOUT many of these products. And the provider, being shielded from competition, is well-positioned to take full advantage of their desperation.

Which is why the Pharmaceutical industry consistently ranks as one of the most profitable industries in the United States.

In response to public outrage over the fact that drug prices consistently rise at a much faster pace than the rate of inflation, the Congressional Budget Office (CBO) conducted a study in 2006 to assess the industry’s R&D expenses.

The study revealed that Federally-funded research has played a HUGE role in the discovery of nearly all new drugs released by the pharmaceutical industry. In fact, the only industry that receives more Federal subsidies for R&D is defense.

Here were some of the CBO’s findings:

  • The federal government expended $25 billion on health-related R&D in the previous year alone (2005). 
  • “Most of the important new drugs introduced by the pharmaceutical industry over the past 40 years were developed with some contribution from public-sector research.”
  • “Out of 21 of the most influential drugs introduced between 1965 and 1992, only five were essentially developed entirely by the private sector.”
  • “In the past decade, federal outlays on health-related research and development have totaled hundreds of billions of dollars at the National Institutes of Health (NIH) alone.”
  • R&D costs for new drugs are usually low, because more often than not, they are merely incremental modifications of already existing drugs.

CBO reported that the amount BigPharma itself contributes towards R&D is a staggering $800 million (2006 dollars) on average per drug release. However, CBO pulled these numbers from a separate study conducted by Tufts Center for the Study of Drug Development, which happens to be financed by – you guessed it — BigPharma itself!

In fact, a recent study published in the journal BioSocieties, entitled “Demythologizing the High Costs of Drug Research,” by Donald W. Light of the University of Medicine and Dentistry of New Jersey and Rebecca Warburton of the University of Victoria, took a hard look at those Tuft numbers. And what they found were HUGE flaws (Note: some of the major flaws are summarized HERE at Slate) which dramatically inflated BigPharma’s R&D costs:

When Light and Warburton correct for all these flaws—well, all the ones that can be quantified—they end up with an average cost of bringing a drug to market that’s $59 million and a median cost that’s $43 million. In 2011 dollars, that’s a $75 million average and a $55 million median.

So the drug companies’ [last stated] $1.32 billion estimate was off, according to Light and Warburton, by only $1.265 billion.* Let’s call it a rounding error.

Therefore, it appears the only credible information that can be gleaned from the CBO study is the taxpayer-funded portion of pharmaceutical R&D, and it is HUGE (to the tune of hundreds of billions of dollars).

A 2008 study entitled “The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States,” published by the Public Library of Science, estimated that BigPharma spends nearly twice as much on advertising and promotion than it does on R&D expenditures, contrary to the industry’s claim. Their research reveals that the US pharmaceutical industry is in fact marketing-driven, despite its constant claims that it is research-driven.

In January, BusinessWire published “2011 Trends to Watch in Pharmaceutical Technology” which reported that BigPharma plans to cut R&D costs in 2011, by outsourcing their R&D operations to emerging markets, like China and India.  

The CEO of GlaxoSmithKline just announced he’s been aggressively closing R&D operations, and instead partnering with academic research centers (again, government funded) & biotech companies:

One of the more vocal voices in the changing R&D landscape has been GlaxoSmithKline (GSK) CEO Andrew Witty. His company has significantly pared down its fixed R&D costs by closing research facilities, doing less discovery work internally, and pushing more and more responsibility for research to external academic and biotech partners.

It’s the same familiar theme that has come to define much of corporate America: socializing much of the risks and costs, outsourcing the higher-paying technical jobs to low-cost-labor countries, privatizing all the profits, and then evading paying US income taxes (as this Bloomberg article highlights).

Except in this case, the government additionally grants BigPharma a 20+ year competition-free environment with which to fleece the American people, to the detriment of their wallets, their health and their lives.

The US obviously needs to find a new creative way to ensure that financial incentives for private R&D remains, but without granting corporations monopolist-licenses to harm the public. Drug patent monopolies make no economic sense, and have proven to be a resounding failure on every front.

A couple months ago, Vermont Senator Bernie Sanders proposed a major reform bill of the drug patent system that sounds like a winning strategy. The bill would essentially replace drug monopolies with prizes:

He has introduced a bill to create a prize fund that would buy up patents, so that drugs could then be sold at a free market price. Sanders’s bill would appropriate 0.55% of GDP (about $80bn a year, with the economy’s current size) for buying up patents, which would then be placed in the public domain so that any manufacturer could use them at no cost.

This money would come from a tax on public and private insurers. The savings from lower-cost drugs would immediately repay more than 100% of the tax.

The country is projected to spend almost $300bn a year on prescription drugs this year. Prices would fall to roughly one-tenth this amount in the absence of patent monopolies, leading to savings of more than $250bn. The savings on lower drug prices should easily exceed the size of the tax, leaving a substantial net reduction in costs to the government and private insurers.

This would help to bolster R&D investment, by ensuring these firms are handsomely rewarded with all-upfront payouts for their products, which they could then reinvest into their R&D operations. Their huge marketing budgets would evaporate, thus saving them the lion-share of their current expenses. And at the same time, it would inject competition into the drug manufacturer marketplace — essential for ensuring these products remain widely available and affordable to the consumer.

And equally important, it would substantially impact our nation’s runaway healthcare costs by reducing our $300 billion annual pharmaceutical expenditures down to $30 billion. This would help to shore up Medicare and Medicaid, save lives, and put more money back into the pockets of the American people.

Here Comes The Pain: Two-thirds of States Cut Mental Health Care Funding

by on Thursday, March 10, 2011 at 1:29 pm EDT in Healthcare, Politics, Tax Policies

Despite an increase in our nation’s mental health care needs due to tens of millions of Americans having lost their jobs, and tens of thousands of military personnel returning home from war, the National Alliance on Mental Illness (NAMI) is reporting that two-thirds of states are making deep cuts to their mental health care programs.

NAMI Executive Director Michael J. Fitzpatrick is calling these cuts “a national crisis”:

“Cutting mental health means that costs only get shifted to emergency rooms, schools, police, local courts, jails and prisons,” Fitzpatrick said. “The taxpayer still pays the bill.

“Mental health cuts mean that clinics, crisis centers and hospitals close. Admissions are frozen. Emergency room visits increase. Where services remain, staff is cut, wait times for appointments are stretched and when people finally are seen, it’s for shorter amounts of time.

“Cuts mean people don’t get the right help in the right place at the right time. Communities suffer and families break under the strain. Some people end up living on the street or dead.”

Their report breaks down each state’s cuts and includes the seventeen states who have managed to increase their mental health care programs’ funding.

This is what President Obama and the Republican Party failed to mention when they insisted on extending tax cuts for the wealthiest 2%, and as they continue to shield multi-billion dollar corporations from paying a single penny in taxes: they have made a choice to further enrich the wealthiest Americans and corporations by kicking the most vulnerable and the most marginalized amongst us to the curb. Literally!

This November, Write-In “Public Option”

by on Friday, September 10, 2010 at 5:10 pm EDT in Healthcare, Politics

I met up with Stan at The Seminal at FireDogLake (FDL).

I’d recently written about the rationality of we on the Left strategically boycotting the upcoming midterm elections, and had continued pushing that notion in the comments of a diary by Democratic Party flack Jason Rosenbaum, seeking help in those elections from we who had given his co-opted little party the Congress and White House on a silver platter just two years ago. In that same diary’s comments, Stan suggested that a strategic write-in campaign, rather than a strategic boycott, would be even better.

And he’s right.

The resulting diary follows. (See it on FDL here.)

Reclaiming the Democratic Party for the American Left

By: themalcontent Wednesday September 8, 2010 11:42 am

Even as elements of the faux-Left media machine crank up their efforts to minimize the inevitable losses Democrats will suffer this fall, a few diaries in the last week [...] at FDL have helped crystallize what I believe could prove an effective strategy by which the American Left might reclaim the party from the DINOs who have so thoroughly and blatantly co-opted it.

The search for a credible, irrefutable way to give voice to our frustration has bubbled up in direct proportion to failure of the Obama Administration – and its Democratic Party majorities in both houses of Congress – to lead, since Inauguration Day 2009. So the diaries I’m about to reference contain merely the latest and perhaps most clear statements (to date) about what form such a statement might take, and are not meant to diminish or negate all the deep thought and dedication to progressive ideals so many here have expressed since the 2008 election.

The first, posted last Wednesday by Bill Egnor, prompted this one from me, over the weekend. Yesterday, I shamelessly whored that admittedly hastily assembled diary on several threads on both the main page and here at The Seminal. Then Jason Rosenbaum posted this, and the comments indicate to me that perhaps something resembling critical mass is near.

TheCallUp’s comment on Jason’s diary was my lightbulb moment, and appears to have been one for others. Not merely a boycott of the two major parties by those on the Left, but a way to register our displeasure, one that resists the Coakley-esque parsing which DINO flacks perpetuated – that’s what’s needed.

While writing-in “public option” or “single payer” or “Medicare for all” (h/t to alternateid), or “John Q. Public Option” (and maybe “Jane Q.,” to differentiate male and female voters?) – and I think we must all agree on one of these, or another that relates to the massive health insurance reform FAIL, so as to further reduce any possibility of parsing – the mere act of writing it in won’t get us where we want to go. If the goal is reclaiming the Democratic Party for the American Left, we need to make clear how we’re doing it, why we’re doing it, and what we expect to happen next. Without a clear, succinct statement of our goals, we will be marginalized by the sycophants and we will fail.

Having just elaborated on How we’re doing it, I’ll again state, below, the other elements I believe critical (for ease of reference as we discuss this initiative further in the comments):

Why we’re doing it: Because Barack Obama has failed to lead based on his 2008 stump speech, and Democratic obstructionists within his administration and the Congress are complicit in that failure. To have even a hope of keeping the White House in 2012, we insist Obama begins leading based on his campaign. If he does, we might, in 2012, even give him a majority in both houses of Congress once more. But that majority will not include anyone who thinks or votes like Joe Lieberman, Bart Stupak, Ben Nelson, Mary Landrieu, and other duplicitous DINOs.

What we expect to happen next: On November 3, the massive Democratic loss still stinging, Obama must fire Rahm Emanuel, Tim Keane, Robert Gibbs, and Tim Geithner, and replace them with Russ Feingold, Dennis Kucinich (or Dr. Dean), Al Franken, and Elizabeth Warren respectively. Further, Warren’s counsel – alone – determines who will head the Consumer Financial Protection Bureau. (Note: If Larry Summers has a problem with any of this, he can hit the fucking pike, too.)

And: On November 4, Mr. Obama addresses a joint session of Congress. In the somber, serious-as-a-heart-attack five-minute speech – two minutes is better – he creates by executive order, as Congress looks on, a public works program which mirrors the WPA, but in 2010 proportion to FDR’s 1935 model. He blunty states, with the wolrd watching, that a vote against funding it is a vote against putting Americans back to work. While he’s at it, he signs another order, ending DADT. Finally, he demands legislation outlawing corporate personhood, in similarly blunt fashion: “Refusal to do so will make quite clear which of you work for real people and which work for phony ones – and, I’ll venture, will subject you who work for the latter to the same kind of popular revolt my party has just undergone.”

In closing this diary, I’ll add one more thing: A lot of people have been saying for a long time that the Internet will change politics forever. It almost did in 2008. We now have a chance to actually make it happen, and (respectfully disagreeing with TheCallUp) we don’t need MoveOn to promote it, at least not yet. In fact, the more obvious it becomes that this has truly bubbled up from independently thinking Dems and Progs, the less it opens us to Righty accusations of being an astroturf org like the teabaggers.

So: What HCR-referencing phrase or name can we all agree is best to write in? And, will you commit to e-mailing at least 20 people and/or blogging your support of this initiative at one lefty blog, in order to help get it going?

Remember, we must move quickly: The campaign season is under way.

Amnesty International Condemns U.S. For Soaring Maternal Death Rates

by on Friday, March 12, 2010 at 4:00 pm EDT in Healthcare, Politics

In a scathing new report released today, Amnesty International calls on U.S. President Barack Obama to address its spiraling maternal mortality rates and soaring pregnancy related complications (which disproportionately affects minorities and those living in poverty): More than two women die every day in the USA from complications of pregnancy and childbirth. Approximately half of [...]

A Final Nail In The Public Option Coffin: Nancy Pelosi

by on Tuesday, January 5, 2010 at 5:36 pm EDT in Healthcare, Politics

The Democratic Party’s betrayal of the Left is effectively complete: Speaker Pelosi (D-Calif.) showed flexibility Tuesday on the public option, acknowledging the political reality that such a plan probably couldn’t make it through the Senate. A public plan, Speaker Pelosi said at a press conference, is meant to “hold insurance companies accountable and increase competition,” [...]

New Ad Shows President Obama’s Broken Health Care Promises, In His Own Words

by on Wednesday, December 23, 2009 at 1:31 pm EDT in Healthcare, Politics

The two most controversial aspects of the recently passed Senate health care bill include the absence of a public option, and a mandate whereby the public will be required with penalty — to be enforced by the IRS — to purchase health insurance policies from the private, for-profit, health insurance industry; policies which may very [...]

PLEASE Sign! EMERGENCY Petitions To Save The Public Option!

by on Saturday, October 24, 2009 at 5:25 pm EDT in Healthcare, Politics

Petition to HARRY REID: “Don’t let the Baucus bill kill the public option.”  SIGN HERE:  CREDO Action Petition to PRESIDENT OBAMA:   “Every day, insurance companies deny care and let people die. Getting one Republican senator’s vote is not worth delaying reform — too many real lives are at stake. We need you to fight and [...]

The Status Quo And How Washington Ensures It

by on Wednesday, October 14, 2009 at 12:03 pm EDT in Politics

A major impasse appears to exist these days between Democrats and Republicans on virtually every issue.  On the surface, it would seem it’s all ideology-based.  But upon closer inspection, their hostilities are, in large part, incited by media-manufactured outrage, where partisan vitriol and ideological demagoguery drowns out all thoughtful discourse. Unfortunately, our country is in [...]

The President’s Eloquent Words Are Beginning to Ring Hollow

by on Monday, October 5, 2009 at 1:08 pm EDT in Healthcare, Politics

After eight tumultuous years of deceit, incompetence, and ideological extremism emanating from the White House the entire world eagerly embraced the ushering in of the new American President and all the hope that his victory embodied.  I vividly recall the night Obama won: watching him give another spectacular speech on television, the tears of happiness filling the eyes of tens of [...]

The Truth About Democracy: It’s Only as Reliable as Our News Programming

by on Sunday, October 4, 2009 at 11:54 am EDT in Iraq, Politics, World

Whenever the people are well-informed, they can be trusted with their own government. –Thomas Jefferson The first decade of this new century will be remembered by many as a time when a significant segment of our society became incapable of differentiating news from propaganda. This phenomenon has endangered the very fabric of our democracy. The [...]