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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.

Candidate Obama VS President Obama On Fixing Medicare

by on Tuesday, July 26, 2011 at 10:55 am EDT in Healthcare, Politics

On the campaign trail, CANDIDATE Obama was very specific on how he intended to fix Medicare:

1. To lower Medicare costs, Candidate Obama said he would permit Medicare to negotiate prescription drug prices with the price-gauging pharmaceutical industry:

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SEN. OBAMA: But one thing I have to say, we are not going to make some of these changes unless we change how business is done in Washington. The reason that we can’t negotiate prescription drugs under the Medicare prescription drug plan is because the drug companies specifically sought and obtained a provision in that bill that prevented us from doing it.

MS. WASHBURN: Thank you.

SEN. OBAMA: And unless we change that politics, we’re going to continue to see the waste that we’re seeing in the entitlement programs.

2. He would increase revenues by $300 Billion simply by ending Bush tax cuts for the wealthiest Americans, and use that to shore up Social Security and Medicare:

 

We’re not going to solve social security and Medicare unless we understand the rest of our tax policies. … Let’s be clear about my tax plan and Senator McCain’s, because we’re not going to be able to deal with entitlements unless we understand the revenues coming in. [...]

Senator McCain wants to give a $300 Billion tax cut to — $200 Billion of it to the largest corporations and $100 Billion of it going to people like CEOs on Wall Street.

If we get our tax polices right so that they’re good for the middle class. If we reverse the policies of the last eight years that got us into this fix in the first place, and that Senator McCain supported, then we are going to be in a position to deal with Social Security and deal with Medicare, because we will have a health care plan that actually works for you, reduces spending and costs over the long term, and Social Security that is stable and solvent for all Americans, and not just some.

 So let’s see how PRESIDENT Obama fared in advancing his progressive platform for saving Medicare:

 1. Promise to allow Medicare to negotiate drug prices:

In August of 2009, the Obama Administration admitted to cutting a secret back room deal with Big Pharma which SPARED the wealthy drug industry from having to negotiate drug prices with Medicare. Obama, additionally, broke another promise by dealing away Americans’ ability to import cheaper drugs from Canada.

In return, the drug industry agreed to kick in $80 Billion in savings over ten years (a mere 2.6% of the $3 Trillion Americans are predicted to spend on drugs over that same time period), and the industry additionally agreed to toss Obama $150 million in television ads to sell his “health reform” bill.  

2) Promise to add $300 Billion in revenues by allowing Bush Tax Cuts for the wealthy to expire (which he would use to shore up entitlements): 

Now you might have expected, by the way Candidate Obama tied Bush Tax Cuts (as a source of revenue) directly to offsetting entitlement expenditures during his campaign, that he would have made entitlements the central focal point last December to make the case for allowing Bush tax cuts to expire.

But to the shock and dismay of his own party, Obama flipped on this campaign promise, quickly agreeing to extend Bush Tax cuts for the wealthiest Americans. And only THEN, after it passed — thereby ensuring there would be no additional revenues — did he moves on to addressing entitlement expenditures. 

His NEW PLAN For Fixing Medicare:

Here was Obama over the weekend, revealing his new — perhaps undisclosed would be a more accurate depiction? — plan for fixing Medicare, Social Security, and Medicaid:

Essentially, what we had offered Speaker Boehner was over a trillion dollars in cuts to discretionary spending, both domestic and defense. We then offered an additional $650 billion in cuts to entitlement programs — Medicare, Medicaid, Social Security.

Who the hell is this guy?

Karl Rove On Obama Extending Bush Tax Cuts: We’re All Supply-Siders Now!

by on Sunday, December 19, 2010 at 4:47 pm EDT in Politics, Tax Policies

The new tax cut bill, signed into law Friday by President Barack Obama, will surely come back to haunt him in his 2012 reelection campaign.  His quick capitulation to the Republicans, and aggressive advocacy for this fiscally irresponsible bill helps to further erode his credibility to one-time supporters.

First came his health care ‘reform’ bill — a backroom giveaway to BigPharma and the health insurance industry.  Then came his watered-down financial reform plan, his escalation in Afghanistan, his refusal to close Guantanamo Bay, his green-lighting the assassinations of American citizens abroad without trial, his complicity in shielding Bush war crimes, etc. etc.

Extending George W. Bush’s destructive ‘supply side’ tax policies only solidifies this President’s reputation as one who has no core principles to speak of.

Candidate Obama promised his supporters repeatedly that he would end, once and for all, the deep tax cuts for the wealthiest 2% of Americans.  To extend these tax cuts at a time when we are engaged in two wars, and with deficits skyrocketing, poses a serious threat to our country’s fiscal health.

Moody’s recently threatened to downgrade the United State’s AAA credit rating if this tax bill was signed into law.  The effects of a credit downgrade during a deep recession could be quite significant:

For the United States, a loss of the top Aaa rating, reduce the appeal of U.S. Treasuries, which currently rank as among the world’s safest investments.

“From a credit perspective, the negative effects on government finance are likely to outweigh the positive effects of higher economic growth,” Moody’s analyst Steven Hess said in a report sent late on Sunday.

After Obama announced his plan, Treasury prices fell sharply in volatile trade last week and yields have hit a six-month high, in part due to concerns over the effect the package will have on government debt levels.

If the bill becomes law, it will “adversely affect the federal government budget deficit and debt level,” Moody’s said.

Moody’s believes this tax bill will add an additional $700 to $900 billion in new national debt.  A downgrade in the US credit rating could push interest rates upwards, thereby prolonging this deepest of all recessions.

The President never even attempted to make a compelling case to the American people for Keynesian economic principles — the ones he ran on; the ones he was elected on — but instead cowardly embraced the failed trickle down policies that helped to create much of our country’s problems: including runaway debt, and redistribution of wealth from the middle class to the highest earners over the last 30 years.  His Democratic party still controls the Presidency and both Houses of Congress, and yet he is too timid to use the bully pulpit to promote any progressive policies.

The irony is, he will personally wear the new debt this bill creates around his neck like a noose.  And the blame for it will be leveled by the very Republicans to whom he capitulated.  After all, they were blaming him for Bush’s debt just ONE MONTH after he was sworn in as President.

The Republicans will shamelessly pick up where they left off a month ago: screaming that Obama has created runway deficits, and pointing out the urgency for government spending cuts.

Having caved in on extending Bush’s tax cuts for the richest 2%, he will be forced to offset the new debt by cutting important programs like Social Security, Medicare, and Medicaid.  In addition, new government spending cuts will ‘trickle down’ to impact state budgets, in the form of more layoffs for school teachers and police officers.

Instead of writing the epitaph on Bush’s failed ‘trickle down’ economic policies, Obama has instead resurrected them from the grave.

So we as a country — governed by a Democratic President — will continue to endure a deepening divide between the rich and the poor, and will continue to watch our national debt escalate in a way that won’t create a single job, but will only threaten our country’s most cherished social programs.

Karl Rove is jumping for joy over this turn of events.  After the signing of the bill, he jubilantly Tweeted:

Judging by remarks from Geithner, Hoyer & others celebrating Bush tax cut extension; we’re all supply-siders now!

Perhaps Obama should tap Rove to run his 2012 Presidential Campaign.  They appear to be on the same page on just about every issue.

Progressive Reactions To The Senate’s Public-Option Compromise

by on Wednesday, December 9, 2009 at 4:34 pm EDT in Healthcare, Politics

While the Congressional Budget Office reviews the Senate’s new health care reform proposal, the key players are remaining tight-lipped about its details.  But news organizations are piecing together from their sources what this public option compromise is beginning to look like. Dylan Ratigan of MSNBC’s “Morning Meeting” outlined some key components he’s uncovered of the [...]

Pelosi To Fellow Democrats: “Come Out Of Hiding On The Public Option!”

by on Friday, October 23, 2009 at 3:17 pm EDT in Healthcare, Politics

This is the kind of leadership those on the Left have been craving for.  According to Huffington Post Nancy Pelosi called together a closed door meeting at the Democratic caucus, and she is pressuring the Representatives to ‘stand up and be counted’ on a robust public option: House Speaker Nancy Pelosi (D-Calif.) ramped up the [...]

Nancy Pelosi: The Lone Democratic Leader Fighting For Health Care Reform

by on Wednesday, October 21, 2009 at 2:08 pm EDT in Healthcare, Politics

New estimates from the nonpartisan Congressional Budget Office showed a healthcare overhaul drafted by Democrats would reduce the U.S. budget deficit over 10 years and cost less than $900 billion.  Reuters reports that: [Pelosi] asked CBO to provide estimates on three versions of the [public] option — one based on reimbursement rates paid to healthcare [...]