close up photo of medicinal drugs
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Some good and interesting ideas about improving global access to medicine in this article.

The problem:

Pharma R&D is expensive: sometimes billions of dollars to research one drug. And for every drug that is successful, there might be 20 that aren’t, and the research into those needs to be paid for as well. That money needs to come from somewhere. At the moment, it comes from patients in rich countries paying sometimes hundreds of dollars for pills that might, individually, cost a few cents to make. The “marginal cost” of each dose is tiny — Jacobin and Oxfam fume that the Covid vaccines, for instance, are priced at many times the manufacturing cost — but that cost needs to cover the “fixed cost” of all the R&D (and marketing, staff costs, etc) you’ve put in.

Should Big Pharma be destroyed?

One suggested solution/idea:

A more low-key version, says Gulati, might be for academic institutions to become better at demanding equity in pharmaceutical products that are based on their early research. He also suggests that countries such as the UK could negotiate cheaper drugs by offering the NHS as a source of clinical trial subjects — as has happened with Novartis’s new cholesterol drug inclisiran, aka Leqvio. That’s hugely valuable to pharma companies, and it’s something the NHS can do easily and safely, with its huge, centralised, well-protected data systems.

Those ideas might help make drugs cheaper in the UK and other rich countries: getting them to poorer countries is a different problem, with different solutions. Governments could buy out patents — if a firm thinks it can make $10 billion over the next 10 years for its product, we could say that we’ll give them the $10 billion now (or a bit less) in exchange for the rights to make the drug available at cost.

Barder likes one idea, put forward by the late economist Jean Olson Lanjouw. “Her suggestion was,” says Barder, “that if I’m AstraZeneca and I show up at the UK patent office asking for IP protection for a new drug, the patent office should say ‘Well done. Can you tell me what you expect the market value for this drug to be in all 200 countries in the world?’”

Should Big Pharma be destroyed?

More good ideas and starting points for discussion in the article.

Michael Josem is a long-term consumer advocate, most prominently as a global leader in combating fraud in the online gambling industry. He was in part the inspiration for the 20th Century Fox Movie, Runner Runner, starring Ben Affleck and Justin Timberlake.

Josem has over a decade of experience as a senior business leader working across various high-tech and online industries, and takes action to build a better community. His primary volunteer roles include service for the Commonwealth War Graves Commission, and Graih, the homelessness charity.