There’s a standard response when people feel the sticker shock at seeing the prices on brand new drugs: that cost is necessary to subsidize the expense of drug development. And that’s true! Bringing a new drug to market takes a lot of time and money and multiple levels of testing and clinical trials. It hurts to pay it, but you’re paying all the costs of development (would that companies that tear up the environment had to obey the same principle).
But now Martin Shkreli comes along, and ruins the whole defense. Shkreli bought the rights to a drug, Daraprim, and immediately jacked up the cost from $13.50/pill to $750/pill, all for a drug that cost him $1/pill to manufacture.
He’s not trying to recoup development costs for Daraprim — the drug has been around for years, and was developed by a different company. Let’s call this what it really is: extortion.
The drug is listed by the World Health Organization as an essential medicine — it’s vital for treating pneumocystosis and toxoplasmosis, diseases that you don’t worry about too much, unless you’re an AIDS patient, or have been exposed to these parasitic infections. Then Daraprim will save your life. If you don’t get it, you die.
Shkreli knows this. He knows he’s got his grubby hands on the rights to an essential medicine, and that if he inflates the price to just about whatever he wants, people will have to pay it. And that’s the rotten greedy heart of his pricing decision: not that it’s a fair price to cover his costs with a reasonable profit, but that he can gouge whatever he wants out of deathly ill people.
I don’t think such a venal little man is going to care much about what people say. But I do wonder what the other pharmaceutical companies are going to do: this shabby tactic makes them vulnerable to exposure, and is going to fuel efforts to take drug pricing out of the hands of greedy marketers.
Oh, look. I should have just waited a few minutes: drug companies are showing some signs of panic.
A huge overnight price increase for an important tuberculosis drug has been rescinded after the company that acquired the drug gave it back to its previous owner under pressure, it was announced on Monday.
However, outrage over a gigantic price increase for another drug spread into the political sphere on Monday, causing biotechnology stocks to fall broadly as investors worried about possible government action to control pharmaceutical prices. The Nasdaq Biotechnology Index fell more than 4 percent.
“Price-gouging like this in the specialty drug market is outrageous,” Hillary Rodham Clinton, a contender for the Democratic presidential nomination, said in a tweet on Monday. She said she would announce a plan on Tuesday to deal with rising drug prices.
I’d say I was a prophet, except it’s a cheap kind of prophet who makes a prediction that’s already confirmed in the morning paper…he just hadn’t read it yet.
Which would be a good thing, although I have no idea how that would even work in the U.S.
The drug is his “property” and so by the holy laws of Capitalism, he can sell it at whatever price he deems fit.
A price gouging regulation on drug manufacturers would be a boon to public health. Which is why Conservatives in the USA will consider no such thing.
He will do this again. Again and again. And he will inspire others. He needs to be slowly burned alive over the course of weeks… or the drug industry should be nationalized. That’ll do, too.
Well, YOB, we do have price gouging laws, and upheld at a State level to be Constitutional. But the thing is, the government has not really turned an eye toward medicinal health aids as one of those “necessary items”. Because not wanting to die is simply a voluntary transaction, what.
My first exposure to Shkreli was in competitive gaming, aka esports. In principle, it is similar to traditional sports like football or baseball, but the competitors play the games through computers. Anyway, he has been trying to get a team into one of the leagues and offered a lot of money to various players to try to do so. Those attempts failed and so now it looks as though he’s going to outright buy a spot from one of the less-well funded organizations. At first, I favored Shkreli getting into esports because more money means that the players will get better taken care of, more exposure for better events and facilities, and just more hype in general. After this broke, I don’t want anyone of his ilk anywhere near the games.
When i saw this i thought there was no way it could be real…it just sounded too much like a made-up story to me. The realisation that it was actually true was not a fun process…
Now in my desperate attempt to rationalise that nobody could be this much of a piece of shit, i’ve concocted the idea that it’s a deliberate way of trolling pharmaceutical companies to show how disgusting this market can be and to highlight the many unethical practices that go on in it. Fuck off, let me dream….
Seems to me this is an opportunity for the free market to strut its stuff. The drug has been on the market for 60+ years. Any patents certainly have expired. I don’t understand how any company can have “rights” to such a molecule. The manufacturing process might be a trade secret; however it’s a fairly simple molecule. I would think an enterprising generic drug manufacturer could develop a synth for it, manufacture it for a dollar a pill, sell it for twenty and not only make a tidy profit but also cut this jerk off at his knees.
I recently saw a “double-down” by the pharma dude. Correcting initial reports that he raised the price from $13.50 to $750 for a 5000% increase, as being in error. “The original price was $18.00 per tablet. so he only increased the price 4000%” I’m sure with the smug face of “see I’m not so bad, so whatcha complainin about?”
And even if he bought the “rights” to the drug as sole provider, how does that work? The drug, Daraprim, is a 66 yr drug. Surely any patents have expired. Is he raising the price of the name only, to offer a generic of the drug for “only” $20/tablet, to boost demand for the generic version?
It’s the principle of and problem with, patents and monopolies. And the obvious advantage of government-funded and publicly available medical research – with open-licensed results.
A libertarian friend posted on FB that this shows that the US should allow reimporting drugs from e.g. Canada.
He’s completely resistant to the news that the reason drugs are cheaper in Canada is that we regulate the price, so effectively he wants government control of the price, but accountable to another country’s citizens.
This is capitalism at it’s finest. It’s working -exactly- how it’s supposed to.
=8)-DX @9: no, this story is not about patents: the drug is long out of patent protection.
It’s about an effective monopoly due to the barrier to entry: the drug cost $1 per dose but sold for $13.50 (or $18), already a huge markup, but there wasn’t a big enough market to justify another entrant bothering to get all the necessary certifications and pay the overheads. I’m going to bet the previous owner was counting the cost of tooling up in the price they set: as high as possible but too low for anyone else to come in. At $750, for sure someone else can come in — but it takes time.
Well, actually, numerobis, that drug has been being raised in price for the last ten years at least, being sold up several times before being sold down to Shkreli. He says that the increase in price is to pay for development of a better drug with fewer side-effects. This, of course, is silly and not at all the way that drug development normally works. It’s also unnecessary; daraprim is highly effective and the side-effects are well managed in the few people who really need this drug to not die.
The thing is, this isn’t a new thing, just something that’s really gotten attention. Daraprim has been increasing in price for no good reason for a while. Other specialty drugs have been trending similarly. This also isn’t the first time that Shkreli has done this.
Check his name on the search engine of your choice, but don’t blame me if what you read makes you want to leave this planet.
The time may be right for my preferred solution: just nationalize pharma already.
Taking just the amount more we pay in the US for drugs than OECD-average countries, that is in total more than the total R&D and marketing expenses of the pharma industry (and marketing, famously, costs a bit more than R&D).
So we’d be ahead to simply publicly fund all the pharma R&D at current levels, even if we literally just gave the resulting pills away. Even more ahead if by doing so we could kill the marketing.
Getting from here to there could be awkward, even without considering the political difficulties: the Takings Clause might require us to buy out existing patents for a considerable sum. Though we might still come out ahead. Someone should write a whitepaper and do the math, I guess.
For an interesting perspective, I would recommend some version of Steven Brill’s America’s Bitter Pill. A short one may do fine.
In a Commonwealth Club interview I heard him assert that one of the biggest fails of ACA is the lack of price controls for drugs and medical equipment, another arena for price gauging. He noted that in most developed countries, government does impose price controls for these things and health care costs are more affordable. Because of the lack of controls in the US and the relative affluence of people here, manufacturers lay it on pretty thick.
He claims that no price controls was the main thing the Republicans wanted out of ACA…they and there deep pocket supporters.
The other fail, he says, is the lack of tort reform. This was the main goal of Democrats who he describes as a pack of tort lawyers.
We ought to extend the concept of imminent domain to intellectual property for cases like this, where public good trumps their goddamn IP rights.
“Don’t be so blatant and greedy, we’ve got a good thing going here. If you aggravate the rubes, you’ll ruin it for all of us!”
@9, numerobis is right. Knowing what a molecule looks like doesn’t mean you can make it cheaply. You still need to work out what are the best raw materials, the best equipment and the best processes. You need to make long-term deals with companies that supply materials and equipment and work out how to build the process, for which you need chemical engineers. And so on, it’s expensive. And since an expiring-copyright brand name is already known, there’s a big risk in trying to establish a rival brand. Yeah, this is determined by market but as usual the market has itself determined how it’s going to go.
More evidence that we can count on the invisible hand of the marketplace to make everything we need available at an affordable price.
That’s true and there are also the costs of drugs that don’t make it. But until these companies open up their books to the public and we get independent business analyzers saying that such a mark-up is justified and that the extra profits are indeed going towards medical research and not to executive bonuses any claim trying to justify why medicines are so expensive should be met with skepticism.
“Patent Medicine” used to be synonymous with snake oil. “Ethical medicine” was not patented.
Most of the cost goes to marketing and profit.
Meanwhile, in Canada;
The drug in question kills parasites.
I’m surprised that Shkreli dares go anywhere near it.
There actually seem to be two different drugs here: Daraprim, an anti-parasitic (price jumped 5500% by Turing Pharmaceuticals); and Cycloserine, which is the anti-tuberculosis drug (price jumped ‘only’ 2000% by Rodells Therapeutics).
@numerobis:
He’s also missing the point that the price gouging was based on the sales rights to all of North America, including Canada. This was on CBC Metro Morning this morning; doctors up here were complaining about the price increase as well. Sure, they could charge it back to the provincial health care agencies (the doctor interviewed was in Alberta), but it was still ridiculous.
http://www.cbc.ca/news/health/tb-drug-price-cycloserine-1.3237868
So what your libertarian friend is suggesting isn’t just giving accountability to another country: it’s literally asking the other country to subsidize your local drug costs.
Not as an advocation for violence, but merely asked as a philosophical exercise..
If one person, solely through their greed, would cause the death of many innocent people..
would it be morally justifiable to assassinate that person if the result would be the saving of many other lives?
I think most people would feel morally justified in supporting the assassination of Hitler in the 1930s, knowing what we know now.
Is there a number of lives saved where assassination becomes morally justifiable? What if Shkreli’s pricing gouging only leads to the preventable death of a thousand, or a hundred people? What about one entirely foreseeable and unnecessary death?
Does it make a difference that Shkreli’s actions are more passive [though still intentional] than those of a mass-murder who personally murders or personally directs the murders of people? Does it make a difference that he’s just limiting access to a treatment, which will lead to preventable deaths?
I’m tempted to think this is a deliberate stunt to show exactly why the profit motive has no place in the health care industry. The free market says things should be priced at whatever price people are willing to pay for it, and if your choice is paying or death, you’ll pay everything you have. Then again, maybe I just don’t want to believe that people are as terribly shitty as I know them to actually be.
So at least we know this friend is a REAL libertarian since he wants someone else to support him.
numerobis @12: I hear that the monopoly gets even better: in order to compete, another firm would have to run tests to demonstrate that their generic product was actually the same — and apparently there was a loophole that said only patients could buy the drug, so competitors could not legally run the comparison. I’m not an expert, and could have this wrong, but essentially the Feds put in incentives to provide low-margin drugs and this, um, entrepreneur tried to drive a big rig through a very small hole. He may be stopped in this instance, but the system presumably continues.
Or you may start contemplating robbing a drugstore..
Anyway: I have to ask: Was I the only one who thought about decaying evil bird warlocks when I first read the guy’s name?
Enough people ARE shitty to make life miserable. Here on the Gulf Coast, whenever a hurricane spins into the gulf, prices for bottled cans & water; gas; and plywood go up significantly.
I agree that Pharma needs to be Nationalized. Enticing another manufacturer to produce generics won’t work; many people—myself included—cannot take some generics, as the “inert ingredients” either interfere with the active ingredient uptake or cause a negative physiological reaction.
I had an emergency gall bladder removal operation in the US several years ago. It cost $15,000 (it would probably be close to $50,000 now, I guess). The same operation in Japan (where I live) at that time cost $2,500. It now costs around $3,000. The government controls how much operations cost and how much medicine costs. Both are way below US prices. Why doesn’t the US do that?
imagine The Simpsons:
SCENE:
setting: Mr Burns office, Mr Burns tenting fingers
Burns: Raise the price of that med there, 5000 per cent. for profit. (slurp)
Smithers: [stuttering] but, Mister. Burns. that med is a life saver! without it people will die! $700 per dose is too expensive!
Burns: hmmm, without it they’d die, eh. pretty good motivation to go with the price increase. (flexing tented fingers) Ekk ccccelllll entt!
[close scene]
ugh. fair representation of Shkeli?
As to the question of what pharma companies think of Shkreli, I suspect that it’s “Why didn’t we think of that?”
ffakr:
No. There are other ways to obtain that result, which is why it fails as a justification. If I come up with some Rube Goldberg type of method for solving a problem, to change a lightbulb let’s say, the fact that it achieves the result isn’t justification for the unnecessarily convoluted approach that I took. You could ask me why I did it that way, as well as ask whether there are better (or acceptable) ways of accomplishing that…. Moral questions are often about exactly that: which options are better or worse, which ones are acceptable or unacceptable. They’re not only about whether one specific consequence is better or worse, because any of the other consequences may also be relevant.
In this case, you could, for example, simply have the state regulate the market, like it should’ve been doing already. That gets you the result you say you want with regard to saving other people’s lives, and it saves that greedy asshole’s life, which you have no right to take.
Just to make some of this a little clearer…. Our society is what we make of it. All citizens have rights and interests, that no single private individual (or corporation) should be able to undermine for their own interests. “The government” is not the authority which takes this thing from that person — we are the authority, and the government consists of elected representatives who are our employees. We have the rights and the power to claim them, and we are responsible for what our government does. That basic fact about democratic systems is simply what makes them legitimate political systems, unlike monarchies, dictatorships, etc. This is not to be understood as claiming the majority can oppress minorities, if that represents what the mass of people want. “Markets” are simply not a coherent basis for a legitimate or functional political system — they are merely whatever happens to be the case, without regard to what that’s like, whether it is a good result for anybody or everybody, with no means of (or even concept of) obtaining better results or avoiding worse results. That is not what politics is. It’s an ethical project at the level of societies, which you do for all of the people in it, not something aimless that just happens to be the case and cannot be controlled.
I don’t understand what makes this “passive” as opposed to “active.” Looks like sophistry, but no, that wouldn’t matter even if there’s something definite to talk about.
redwood: Because FREEEDOMMMM!
@ffakr #25, that is precisely the reasoning that supports assassinating abortion providers. So to your question “Is it morally justifiable”, I’m going to go with “No.”
And I’ll elaborate. Your moral justification requires that you be absolutely certain the purported evildoer is going to do the evil. If the evildoer is just a part-time evildoer, your preemptive strike might just be a murder that saves nobody. You have to KNOW to be justified: if you only strongly suspect, you are willing to be a murderer on less evidence than the state requires for conviction.
Even if someone has a track record, like Shkreli does, it’s still not a guarantee that he’ll do the same in the future. People can change, or alternatively be prosecuted for deaths resulting from their past actions and locked up. Either one would prevent him from making decisions that lead to people’s deaths. So you are still willing to countenance murder on just a chance of preventing future deaths. Still not justifiable.
there is no need to think that this is some action to point out the true nature of the Pharmaceutical industry.
It was only a matter of time before someone would try this and go this far. As it is it is perfectly legal, not every corporation nor all individuals have the ability to restrain themselves and their greed. In a system where wealth and power are of the highest value like we have here and now it would be inevitable wouldn’t it?
It is not unusual to hear of some large corporation getting caught and having to pay some kind of fine for unethical or for cheating and lying, VW just the other day.
uncle frogy
Numenaster:
I would go much farther (perhaps you too, but you don’t say it). There is not only an epistemological problem with capital punishment, that you can’t take it back if you’re wrong. Even if the person really is guilty of whatever it may be, leaving aside the question of whether/how we think we know about it, that is not all on its own a reason to kill the person. You still have all of your work cut out for you at giving an actual justification, which is a set of reasons for doing that instead of anything else. I don’t think we should be doing it at all. I cannot see, and have never been offered, any explanation of how it makes anything better. We also shouldn’t be starting wars either, for that matter. Only fairly rare cases, which really do amount to self-defense, not simply those which are convenient or cost-effective or alleviate our fears, actually require any violence at all, much less killing the person.
Well, Shkreli is according to wiki former hedge fund manager, entepreneur and current CEO of a company in US. It maybe unfair to some people, but when I read words “hedge fund manager”, “entepreneur” and “CEO in US” my brain automatically translates them to “parasite” and “selfish greedy asshole”. He is incapable of doing any actual work that actually produces something and can do nothing that is of any tangible value. His – and his ilks – whole livelihood depends on moving money around and skimming the fruit of someon else’s know-how and labour.
Consciousness Razor:
I was trying to focus on the specifics of the example at hand, and show that the unknowability of the future makes it impossible for this justification to hold up. I agree that in the wider context it hasn’t been shown that killing the hypothetical evildoer improves anything (it doesn’t keep someone else from doing the same thing) or that it is the best of the possible options (which didn’t get explored).
redwood@31: As for why the US doesn’t price-control like other civilized nations, besides the political reasons, is the idea that our overpayment is subsidizing the other nations; without it, people fear medical innovation would dry up because nobody is funding it.
The problem with that logic is that, if everyone’s free-riding on our innovation, that makes medical innovation a textbook “public good”, and even most libertarians (and Libertarians) agree that public goods are under-provided without subsidies. Another problem with that logic is that the amount we’re overpaying is quite a bit more than the amount we’re subsidizing the innovation (e.g. we’re also footing the bill for marketing and shareholder returns).
Taking those together argues for nationalizaiton; we could just make the subsidies explicit instead of implicit in the prices, and probably save money doing so. (Even if we didn’t save much or any money overall, there’s still an improvement in the moral dimension, by shifting the costs of the subsidies from the sick to everybody).
Sure. However, in the case at hand, prices already have gone up. It’s not something which might happen in the future which we can only make uncertain predictions about. We do know that. We don’t know how long they will stay that way, because the government intervenes let’s say, nor do we know the situations of everybody who is affected. So the exact magnitude of the consequences are of course uncertain. Many of them have not yet happened. But there’s no reason to doubt they’re (probably extremely) negative or that Shkreli is in fact responsible for that. Perhaps, despite his efforts, no one will die but will only suffer in various other ways. Perhaps only a few will die. But that’s different from saying we don’t (yet) know the guy is guilty of whatever the (fairly predicable) results will be. Doing that isn’t doing the same thing as extrapolating based on his previous track record, nor is it worrying about whether he (or someone else) will do this same kind of shit again in the future.
So, we can be very sure that what he’s already done is bad, full stop. That’s not a problem for us in this case. Assassinating the guy is still a very obviously bad way for us to respond. I hesitated responding to that at first, because it looks like such a ridiculous and trollish comment, but I can understand at least why people are extremely upset and might seriously consider things like that. Hopefully it was also slightly useful as a response, for anyone else who’s reading.
CR said “…we can be very sure that what he’s already done is bad, full stop. That’s not a problem for us in this case.”
Exactly right. The hypothetical scenario at hand is NOT punishment for past deeds, the outcomes of which are still unfolding. The hypothetical scenario was preventing future harm by causing targeted harm early. Any past harms are outside the discussion.
I’m astonished there hasn’t yet been a glibertarian along to explain that the real problem is gubmint regulation of the pharmaceutical industry, and if anyone was allowed to sell anything as medicine without any testing or registration, the Great God Market would soon put everything right.
And the Great God Market would do that by allowing such astonishing abuses of the public’s trust that public outcry would force the government to create some regulatory body. Ref. the Pure Food & Drug Act of 1906.
So that’s what a cartoon villain in real life looks like. Except he probably doesn’t even sing catchy tunes next to an invisible choir alone in his house.
Shkreli is using a form of violence which is only available to the rich. Only forms of violence that are also available to the poor are recognized as “violence” by our society. Even the people who really ought to know better. Thus there’s DERP no comparison.
Aside from the part where what Shkreli’s doing is actually wrong.
Shkreli appears to be little more than a career white collar criminal:
Sadly, too many of them get away with it these days. Hopefully, his past will catch up with him in this case.
Nick Gotts@44: see me @10.
Eliminating border controls for the pharma trade is pretty close to eliminating all rules. You first start shipping from Canada, but pretty soon your shipping from A to B to C to D to … to US and magically somewhere along the way your $1 pill got replaced by sugar.
But apparently I was wrong @12, and there is an actual monopoly grant involved: something about patent-like protection for companies that take an old, pre-testing drug and make it pass tests to modern standards.
I’m unclear on the effect of the daraprim price hike in Canada. It is going to depend on the provinces. Communist Quebec is pretty stringent in its dealings with pharma, but I haven’t seen any reports about the effect here (are we immune to it, or are we fucked?). Alberta, the Texas of Canada, would of course have a loose regulatory system.
I work for a real drug company. We do real research, we discover new molecules, and take risks. Over my career, I’ve worked on dozens of compounds that failed, and have gotten 3 compounds approved. My last approval involved an almost 10 year long clinical study program with thousands of patients. There was no guarantee that the drug would work well enough to gain approval.
What this guy did is different. He took advantage of a well-intentioned, but poorly executed, FDA regulation. For background, go to the FDA website and search for document ucm070290. The agency is eager to get rid of very old drugs, on the market since before 1938, that have not been adequately studied. So, to advance the state of scientific knowledge, they ruled that if a generic manufacturer of an old drug conducted adequate trials (which is low-risk, because most of these the drugs are well-understood), then FDA would remove marketing authorization from other versions. They meant well, but this creates a monopoly for an established drug, on behalf of somebody who only has to conduct a relatively simple clinical program.
In this case, the problem is a venture capitalist swooping in (“vulture capitalist”) to take advantage of a poorly-written regulatory guidance.
Several commenters above seem to think that nationalizing pharma research might be a good idea. I’ve worked in academic labs, I’ve worked on government research grants, and I’ve worked in a pharma company. Very few academic research programs would stand up to the rigor of an FDA inspection. If you want good-quality drug development, it has to be done by a company that is motivated to make money, with close regulation by FDA. It’s the partnership of capitalism for motivation and intelligent, thorough regulation to keep it honest that makes the system work.
This is my opinion, not my employer’s.
I think it’s very easy for pharma companies to blunt this threat. This drug was created in the 1950’s, it cannot be under any protection anymore.
All that is required for pharma companies to prove they do not support this practice is to announce (and follow through) with a plan to market the same drug for about $2 (cost plus reasonable profit so claims of dumping cannot succeed).
It’s a no-brainer PR move that may also make money thus is a capitalist ideal. If it doesn’t happen then isn’t something missing from the argument competition corrects such abuse?
The fact he chose a drug that is used to treat AIDS patients is not a coincidence, I think. There are plenty of drugs that are pretty much life-long type drugs, but AIDS is still treated differently in the U.S. I imagine he knows full well that most of the GOP still views AIDS as “the gay disease” and can count on them completely blocking any attempts by the public to force him to drop his prices to more reasonable levels.
david:
What supposedly makes academic research less rigorous? If you need a public agency to inspect private programs anyway, why would that be a reason to think public programs are lacking some kind of special magic sauce?
Why? Is money the only thing that motivates people? Is that a scientific motivation? Is it a motivation to be honest or thorough or intelligent? Do you believe people aren’t paid if they work for a public institution? Do you, as a researcher, see even a tiny fraction of the massive profits your employers make, and if not, how could it affect how well you do your own work?
Have you ever asked yourself what those profit-making “managers” or “owners” or “executives” at the top actually do, in terms of productive work or oversight or whatever it may be that’s aimed at making a safe and effective product? If you have asked that, could explain exactly what that is to me? Because my experiences with corporate types in various sectors is that they are invariably useless fuckers who happen to be lucky.
Other than “trust me, I’ve had jobs related to this,” is there any general reason why I am supposed to believe what you’re saying?
It’s sort of true. The absurdly high cost of drug development is itself a symptom of the larger problem. Drug companies have no incentive to control costs because they get to pass them on to consumers and Uncle Sam without any concern for competition, and in the case of Medicare, no ability of the buyer to negotiate down the price. The higher costs can actually boost their profit margins by justifying higher prices. For similar reasons, weapons contractors routinely end up with cost overruns of 1000%, yet somehow always remain highly profitable.
Until the money they waste actually hurts their bottom line, drug prices will continue to be insanely high. There needs to be serious reform of the patent system and Medicare needs to be given very aggressive negotiating power. Just for starters.
It isn’t as rigorous in the regulatory sense. You need a certain mindset to wade not only through the ICH guidelines, but also the commentary on those guidelines, about 10 pages per paragraph, on how those simple sounding regulations are seen and implemented by the agencies. You really need a dedicated quality assurance/regulatory affairs group. Which academic labs lack.
Since toxoplasmosis is also very dangerous to fetuses, this ingrown dickhair’s price jacking bullshit would logically be a major issue for “pro-lifers” in a world where being “pro-life” wasn’t just a cover for punishing people with wombs for having sex.
Area Man wrote:
I would be able to take the complaints about the high costs of development and regulatory compliance a little more seriously if drug companies devoted more of their money to R&D and less to marketing. The former budgets have been consistently shrinking and the latter have been growing.
If we’re going to have academic researchers run the drug trials (which is something I support), we’ll need a lot of major changes to how drug research and drug production is done. Setting up a QA and regulatory affairs group at each university is the least of our worries.
david @52:
Are you suggesting that the system is working?
The regulation “to keep it honest” depends on (especially in the US) legislators who receive large contributions from corporations, and officials who seem to take frequent advantage of the revolving door between government and industry. Hardly an optimal arrangement for hoi polloi.
I’m not surprised that’s necessary, but why expect there would be no such thing, if the field were not dominated by private corporations and academic (or other public) groups were responsible for it and held to just as a high (preferably higher) of a standard? We have no relevant guidelines to look at and make a real comparison, because they would concern a system that doesn’t currently exist.
Shkreli should be running for President. On the Republican ticket.
If we had Econ 301 capitalism companies would be price takers, and the price they charge would be just a fraction above their cost of production. Consumers would be the marginal benefit of the product.
With regulatory capture and crony capitalism we have artificial monopolies. Drug companies are price setter who can raise what you pay until the benefit you derive is just barely above the cost you must pay.
Translated into English: Get out the tar, feathers, horsewhip and split rail. Those sumbitches need a lesson in alternative enforcement mechanisms.
I’d only be comfortable with stronger price controls on drugs in the US if the US government agreed to heavily underwrite/subsidize the cost of clinical trials for bringing compounds through Phase II and Phase III rounds of testing. That’s the big killer in expense of bringing new drugs to market IIRC, not just in terms of money but in terms of the time involved.
I wonder why this sort of behaviour is suddenly getting publicity now, because it isn’t entirely new, even for Shkreli.
There are a few (possibly) relevant posts on In The Pipeline (and probably others that I don’t recall).
– Thiola, Retrophin, Martin Shkrell, Reddit, and More
– More Price Hikes on Obscure Medication
– Market Exclusivity Is Sometimes Too Much
As david pointed out above, this is all basically taking advantage of a recent FDA loophole, and Shkreli isn’t the only asshole to do this. Not that he isn’t entirely deserving of the bad press, of course.
My senior-year college roommate had a parent who was a researcher in one of the big drug companies here in the U.S. — not sure if it was the one which has now expanded to own most of the overall pharmaceutical market (Antitrust legislation? What antitrust legislation?) or one of the companies they have swallowed, or one of the few remaining competitors, but she said this was bullshit and cited her own experiences. The tests aren’t that onerous — and are often skipped; every time a drug is found to be potentially fatal and recalled, it’s because an obvious test was not performed and the FDA didn’t care — and options which might provide slow, steady profits are ignored in favor of long-shots which might generate large, instantaneous profits. Most of the money you pay for expensive new drugs is actually going to dividends and executive bonuses.
Saganite, a haunter of demons, @17:
Yup. The Nasdaq Biotech index dropped 4% yesterday. I bet a lot of people are pretty pissed off with him right now.
PZ
OT, but you might like to know that Richard Sanderson is currently spreading more malicious lies about you and the network here.
He’s claiming that you’re somehow “responsible” for “creating” CJ Werleman, that you provide a haven for (and defend) pedophiles, and that he’s going to “take you down” any day now.
And back ON topic — There should not be any patents on drugs, no private or corporate “ownership” of drugs, and a hell of a lot more price controls (to prevent this sort of price-gouging).
The biggest expense of a new drug is advertising. Typically it is more than half the cost.
david@52: The profit motive giveth, but it also taketh away, including in the case under discussion. You can get lean and mean operations that are highly motivated to meet targets, but you can also get unproductive rent-seeking as in this case, marketing expenses, profit overhead, etc. And in public-private partnerships one often gets the worst of both worlds.
In general I don’t see why the same people can’t be paid to do the same things by government agencies that they’re doing for private companies (there might need to be pay scale changes?). And there’d probably be some savings in regulatory compliance cost if the regulators are among the ones doing the work. (E.g. NIH does the R&D, CDC does the trials, FDA does the QA, to keep things appropriately adversarial).
The biggest downside I could see to having the government do the R&D would be the risk of political interference. Even on-topic for this blog – imagine a theocratic legislative bloc blocking research into childbirth pain relief because it’s divine will that childbirth be painful, as a punishment for Eve’s role in the Original Sin (I believe that was actually conventional medical wisdom until the 1940s or so).
@cmutter
That’s my biggest concern. Look at the delays that were thrown in the path of Plan B – if all research on pharmaceuticals were government-run, stuff like that might never be researched in the US at all because of anti-choice and religious conservative political sabotage.
Say what you will about the existing set-up, but one of the benefits is that it encourages investment in drug research and development in an unguided fashion, with tons of attempts to find stuff – anything – as long as they can sell it successfully for a profit. That means you hit a lot of dead-ends, but you also find the functional treatments among them.
cmutter:
It could happen. But you still have to reject Plato-style distrust of the plebs and accept democracy with all its imperfections.
I mean, it wouldn’t necessarily be a bad thing in a lot of cases. If a drug would be genuinely beneficial (i.e., something very important for their basic needs, perhaps life-saving) to a large segment of the population, there could be greater “political interference” to develop it and produce sufficient amounts of it, compared to other kinds of drugs which are made and distributed primarily for their potential to generate a profit for a handful of individuals. People actually have a say in what their politicians do, although granted that they don’t often exercise this right appropriately. But that does not come after the fact, simply in terms of what they’re willing to pay for (if you convince them with tons of ads that they want it). It comes in the form of oversight and accountability through legitimate democratic processes like elections/referenda/etc.
Of course we vote for the wrong things a lot of the time, but our concerns are not a significant factor at all for someone interested in making a quick buck for a corporation or its shareholders. We could all be the “shareholders” that this project is meant to benefit, since that appears to be the obvious thing to want, which capitalist schemes can only pay lip service to and make empty promises about. The fact that somebody makes money in a voluntary transaction — “market interference” if you like — just isn’t sufficient to tell you that this thing is actually going to be genuinely useful to society. It is a completely aimless process: it makes profitable junk as readily as it makes socially-valuable goods. Why wouldn’t we want to “interfere” in a way that is aiming for products or results that actually matter to people?
What this means, based on fallible online info I have found:
http://www.rxlist.com/daraprim-drug/indications-dosage.htm
Daraprim comes in 25 mg doses.
For malaria, you either take 2 to 4 pills a day for two days, and then a pill a week for 10 weeks. Estimate at 16 pills. This price hike costs these people at $11,784.
For toxoplasmosis, you get 2 to 3 pills for one to three weeks, and THEN maybe an additional 4 to 5 weeks at half that. So you could require anywhere from 14 pills to 63 pills for the initial therapy, and then additional 28 or 53 pills beyond. Which respectively translates into a price hike of $10,311, $46,400, $20,622, and $39035. Someone could be paying an additional $80,000 for a 2.5 month therapy on this one drug, because of this greedy, abusive price gouging.
People will die because of this. People will suffer. Insurance might eat some of the cost for some people, but not everyone is so lucky. Amoral uber-capitalism is just so great though.
brett @ 71:
[My emphasis]
It’s perfectly possible to have both public and private enterprises co-existing. Having a public agency doing pharmaceutical research does not necessarily imply banning private research.
CR @ 72:
Speaking as an end user, I’d be much happier if the US govt stayed the fuck away from drugs. Anyone who thinks they aren’t involved should try and get painkillers. Once you get through the close-to-insane regulations, jump through all the red tape hoops to get them (and must continue to go through red tape hoops), you get to be tied up in paperwork for several hours, signing opiate agreements, and consenting to random drug tests, because war on drugs, doncha know. And it would not be a good thing for anyone to take an amount of scrip drugs that was actually effective or anything, because there’s a chance someone might enjoy that sensation. Can’t have that, nope. The govt is already involved in the manufacture and distribution (including prescription distribution) of drugs, and not in a good way.
Pharma Bro is having trouble with some musicians.
More details, more musicians who are upset, at the link.
Well, that’s understandable, but just so it’s clear for everybody, I’m not making any claims in favor of the US government’s current policies. I was making very general arguments in favor of democratic socialism, which is obviously a far cry from what we have now. That supposedly has certain downsides (and if you look at it a very particular way, it clearly does). Or it’s supposed to be incapable of doing as good a job or better than systems which are much more heavily dominated by capitalism. I think that’s entirely wrong.
That’s true too. Meanwhile, the only good thing markets are supposed to do is motivate people, not to provide better drugs or regulations or to lower costs. Is it really so bizarre to question whether even that much is true? Money is one thing that motivates people … but is that necessary? (Same question that assassination-guy got above, really.) Is there nothing else that people care about? To the extent we have any evidence on it (which isn’t only coming from right-wing economists fluent in Marketese), what does it suggest?
@Nick Gotts
To be fair, IMHO it seems that a lot of the problems are bad regulations and bad patent law. To be excessively clear, no regulation is not the preferred alternative. Better regulations are the preferred alternative. The granting of monopoly rights to drug manufacturers is done by patent law, and it doesn’t have to be that way. The US Congress has the authority under the constitution to set up laws to grant patents, but it’s not a requirement. Patents (and copyrights) are morally justifiable to the extent that they foster innovation and creation, but today patent law (and copyright law) is so incredibly fucked up and tilted heavily towards large corporations.
The following article sums up my position well concerning copyright. The issues involving patent law are very similar.
http://www.gnu.org/philosophy/misinterpreting-copyright.en.html
I don’t like thinking about the right solution in terms of “government price controls”. I think that implicitly assumes that the drug manufacturers somehow deserve monopoly rights over their invention because it’s their (intellectual) property, and I heavily contest that claim. Rather, I think a better way of thinking about it is “We’ll give you monopoly rights to manufacturing and selling this drug, but only if you sell it at X price per pill or less. Otherwise, we’re not going to give you monopoly rights. Deal.”
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@Area Man
Agreed.
And some sort of overhaul to the FDA to make it less captured by industry interests. Can that be done? I have no idea how.
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@WMDKitty
Hey hey now. Let’s not get too silly. Patent law need not be a zero-sum game. The authorization in the US constitution to grant patent protection does not automatically entail 100% monopoly rights. The US congress has a lot of discretion in what protections a patent grants, and the congress can change those protections from field to field. As a gross example, the congress could pass a law which limits patent protections for drug developers to merely X dollars per pill, or X% gross profits per pill, etc., and that is the extent of the protections. This would allow any manufacturer to legally produce and sell the pill, as long as they pay their cut to the inventor. This system seems reasonable, and far more preferable than the current system.
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@Caine
Entirely separate problems. That’s a result of the Puritan war on
alcoholother intoxicating drugs. The war on drugs was a miserable failure a century ago, and it’s a miserable failure today. It should be ended immediately, and all such substances should be legalized for consenting informed adults. A fraction of the money that is being wasted on the war on drugs could be spent on education and rehab which would produce far better results for the goal of actually helping people addicted to some of these drugs.What’s silly? Does anyone own physics itself, or chemistry or biology in particular? What legitimate claim can anyone have over a molecule? Does anybody believe that they invented water or oxygen or uranium, and if so should we take them seriously? Do potential competitors have any physically possible option, like getting their resources from an alternative universe with different laws? What exactly are they supposed to do? Can we put whatever arbitrary things we want into a person’s body and expect them to work? What about cases when we can’t do that? Where do you go for an effective alternative then?
Lots of things are preferable to the current system. I don’t understand what’s “reasonable” here though — as a matter of fact, there don’t appear to be any reasons at all. Why can’t the public claim such rights for itself? The medical benefits of a particular molecule are a public good, as the high-minded talk about scientific/medical/social progress always emphasizes, at least whenever you can get people to start thinking about the point of it all instead of what is merely profitable. If the public were supporting the R&D, not this company or that company (with tons of government help, of course) would there be any reason at all for one person or a handful of people to ever make such a ridiculous claim in the first place? Why would anybody get paid any more than somebody else, for doing exactly the same work?
I was under the impression that anyone could make a “generic” version of a drug and sell that without running afoul of copyright law. I think I have completely misunderstood what a “generic drug” is.
Sure. That sounds fine too. I guess it depends on the relative effectiveness of free market incentives vs government sponsorship, but if government sponsorship is more effective – or even effective enough – then that sounds like a wonderful plan, and we can simply not offer patents for drugs and other medicines.
Dunno. Note that this argument applies equally well to all patents, not just drug and medicine patents. The ability to exercise certain privileges over a certain domain of physics (or chemistry, or biology, etc.) – that’s what a patent is. That’s what all patents are.
@Dark Jaguar
Copyright law covers books, music, and all forms of art. Patent law covers all forms novel physical inventions, including physical machines (such as the telephone), physical processes (the classic example is the Fischer-Tropsch process), and so forth. Thus, the relevant law is patent law, not copyright law. It’s about the discovery of the particular drug (for a particular purpose) and the discovery of the process to make the drug, and that’s the domain of patent law, not copyright law.
For chemistry/pharmaceuticals, three types of patents are important
Composition of matter matter patents, where you own the molecule during the lifetime of the patent. This is the one that keeps generics off the market until the patent expires.
Process patents, where you own a process to make a compound. This can be used to keep the generics out of the market due to costs, if your present process is superior to your original process.
Use patents, where you own the rights to use the compound in certain formulations. This allows for things like once a day timed-release pills to be preferred over thrice daily dosing.
Eventually all patents run out.
If you and I both design a machine which does essentially the same thing (a steam engine, for example), we can decide who owns this or that specific design, whether its or yours or mine. In doing so, I would not be making a claim that I invented thermodynamic processes, or as if I invented motion itself, or as if I have some right to the concept of steam itself (not this particular collection of steam here, which I own as property, but all steam everywhere).
I couldn’t claim the rights to all possible designs of all possible steam engines. There clearly are countless different ways of making steam engines, many of which will be just as effective as others (perhaps more effective for some uses than others). Doing so for one specific design of steam engine (which, again, you and I can both independently get, for our respective designs) is not therefore granting me a monopoly on the entire category of steam engines, as a matter of physical necessity. It wouldn’t be, like the case of some drugs, as if there are no other kinds of machines which are functionally equivalent to a steam engine. Someone could use an internal combustion engine, a nuclear powered engine, literal horse power, or countless other things. Even if I did have the patent on every conceivable steam engine, there would still be alternatives that could get the job done. I would need to be granted an extremely expansive and utterly ludicrous patent to get a monopoly on all of it.
However, once you get to roughly the level of molecules, you often run out of such options. There are not multiple forms of ordinary H20, which some competitor could use instead of “my” water that I have “patented” as my own “invention.” It’s not just an unfair advantage we’re talking about anymore, but simply doesn’t make any sense. I don’t really want to make this into a reductio, but just give me some solid answers that I can use…. If water were classified as a medication (after all, it’s necessary for human health and used as a treatment), what exactly would tell you that a drug company can’t legitimately patent it, whether that means having the sole right to its sale or distribution, or whether it means having the state force others to pay off the company in question to avoid (even more costly) lawsuits for selling/distributing “its” water? What is it about the chemicals drug companies patent which makes them somehow categorically different? Or at what point have I made some kind of a mistake? Am I (or is the state or a company) responsible for the fact that the world just doesn’t give us all of the options some of us wish we could have?
@consciousness razor
First, I disagree in large part about the dichotomy that you’re trying to set up. I also think that you’re not giving a proper description of how patents have operated in the past. The original patent for the telephone is not just one particular way to make a telephone. It would have covered more or less all possible ways to make a telephone. Borrowing language from copyright theory, standard patent protections would have covered all derived works.
In the theoretic sense, patents need to give an economic and competitive advantage of some sort. So, using your steam engine example, if the patent only covers one way to make a steam engine, and there’s an immediately obvious alternative – or even better! – way to make a steam engine that is not covered by the patent, then the patent is a useless piece of paper.
Again, you’re just arguing against patents in general.
I’m actually incredibly mad with current patent law. This is especially relevant to my job of a software engineer. From what I’ve seen, 90%+ of all software patents are pure unmitigated bullshit (probably more).
To explain the standard I want, let me give an example. Long ago, Amazon added a UI button to their website called “one-click” which allowed return customers to make an order in far fewer clicks than was customary on other websites. Amazon filed for a patent for this idea / concept / process whatever, and they got it. The patent was challenged in US courts, and IIRC Amazon won. This is an atrocious miscarriage of justice that is comparable to the monopolies of guilds granted by the English crown centuries ago.
At a minimum, before granting a patent, the standard should be: Hypothetically ask a bunch of experts on the topic, and give them the problem statement, and ask the experts if there is a trivial and obvious solution. If any of the experts can happen upon the same solution that someone else is trying to patent, then it’s not patentable. To patent something, it must be novel and non-obvious.
What happened in the Amazon case and what par for the course today is that patent clerks will look for literature of prior work, which is the wrong standard. “One-click” might not have any literature of prior work, and it might not have been done before, but that doesn’t automatically rise to the challenge. The implementation is storing user information on the user’s computer in the form of a cookie. If I gave the problem statement to any competent person graduating from undergrad in CS before “one click” was widely known, I expect undergrad to be able to give the same solution. Any freaking undergrad could do it, let alone an expert in the field, which means this should not have been patentable. At all.
So, I think novel and non-obvious are the important metrics. Concerning your water example – what sort of processes, methods, machines, etc., are claimed to be non-obvious and novel? Presumably your example would miserably fail the non-obvious and novel tests, which means it should not be patentable IMHO.
To continue, when Alexander Graham Bell invented the telephone, no one else knew how to transmit voice over wire, not even the experts, and that’s the minimum standard you should have to meet IMHO to get a patent of any kind. Even then, the privileges that are granted can be custom tailored to the domain, the duration of the privileges can be custom tailored to the domain, and the durations of the different privileges can be set differently. Patent law should be aimed at fostering innovation for the public good, but no further. We are trading away our liberties and freedoms when we grant patents, and we should do so only when the trade-off is in our best interests, when the cost of giving away certain liberties and freedoms is outweighed by the incentive in the market to produce inventions. If ever the situation changes and the trade-off is not advantages from the perspective of the public, then patents should be changed or ended. And again, this determination can be made independently for every domain of patents.
It appears that the Shriek has heard some of the criticism of the price gouging.
Link (with autoplay vid) here
What dichotomy and what’s disagreeable? I’m pointing out how it isn’t true that “this argument applies equally well to all patents, not just drug and medicine patents.” It doesn’t apply equally well. There are a boatload of distinctions we can make that apply to drug patents and not other kinds of patents. You were being too simplistic if you thought in some abstract sense that they’re all the same.
I do think (you’d apparently agree) that it’s been abused in all sorts of ways in the past. I care about what we ought to do, and I don’t count on the status quo or tradition, to tell me that everything is as it should be. I’m sure you’d have no problem with that, so what is the problem if you understand the purpose of my comment (which clearly wasn’t about giving a history of patent law in actual practice)?
Do you think that this stopped multiple parties from producing their own brands of steam engines, which to most people probably look indistinguishable? People do still make tangible objects and sell them. They’re paid for their labor and any resources that went into producing the thing. I sincerely do not care if no one could live comfortably for the rest of their lives from a single patent, because it by itself is not as valuable as some people want it to be.
I also don’t really see why there is a general concern in creating additional economic incentives for inventing new things, making them cheaper, more effective, efficient, etc. There has been built-in utility in doing that sort of stuff, no matter what economic system it may be, for as long as there have been people. What’s supposed to be the point of incentivizing activities that are already inherently useful? How could that be more important to you than every other concern, including basic human welfare? Why even distract ourselves with talking about that, as if it’s such a major problem?
No, I’m not. Do you not understand what I wrote? What part?
So, if one person had figured out a “novel and non-obvious” way (whatever that means) to produce water, then what? Could others still make water, but not in the way that person did it? They would have to pay the “inventor,” if they made water that way? Once some people gain enough expertise about this mysterious process, what happens then? Does it usually (or ever) take 50 or 100 years to resolve such questions? As soon as they know how to do it, is that when they can stop paying the “inventor,” for the privilege of doing it themselves with their own labor and resources? Would the inventor ever be reimbursed, or would they have a useless piece of paper in this system?
But aside from all of that nonsense… I did choose water for a reason. The question is whether anybody should be deprived of that, for the sake of some individual’s or corporation’s interests because they believe it’s somehow their property instead of everyone’s. How much does that matter to you, compared to the finer details of patent/copyright law which aren’t at all the important issue to me? Do I really need to explain the relevance of the sort of example I picked, in the context of a discussion about medicine? I’m very sure that that discussion has nothing at all to do with criteria like novelty or non-obviousness.
Nerd of Redhead @70,
Wow, really? Do you have a citation for this?
Just asking because we’d like to pass this information along to others but without a citation to some third-party evidence we’re afraid it might appear to them like just our unevidenced opinion. Would be nice to be able to provide them a citation to support this if you don’t mind passing it along.
According to <a href="http://www.scientificamerican.com/article/cost-to-develop-new-pharmaceutical-drug-now-exceeds-2-5b/"%5Dthis Scientific American article from November 2014 the cost to develop a new (prescription) pharmaceutical drug is about $2.6 billion and the the total life-cycle cost is about $2.9 billion.
You’re saying that it’s typical that more than half of these costs or $1.25B-$1.45B are spent on advertising? That is mind-blowing.
From the SciAm article linked above:
It’s telling that SciAm did not mention advertising costs at all in their analysis. Do you think they are trying to hide this information from the consumer perhaps?
Here’s the corrected link:
http://www.scientificamerican.com/article/cost-to-develop-new-pharmaceutical-drug-now-exceeds-2-5b/
Cost to Develop New Pharmaceutical Drug Now Exceeds $2.5B
http://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2013/11/11/persuading-the-prescribers-pharmaceutical-industry-marketing-and-its-influence-on-physicians-and-patients
http://www.fiercepharma.com/story/new-numbers-back-meme-pharma-does-spend-more-marketing-rd/2014-11-06
This statistic is very well known in the industry. Needless to say, the Pharma industry doesn’t like it spread to the public.
EnlightenmentLiberal. Let me emphasize the point more directly. Maybe it just doesn’t occur to you to think about it in these terms, because we’re looking at it from totally different angles.
Somebody patents water. We both apparently agree it would be an absurd thing to do. The basic complaint I think you would hear (because you know people would have great reasons to complain) is that water is such a fundamental and irreplaceable necessity for human beings, that no such patent could be recognized as legitimate. Anybody (or any system) agreeing to it simply cannot be trusted to make responsible decisions which are in our best interests.
I don’t think technicalities like novelty or non-obviousness would make any difference to most people as criteria, in making a decision to either respect this law or overturn it (I think we can very safely predict they would do the latter), even if such criteria do happen to apply and could theoretically be used, because there are much better reasons to reject it. They also don’t care about some vague principle that we want to create incentives for people to make new inventions — there are much more immediate concerns, like people dying of dehydration. Such things, to the extent they do matter, simply don’t matter that much.
What matters more is the fact that, like many medicines or medical treatments, water is something you simply can’t do without. You have no genuine freedom to voluntarily choose something else (or abstain from it) in any real-world market whatsoever, since often what you really need is water and nothing other than water will do. You can’t go to another shop and get something else which is just as good (or cheaper, etc.). Similarly you don’t have such choices about drugs or medical care. We have no business, and it makes no sense, to give such things the Free Market treatment, if anything should ever get that kind of treatment, which it probably shouldn’t.
Those are important considerations we cannot simply neglect, which make a substantial moral/political difference from your example of telephones (or even my own example steam engines, as I pointed out). It works very differently for things like water or medicine. All people really do need those things, simply to survive and have any opportunity whatsoever for other (less essential) valuable things in their lives, like wealth or property or a growing economy or whatever else they may care about.
Ok. I was just checking with you if you are arguing that patents should never be granted, and it seems that’s your position.
That’s the basic gist of patent law theory as currently done, yes. For example, if someone came up with a brand new way to desal water, all of the old ways would not be covered by the patent, but the new way would be covered by the patent. No fees, penalties, royalties, etc., would be imposed on anyone using any old method not covered by the patent.
And other quotes.
Again, I think we’re talking past each other. “To grant a patent” does not necessarily entail “to grant full arbitrary monopoly control over”. “To grant a patent” could simply entail “everyone else must pay royalties at a rate determined by congress and/or a particular executive agency, and where the royalty rate is determined independently for different domains”.
I’m in your camp that allowing full arbitrary monopoly control over the fruits of basic R&D is absurd, and that level of control is not required IMO to provide for proper incentives for R&D. (I also have the same feelings concerning full arbitrary control over copyrighted works.) Just off the top of my head, a scheme where patents give the holder a guaranteed royalty at a rate fixed by congress – or more likely an executive agency – dodges many of
yourour complaints.Again, it may be true that today that all patents grant “full arbitrary monopoly control”, but it doesn’t have to be that way. The provision in the constitution to authorize granting of patents can be used to grant varying degrees of control, or none at all. The power that it grants congress is very wide.
So, if some person or some corporation spends a lot of money on R&D to find brandnew way to desal water cheaply, safely, environmentally friendly, etc., and that person / corporation eventually finds it, I think it’s quite reasonable to reward that person / corporation for their money spent by providing some amount of reward, and many forms of reward would properly be called “patents”, which includes a simple royalty rate set by law / executive agency.
Doesn’t stop us from currently charging for it.
Finally, we’re edging close to a very thorny area where I don’t have a good answer. In short, if we had a situation where we knew someone would die with no action, but if we also knew that the person’s life would be saved and extended for 80 years by spending 1 billion dollars, should we spend that money? A trillion dollars? That’s starting to get in the ballpark of having all labor in the entire country devoted for one year towards saving that one person’s life. I think the reality of the situation is that there is a cut-off of how much money we as a society should spend to save one individual.
So no, I don’t think it’s as black-and-white as you put it. Example: if the drug costs a little more because of a patent, and someone dies because they cannot afford it, it’s entirely possible that incentivizing R&D of this kind means that without the patent, the drug never would have existed in the first place and the person still would died, or perhaps the drug would be invented still, but other drugs would not be invented without the legal atmosphere and economic incentives to spend on R&D which would result in even more deaths in net. Further, if we’re going to pay for this medicine with taxes, how far are we willing to go? Every increase in taxes represents taking time from every member of society, so how much time are you willing to take from everyone else in order to save 1 person? I don’t think these questions have easy answers. These problems manifest with or without patents. So, I must politely disagree with your black-and-white sentiment. It is true that sometimes there are going to be some people who are going to have to do without and die. Shit sucks. Life sucks. The world sucks. I try to do the best I can.
Having said that, I am a pretty strong socialist (according to the vulgar understanding of the word), and so I would spend a lot of tax money to provide good public health care. I don’t know how much time exactly I’m willing to take, but I’m probably willing to take a lot of time from people to save the few compared to the position of many in the population.
Nerd of Redhead @92,
Thanks you are the best!
EL:
Of course, that’s obviously implied by things like “How could that be more important to you than every other concern, including basic human welfare?” Obviously.
Or maybe this is just the patented EnlightmentLiberal brand of bullshit that I should’ve expected. (Do I owe you anything, or is mentioning it fair use?) You answer none of my questions, didn’t clarify anything, didn’t even attempt to resolve the problems with your own position that I brought up, and you very badly misrepresented my own position. It’s remarkable how often you do things like this.
If we got to talking about music piracy, which of course matters a lot to me as a composer, you might come away thinking my position is somewhere on the extreme opposite end of the spectrum (which would be equally baseless and wrongheaded). In typical cases, when it wouldn’t be so utterly disastrous for society if someone had a patent/copyright on something, I think the more or less standard thing that you do: they’re a good thing that’s worth protecting. We’re not talking about a typical case right now.
If people can’t go elsewhere for some other option that will suffice, without paying the inventor, it may not be what you mean by “full arbitrary monopoly control” but why would that be relevant? They still have some kind of control over what happens throughout the entire economy (not to mention ecosystems). Given certain facts about what specifically is patented, nobody else could patent alternative water-like substances or processes (since they don’t exist) that will do what we need water to do.
I’m not saying anybody is spending any additional money on anything. You’re saying all kinds of money should be funneled, away from everyone else’s pocket and toward the person who claims they have a patent on fucking water. That’s where it should go, because reasons. Do you hear yourself?
Sorry, I thought I was clear and did answer your questions. I sincerely do not understand how I misrepresented your position.
Again, in short, I believe that you’re setting up some false dichotomies. Again, let’s take some breakthrough water desal technology as an example. As best as I can determine, you would be against any and all patents concerning water desal because you say it’s a basic human need. Again, my position is that it’s quite reasonable that perhaps the world is such that by guaranteeing patents in cases like this, that makes the invention of better water desal more likely to happen, and even though this introduces a higher cost for water from this new desal method, which will result in human deaths, it’s quite reasonable that it’s possible that the world is such that the scheme will save more lives overall because the invention of the water desal will save lives that would have died otherwise, and without patents to protect the results of R&D, the work to discover the new water desal process might not have happened. I’m not saying that this necessarily is true in every case. However, your seeming position is that this is obviously false in every case, and I think that’s obviously wrong.
Yes, but I think you are not hearing me.
Further, I think you’re setting up another false dichotomy. I am in favor of subsidizing wholly basic human needs like food, water, and shelter. Our society is rich enough and efficient enough that guaranteeing free food, water, and shelter for the poor is well within our power.
Suppose we allowed a patent for a new water desal process. In my ideal world plus this supposition, the government would provide money to the poor to cover the royalties and other costs associated with the patent to ensure that no human would be denied water. The net result is simply that some amount of money from those who are better off in society will be transferred to the patent holder via taxes to government subsidies to payment for water. It seems like a reasonable system to me.
How is this ideal? You’re essentially agreeing that water is a public good, as are other things. We would have no real problem simply giving it away to people, as you say. It will come from fresh water sources, saltwater sources after desalination, recycled from waste water, or whatever the case may be in one location or another. It would still require water treatment to reduce containments and so forth (not just salt), which should also be (and sometimes is) a part of the public infrastructure, since it gets us nowhere to secure unusable water for everyone.
But you’re saying that the rich need to pay something extra, paid to some other (also rich) patent holder, so that everything’s fair somehow, in order to make sure nobody actually has to pay for water whenever and wherever they might need it? If the entire system — except for this one oddball part of it, because you insist on somebody having a patent for doing some inscrutable thing the public couldn’t have done itself — if it’s publicly owned and operated, why even try to jam private ownership into little gaps like this? Who says somebody must own that? How is it any better? How does it make any sense?
Two points.
Actually, I don’t think we can simply give away water freely to everyone. I think that would be a horrible mistake. I said (or meant to say) that we as a society are materially wealthy enough that we can provide water for free to the poor, not to everyone.
Indoor plumbing requires pipes, sewage treatment plants, and other infrastructure which much be maintained, and that requires labor, and we should pay the laborers. This can be by taxes, or it can be paid by charging individuals for use of water (with subsidies for the poor). Both approaches achieve the same result – money is transfered from everyone in the population (except the poor) to the laborers who maintain the water infrastructure.
In my native California, we are suffering an extreme dought. Water is not endless. Requiring people to pay money for water is a great way to ensure that water is not wasted nor spent on bad purposes. It’s not the only way, and it’s probably not sufficient on its own, but I think any workable solution must involve the element of charging money for water to prevent shortages by disincentivizing waste of water and inefficient use of water. With California’s arcane system of water rates, this is not being done. Large farms are being done growing crops that are wildly unsuited to California, and they are incredibly inefficient uses of water, but it’s economic for these farmers to do so because they don’t have to pay market rates for their water.
Finally, if market rates for water usage would not be sufficient for conservation, then all that would need to be done is a simple additional fee (tax) on water to further incentivize less use of water – plus additional subsidies for the poor as necessary.
Point two.
We want people to do R&D to improve our quality of life. The only way that this goal can be accomplished is to give money to people to do R&D. I hope this is not controversial. However, this payment can take many forms.
The United States maintains many national labs, and it funds many research programs at public universities, and so forth. These people are generally salaried and are paid for set periods of time regardless of whether their research is successful. Money is taken from every individual (except the poor) by taxes, and then transferred to the inventors – successful and not successful. This is the communist approach.
The United States also maintains a patent system. Any private inventor can spend their own time and their own money, and if they discover a good and useful invention, then they can apply for a patent, and charge monopoly rates for that invention from the public. In a better system, United States patents would not guarantee monopoly rates, but instead the United States would guarantee some lesser royalty rate to inventors where the rate would be by a congress (likely by an executive agency). Finally, the government use taxes to gather money and give that money to the poor to use this service. Just like the communist approach, money is transferred from individuals in society (except the poor) and given to the inventors. However, in this approach, only the successful inventors are given money, and the unsuccessful inventors are not given money. This is the capitalist approach.
I happen to think that pure communism failed for a reason. I think that some form of reward to successful private inventors is a good thing to do. Whether you want to call that “patent” or “inventor bounty” – I do not care. However again, I recognize that pure research is incredibly useful, and some degree of national labs, public universities, etc., are incredibly useful and should be kept. A pure capitalism approach would be just as foolish. I simply think that it is wrong-headed and naive to argue that expanding national labs and research programs at public universities would be a suitable replacement to private R&D of all kinds.
Ack, fixes:
>Finally, the government should use taxes to gather money and give that money to the poor to use this service.
If anybody happens to be in a situation where they need water badly right now, but don’t have access to their giant pile of money elsewhere (if they have one), then just like in the case of sending a person to the emergency room, you shouldn’t be asking such questions. You just do it. So, it should be nationalized and provided to everyone, just like healthcare. Of course that’s obviously going to be funded with taxes, which doesn’t make it “free” for most people, but there would be no cost in addition to the taxes you’ve paid.
The result isn’t the same. You’re not looking at whether the individuals/corporations who own these things are accountable for the best interests of all of the people, not whether they can profit, in the same way a public utility or agency is accountable. I don’t care only about the price. Who has control, why do they have control, and what should we be able to do if control is unjustly taken from us?
Since money isn’t enough to get people to do what they need to do for a stable and functioning society, charge them even more money. Not the most compelling plan I’ve ever heard.
Of course it isn’t. Government employees are paid to do their work. Do you find that controversial?
There never has been pure communism. The states you’re thinking of failed for lots of reasons.
I’m not saying it’s bad. Money isn’t the only thing people value. We don’t pay people to not murder each other, for instance, yet for some mysterious reason, they’re generally motivated to not murder each other despite that fact. You could draw up some convoluted and highly implausible way, in which people rationally assess the monetary costs and risks associated with anything and everything, but they do not actually think that way.
For fuck’s sake, once again, I’m not talking about “private R&D of all kinds” just like I was never talking about patents of all kinds. You’re making generalizations and extrapolations which simply aren’t necessary or helpful. Is water the only thing people might research or invent or patent? What about if we toss in medicine? Is that it? No, there are lots of other things, including some examples we already went over, which very well could be privately funded and privately owned.
Agreed.
You do mean provided with no cost based on usage, right? Then disagreed – for the reasons stated in the previous post.
Taxes are a very effective way at changing people’s behavior. I have no idea what you’re on about.
Yes, in this case, another incentive is provided apart from money: It is well-known that the people and the government have a standing threat that if someone commits a murder, then force will be used in response on that person to make their life uncomfortable in some way, i.e. prison.
Earlier, in several posts, you argued that all patents are bullshit, and now you are wrongly purporting that your position has always been that patents for certain core goods are bullshit. I’m sorry. It’s hard to understand your position and to fairly represent your position when you flip-flop like so.
Still, let me respond to this new position. I think you agreed with me that pure capitalism is foolish, and pure communism is foolish, and thus we should have a healthy mix of both. That’s good. I understand this new position that certain kinds of goods and services should not be patentable because of the public good. Again, I have to state my factual disagreement. I think that allowing some form of patent in areas of indispensible goods and services – especially when combined with a proper guaranteed minimum income scheme – will improve the lives of everyone.
I did not. It should’ve been very clear in #85 and everything after it. What do you think the stuff about steam engines was for, if not acting as an example of a non-bullshit patent? Of course, I’ve also tried to make it clearer each time you’ve misrepresented me. I also implied music copyrights (and other IP) should be respected, at least given our current economic situation… what do you think that could’ve possibly been about if not that?
What am I supposed to do? Would it help you somehow if I tried to make it more ambiguous or obscure?
Let me put it this way: “patents?????? You tell me what to think, EL.”
Is that what you want to hear?
I’m wrong about my own position? I’ve flip-flopped like how? Quote anything I said, which confused you about it. I suspect you’re just arguing dishonestly like you typically do, and/or you’re not reading for comprehension. You can just stop, and I’ll be very happy to let it go, since I have no use for bullshit like this.
Well, in my experience, your factual disagreements often amount to disagreeing with facts. What actual evidence is there, not what you believe might be true for whatever odd reason, that it would be better for everyone than nationalizing systems like that? I don’t know of any such evidence, and I can’t wrap my head around the idea that I should for some reason expect that to be the case. So I default to the choice that obviously and purposefully is all about doing exactly that. Just so we’re clear, so you won’t think I’ve flip-flopped about whatever you like, some crusty old theory from Mill or Locke whoever is not going to be something I count as a fact.
Post 85:
I guess the above was sarcasm? I took it at face value, especially in the context of the previous post of yours (which I still read as attacking patents in general, and I still disagree with your repeated assertions that there is a useful dichotomy that can be drawn w.r.t. patents on steam engines vs patents on molecules).
Sorry. I’ll try better next time to notice sarcasm, and I’ll try to ask if it’s unclear. So, let me ask – “Of course, that’s obviously implied by things like “How could that be more important to you than every other concern, including basic human welfare?” Obviously.” – that was intended as sarcasm, right?
However, for the future, please try to remember that sarcasm doesn’t carry over well in text.
My reasoning is that centrally planned economies like this lack the necessary incentives in the long term to produce good products and services because the individual persons lack an appropriate feedback mechanism that punishes for failure and rewards for success.
Insulting J S Mill?
1- He had almost nothing to say about economics AFAIK, and so I don’t see how that’s relevant.
2- Fuck you. You just insinuating that you lack respect for Mill and his Harm Principle, that you disagree with his Harm Principle, which means you think that you have the proper authority to tell me how I should live my life for my own good irrespective of the concerns of others. To that position, I have nothing but disdain. Of course, I recognize that you are probably not cognizant of what J S Mill actually wrote, and that you’re just trying to egg me on, which is also grounds for saying “fuck you”.
In this discussion, I have been trying exceedingly harm to be polite, reasonable, and fair, and I’ve gone nothing from undeserved shit from you. Fuck you again.
Say what you will about my knowledge of facts, my morality and ethics in general, but I’ll be damned if I can figure out why you think I’m dishonest and argue in bad faith. I am honest and argue in good faith to a fault, and I am neurotic about it. I don’t deserve this shit.
At face value, and factually speaking, it literally does not imply that. If I had meant it unsarcastically, you should’ve disagreed with me about it, as an assertion that there is any such implication, because it’s simply not what those words mean in plain English. Even if it’s a convenient strawman for you (it evidently is), you might have been charitable enough to step back from your own argument and simply think about what’s actually true, instead of what’s going to help you win this little debate.
Alright, but I hope you understand the content of your claims (how unjust you think society should be, or what you think is acceptable) is pretty upsetting, however polite you are about it. Things have escalated a bit as we’ve gone down these rabbit holes, but looking back it’s very hard for me to understand what’s really going on here — maybe it’s not dishonesty on your part, just not paying nearly close enough attention to anything I’ve been trying to say.
Would you still agree with these statements from Wednesday?
That’s something we could certainly agree on, if you meant it the first time and are still being consistent with that. But this doesn’t seem to sit next to it very comfortably:
Does it no longer sound like a wonderful plan? Are you just offering a different one that you think is also okay, or do you think there are real problems with the wonderful-sounding plan that I need to address?
EL:
I could be mistaken, but at times you seem to think we only have an on-off switch. Either we’ve got the whole package deal, of all conceivable patents no matter what that entails (given the adjustments you’d want to make to the current system, which maintain the ability to patent anything and everything), or the whole edifice collapses so that we can’t consistently justify having any patents. (The latter is basically what you thought my view was, even though I never said anything close to it).
I think we have lots of switches, dials, levers, wheels, pulleys, etc., which let us adjust many of these details more or less independently of one another, because those things don’t appear to be logically (or physically) dependent on one another. I think you need some kind of reason or evidence to claim that they do depend on one another somehow, since there’s currently no evidence or any other sort of reason to believe that.
I’ve been doing variations on the fairly standard liberal point that healthcare (and simple things like water, I’d add) can’t justifiably be treated as an ordinary marketplace. Whatever ordinary markets are really like (maybe they’re not even a concept worth discussing), in these kinds of situations, the fact is that people don’t have genuine choices which they can make voluntarily and rationally. It’s a big moral concern that their health or lives is at stake. Of course, you can’t enjoy any other goods, like owning property, if you’re dead. So how these different priorities relate to one another should be obvious. We should not be comfortable relying on “market forces” or “incentives” to accidentally solve such problems for us in an acceptable way, even if in other typical cases those are worthwhile priorities to have.
Keeping our eye on the ball, knowing that the purpose of whatever exact policies we eventually come up with is that everyone will have healthcare, whenever and wherever they need it, is very suggestive that it ought to be (generally, at large scales, at least) nationalized and not privatized.
Now here’s another pharmaceutical company gouging customers: Soliris costs $700,000 for a 12 month supply for a single patient to treat a permanent life threatening disease. The U.S. manufacturer is presently suing the Canadian government which is trying to make them lower their price.