can certain diseases/illnesses be cured

[boykster]

Make the patent protection period shorter and you will effectively squash innovation by smaller companies; in fact smaller biotech companies will become more and more scarce.  Oh, and that prospect of a billion dollar blockbuster drug?  Well, you can forget companies developing small indication treatments for less common afflictions - where's the market and how can you recoup development costs if there's even less time to market the drug before generics hit the market.

Don't listen to your gut, its oversimplifying the issue.

[shmokes]

Oh, I know the argument.  I'm just not sure I buy the pharmaceutical's side of it.  As I said, you have to have a balance.  The profit incentive has to be there.  It's also worth noting that you don't simply stop making money the day generics become available.  Last I checked Tylenol was selling like gangbusters, in spite of the fact that Wal-mart-brand Acetaminophen is sitting right next to it for half the price.  Claritin is probably making more money now than ever before (of course it went OTC, too).  Additionally, y'all send the doctors on cruises and the doctors mark the little (no substitutes) check-box on the script pad (actually I have no idea if this is legal).  You do fine. 

And, let's be realistic.  Maybe there is the occasional drug that gets only a year or two on the market before the patent runs out, but how often does that really happen?  The vast majority of drugs that come to market, sit on the market with no available generic for many years.  Think of any famous drug out right now, from Viagra to Propecia to Prozac to Cipro to Vioxx to Acutane to whatever.  These drugs sit on the market for years and years without competition from generics.  The bleak picture you paint may be true here and there, but it is the exception, not the rule.  FDA approval is not holding drugs in limbo for 15-19 years.  That just ain't happening.

And maybe not every drug can be a Prozac (which was pulling in multiple billions of dollars per year in sales during its exclusivity period), but the superdrugs subsidize the research of the smaller drugs.  And, hell, sometimes you end up developing an indication drug like Proscar (a moderately useful drug for people with enlarged prostates) only to inadvertently realize you're sitting on Propecia.  Exactly the same drug.  That it cured balding was a completely accidental discovery.  So just reduce the dosage from 5 mg to 1 mg and multiply the amount you charge per pill by five or ten times and you've got a recipe for success.  Is that what you call cost recouping?  Or is that just profiteering?

So, like I say, balance.  Drug companies need profits.  The profits drive the innovation.  But Merck will put its drug on the market at EXACTLY the price that will maximize its profits.  Period.  And Merck's not going to altruistically lower the price of a drug once its costs have been recouped.  There is one thing and one thing only that lowers the price of a drug: supply and demand.  Demand is fixed by mother nature.  So long as the Merck has exclusive control over the supply, Merck will set the price to maximize profits, not to ease as much pain as possible.  And this will go on until the day a generic or an alternative hits the market.  You know this is true.  So, while drug companies need profits, people need drugs. 

Maybe 20 years is too long, maybe it's just right, maybe it's too short.  But your response to me is every bit as much an oversimplification as the gut instinct I expressed. 

[boykster]

My point about your oversimplification has more to do with the wide difference in how "big pharma" and smaller biotech companies operate within the same regulatory environment.  They operate under very different financial and even business environments, yet still have to deal with the same timeframes

I'm well aware of new indications for existing pharmaceuticals developing new sales and marketing.  TOBI for inhalation was a new forumulation and new indication of the orphan drug Tobramycin.  Why did our company develop it?  Because the 'big pharma' companies had essentially ignored the very small patient population who were suffering from CF induced respiratory infections, and didn't see the profit in developing it.  Our company did, developed a new delivery system (aerosolized dry powder), took the drug through regulatory approval, and brought the drug to market.  So what happened?  The company failed financially due to the extremely high cost of development, regulatory trials, and marketing.  We were bought up by a larger biotech company who was looking to broaden their portfolio.

Superdrugs subsidizing smaller drugs is like Reagonomics - sounds like a good idea, but doesn't really work as advertised.  How does the sales of a  superdrug by a big pharma company subsidize the discovery and development of a small market drug - developed and discovered by another company?  Sure, big pharma (and even sucessful larger biotech companies) subsidize innovation within their company thru the sales of their approved products, but are you aware of how many drug candidates FAIL well before even entering Phase I clinical trials?  And how many drugs never make it to NDA filing phase? 

You're absolutely right, pharma is a business, and business is driven by profits, not goodwill.  People don't NEED drugs; people want drugs to prolong or increase their quality of life.  Civilization existed long before there were drugs.

EDITED for spelling 

[boykster]

Don't mistake my inside opinion as "blind support" for the drug industry.  I've seen the drive to satisfy the corporate bottom line drive companies to ruin by cutting early research and shortcutting development in the name of profit, rather than scaling back the commercial side of the business or reducing street expectations.

I'm a small biotech guy by nature; not as "pure science" as the non-profits and academia, but not nearly as money hungry and "business of science" driven as larger biotechs and big pharma.  When my previous company was bought out (big biotech bought out by big pharma) I was offered a relocation to the SF Bay area (from Seattle), nice position, etc, but declined mostly because of the culture of "big pharma". 

I now work for a non-profit cancer research organization, but I'm working on the clinical data side of things; not where my real passion is in R&D. 

[boykster]

I'm a small biotech guy by nature; not as "pure science" as the non-profits and academia, but not nearly as money hungry and "business of science" driven as larger biotechs and big pharma. 

After working for a private foundation, I really think it's a better environment for worthwhile research.

I partially agree; it depends on what your definition of worthwhile is.  I totally agree that the non-profit / academia world is much better suited to non-product-directed research - ie research for the sake of research and the greater understanding of X.  I'll also agree that the rigor of the research is much higher -> academia: spend X amount of time to discover something, spend X times 10 the amount of time to try to disprove it; if you can't disprove it, it might be true.  industry: spend X amount of time to discover something, spend X / 10 trying to find additional data that supports your discovery, patent it.

Where I've seen the academia world break down is big picture focus.  Where I work now, there's essentially no single "mission" of the organization, short of get grant, do research, publish, get more grants, wash rinse repeat.  That has led to a TON of redundancy of function, waste, and serious political issues within the organization.  And yep, the research suffers because resources that could be utilized more efficiently get wasted due to political spats between department heads.  Sure, that happens in industry too, but I'll be damned if its a LOT easier to get fired in the corporate world than it is in the non-profit one.

 

[shmokes]

People don't NEED drugs; people want drugs to prolong or increase their quality of life.  Civilization existed long before there were drugs.

Well now, corporations don't NEED an exclusivity period on their products;  Corporations want an exclusivity period to prolong or increase their quality of life.   Civilization existed long before there were patents.

Now, don't get me wrong.  I don't buy what I just said; but it's no more ridiculous than quoted bit above.  Corporations don't have some kind of natural right to patents.  Society grants them artificial exclusivity to the extent that it benefits society.  Society is people.  There's no reason for the people to grant artificial exclusivity to a corporation beyond what is beneficial to the people.  To the degree that patents encourage advancements and innovation they benefit both society and corporations.  To the degree that patents keep prices artificially high and stifle innovation by establishing a monopoly, they benefit only the corporation.  Since only society has the power to grant the monopoly, what would possess it to do so in a way that wasn't beneficial. 

So, yeah, maybe people only WANT drugs.  But corporations only WANT patents.