June 25, 2017
The Washington Post had an interesting column by a doctor that discussed the difficulties his diabetic patients face dealing with the high cost of insulin. While the doctor, David Trigdell, does call for measures by the government to reduce the price that patients and insurers have to pay for the drug, he doesn’t ask the most basic questions about why the price is high in the first place.
This gets back to how the government finances medical research. To a large extent it relies on patent monopolies, and other types of monopoly rights, to pay for drug research. These monopolies are the reason that insulin is expensive. If it were sold in a free market, insulin would be cheap, and Dr. Trigdell’s patients would have little trouble covering the cost.
Of course, it is necessary to pay for the research, but there are other mechanisms. The most obvious would be for the government to pay for the research upfront as it is doing now in the case of the development of a Zika vaccine by Sanofi. (Unfortunately, in this case, the government is both paying for the research and planning to give Sanofi a monopoly on its distribution.)
If drug research was paid for upfront it would have the benefit that all research findings would be fully open (that could be a condition of the funding) and there would be no reason for unnecessary duplicative research, as no one would have the incentive to try to innovate around a patent just to develop a copycat drug. I discuss this in chapter 5 of Rigged: How Globalization and the Rules of the Modern Economy Have Been Structured to Make the Rich Richer (it’s free).
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