Just as the media in the Soviet Union were not allowed to talk about alternatives to one-party rule, the Washington Post apparently can’t raise the issue of alternatives to patent supported drug research in the United States. This should be apparent to readers of an article on Sovaldi, a new drug to treat Hepatitis C.
The drug is currently subject to a government granted patent monopoly which allows its manufacturer, Gilead Science, to sell a year’s dosage for $100,000. By contrast, a generic version sells in India for about 1 percent of this price. As the piece tells readers:
“If all 3 million people estimated to be infected with the virus in the United States were treated with the drugs, at an average cost of $100,000 per person, the amount spent for all prescription drugs in the country would double, from about $300 billion in a year to more than $600 billion.”
To put this number in context, the additional cost of Sovaldi due to the government granted patent protection would in this case be equal to more than 1.7 percent of GDP, or a bit less than 25 percent of after-tax corporate profits. In short, it is real money.
One might think that an article that raises ethical questions, as this one does, about how much we should be willing to pay for saving a person’s life, might also ask the question about why this drug is so expensive in the first place. Not in the Washington Post.
The granting of patent monopolies is a government policy to provide incentive for innovation. There are other ways to provide incentives, like paying people directly. (Has anyone heard of the National Institutes of Health? They get $30 billion a year to do basic biomedical research.) The government also finances a large amount of research directly through the Defense Department, with military contractors paid to develop new weapons systems. So there is a great deal of precedent for the government paying directly for research.
Some economists, like Joe Stiglitz, a winner of a Nobel prize, have suggested a prize fund where the government would buy up patents and then place them in the public domain. Under either system, all new drugs could be sold as generics at generic prices.
This would meet the condition that the price would then equal the marginal cost, which is usually a high priority for economists. Economists and people who have been through intro econ classes usually get upset when government policies like tariffs raise the price of a product by 15-20 percent above marginal cost. In this case, the patent monopoly is raising the price by close to 10,000 percent above marginal cost.
All the economic distortions and incentives for corruption that we would see from a 15-20 percent tariff also appear when a patent monopoly raises the price by 10,000 percent, except they are several orders of magnitude greater. The company has enormous incentive to mislead patients and doctors about the effectiveness and safety of their drug and also to market for uses for which it may be inappropriate. Drug companies also have incentives to pay off politicians to get their drugs covered by public programs. And drug companies act all the time in exactly the way predicted by economic theory. (Think of Vioxx.)
It is incredible that alternatives to patent supported research were never mentioned in an article that poses ostensibly difficult ethical questions about how much a life is worth. Without the government granted patent monopoly such questions would not arise, unless the Post puts the value of human life at less than $1,000.
It is also amazing that, at a time where much of the intellectual class has been obsessed with Thomas Piketty’s book, Capital for the 21st Century, which warns of a growing concentration of wealth and income, a policy that both creates enormous economic distortions and leads to upward redistribution of income, is not even a topic for debate.
It is probably worth mentioning that the Post gets substantial advertising revenue from the drug industry.