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Monday, October 17, 2005

Reforming Drug Research: First Do No Harm

Presswatching economist Dean Baker has an interesting post over at MaxSpeak, proposing that the government take over financing all drug research. Baker points out that the government already provides most funds for basic research. He thinks the feds could also do at least as good a job as the private pharmaceutical companies that currently fund drug development with the support of profit-raising patents:
Why shouldn't we believe that if we doubled [federal drug research spending], to replace the $25 billion that the drug industry claims to spend on drug research (two-thirds of which goes to research copycat drugs) that we would end up with at least as good progress in developing drugs as what we have at present?
It seems to me the current system works awfully well at producing lots of amazing new drugs. I think we ought to place a high priority on not messing up a good thing. "First, do no harm," as doctors like to say.

So why not start "small" at, say, a billion dollars a year? That would be enough to start developing at least a dozen new drugs, a few of which would eventually prove beneficial. If it looks like we're getting somewhere, we can up the funding in a few years. But it's crazy to start by eliminating patents, which I think is what Baker has in mind. Certainly that's his long-term goal, and he places great emphasis on the evils of patents in his writing.

Really, there's no choice but to start small. To put Baker's idea into action, we'd have to set up a nonprofit or a new government agency, and let them try their hand at picking drugs and running drug trials to test for safety and efficacy. I don't know of any existing institution (other than the drug companies) that can do this.

Baker and lefty Congressman Dennis Kucinich suggest that the NIH and universities could replace the pharmaceutical companies. But drug development is mostly a hard, unglamorous slog. It's not the kind of thing academic researchers want to do. And it involves a large administrativeapparatuss to recruit thousands of patients into drug trials and collect data. Again, the NIH and Universities just aren't set up to do this kind of thing.

So there's no way to start spending $25 billion a year tomorrow, or even in the next decade. We'd have to build entirely new institutions.

So instead of trying to score rhetorical points by proposing to turn the existing system upside down, why try something modest? There will be plenty of political points to be scored when something so obviously reasonable is killed by the right and the drug companies.

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