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The book goes into quite a bit of depth if it is a topic that interests you.

I would flag that we’re getting into “prove a negative” territory here: the goalpost is that we need to prove empirically that patents achieve the desired outcome. If the scenario you describe accounts for all game-theory/incentive/complex-adaptive-system universes, we should see this reflected in the data.

When it comes to pharmaceuticals, they looked into Italy and Switzerland who switched to a patent system in 1978 (and I believe Portugal in the 1990s). They looked at the growth curves of things like # of inventions, total factor productivity, percentage R&D spending, and the conclusion was that there was no statistically significant change in trajectory that would suggest the introduction of the patents had any positive effects. (Edit: they accounted for domestic/international + US filings before/after as well).

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Thanks for actually giving a great answer to this versus the other knee-jerk comments! I will definitely look into this more.

I think it's important to note that the cost of bringing a drug to market has increased a lot (about threefold) since 1990, so if the case studies are that old they might not generalize.

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> You spend billions

The you being taxpayers, right?

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No, only a small part of this is publicly funded.
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Which part is small? Productizing? R&D? Marketing?
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> Why would anyone invest in drug studies?

To make a shit ton of money. These things are insanely profitable. Generics exist and they're still profitable. You can get 99% of drugs from over seas and they're still profitable. These companies make trillions of dollars over the years. Yes, they might make slightly less money, but they still would be making a shit ton of money.

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Generics exist for drugs that usually someone did hold a patent for that has since expired and they're much less profitable than patented drugs.

Not sure how that address the point. Again, the investment to get a drug to market is gigantic and you're saying that someone should pay for that and someone else should get the reward. It really doesn't work that way. Everyone would want to be the one who didn't pay.

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This may surprise capitalists but people genuinely want to make the world a better place, let's not act like the only human desire we have is to accumulate wealth.

If the current iteration of pharma companies refuse to share society progress with all humans, we can create different pharma companies that build drugs for the public good rather than the private benefit.

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It's not black and white- in pharma there are notable sources for investment that are not private, e.g. for orphan diseases that would otherwise not see enough investment due to lack of profitability.

But here's a mechanism to mobilize private capital for those diseases that are. Again, the investment needed boogles the mind, around 10B currently, for a single drug.

You're asking someone to pay that money and allowing others to reap the rewards. Why wouldn't everyone want to be the one who didn't pay the money?

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Some will surely exist. We already have public funding for things that are not particularly profitable. The question is if it will net a better system overall.

Even with the current system everything older than X years is public. That means we should have better care options available then anything X years ago. And that keeps increasing.

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People talk about capitalism as if there is a choice; as if Gravity might not pull us towards earth.
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I'd quibble with that. Capitalism is a choice, market dynamics are not. E.g. The Soviet Union successfully outlawed capitalism, and in response market dynamics made their country collapse.
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Unregulated market dynamics also gave us child labor, slave trade, 12h work days, company scrip, companies ruling over governments, etc. A powerful engine without constraints is out of control.
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England imposed the institution of slavery on the American colonies by means of their regulation of economic affairs. It didn't occur spontaneously from market dynamics, but was specifically provided for by (their) laws.
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I don't think there's much meaning in saying the Soviets outlawed capitalism.

Capital continued to exist and there continued to be people who decided what got built and who received them. To me, that's private ownership. I mean, it's not like apple trees suddenly began bearing Ladas. If I wanted to acquire a field to occupy / farm, it was presumably controlled by someone, either an individual person or group of people. I don't see the difference in saying that in one situation my neighbor owns the field as personal real estate, versus whatever terminology the soviets used for why I can't just take it.

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I do however like the imagery from the parent of a big collection of people working for a decade to produce one (1) drug and then burning all that infrastructure and training down and then being shocked when someone with no infrastructure or training or history in drugs comes along and somehow produces it but outsells the original.
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This may surprise socialists, but you can set up a pharma company yourself right now that makes all its research open.
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I agree, but man, getting the money to make the world a better place goes through the capitalists right now so unfortunately that's the game. Can't fix the problem without fixing the system. (I'm not like hardcore marxist or anything, but incentives shape everything; have to fix the incentives)
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This may surprise extreme altruists but there are people who genuinely care about profit motives and are only willing to make the world a better place at a price. I don't see software engineers in advertising and finance quitting their jobs en-masse to work for teach for america, doctors without borders, etc.

Also, the bulk of the cost of manufacturing a drug lives in the scientific & engineering exploration space, which we should incentivize.

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