[alzamos]

Worth mentioning that the evidence says that patents don't have an effect on new drug creation/inventions. Evidence is collected here http://www.dklevine.com/general/intellectual/againstfinal.ht..., pretty neat to know that Italy/Switzerland had a patentless pharma industry until quite recently.

Having said that, I think you're right that under this system, research/capital definitely gets directed in a different way.

[missedthecue]

A major reason Alzheimer's research hasn't advanced in the last 25 years is that patents aren't long enough to study it. Remember: patents don't kick in after the FDA approved your drug. It's after you develop it. That's why ozempic is going off-patent in a just few years even though it's a new product. They patented it a long time ago.

With Alzheimer's though, the clinical trials are going to take a long time. Probably 10 years at least, because our current understanding of the disease is that it begins in your mid to late 40s, and only manifests as severe memory loss decades later. Our current method of trying to treat it is like putting someone in pallatiave care with stage 12 cancer through chemo. Just doesn't work.

But drug companies have no choice because if they run 10-15 year trials, their drug will be off patent before the FDA/EMA even looks at it.

If I were King for a day, one thing I'd do is a blanket 40 year patent life on Alzheimer's drugs. It's worth the cost. This disease will bankrupt every nation otherwise.

[alzamos]

While I understand the narrative you're proposing, what I brought with my source was a collection of evidence where pharmacological innovation happened at an unaltered rate pre and post patents in e.g. Italy and Switzerland. While I understand the hypothesis of "Pharma innovation, due to high costs of entry, only happens (or is greatly improved) when guaranteed a monopoly", it doesn't seem to be backed by the data.

I agree with you in principle though - if all that were stopping us from achieving a cure were a 40 year patent, I would support your 1-day monarchy in a heartbeat.

Chapters 9 and 10 of the book cover this in more detail if you're interested (very self-contained).

[cyberax]

This is bullshit. Drug research costs money, A LOT OF MONEY. A new drug right now costs somewhere around $5 billion, mostly because 90% of drugs fail in trials.

mRNA vaccines, semaglutide, mAB therapies, none of these would have happened without patents as an incentive.

[alzamos]

Then why is it that when pharma patents were introduced in countries that didn't have them, the rate of innovation, TFP, R&D-as-%-GDP didn't increase? I brought a source to this debate, if you have sources showing that increases in patent scope, length, or introduction of patents increased pharamacological innovation I'd love to see it - I'm going down this rabbit hole now and am collecting info.

Another interesting one is [1] where they asked readers of the BMJ to vote on the top 15 most important medical milestones. Of the 15, only the contraceptive pill and Chlorpromazine had anything to do with patents.

In [2] the "Chemical and Engineering News magazine" collected a list of top pharmaceuticals (46 total). To quote the book I linked:

> Patents had pretty much nothing to do with the development of 20 among the 46 top selling drugs [..] . For the remaining 26 products patents did play an important role [..]. Notice though that of these 26, 4 were discovered completely by chance and then patented (cisplatin, librium, taxol, thorazin), 2 were discovered in university labs before the Bayh-Dole Act was even conceived (cisplatin and taxol). Further, a few were simultaneously discovered by more than one company leading to long and expensive legal battles, however, the details are not relevant to our argument.

Regarding the cost of drug trials, they cover this well in Chapters 9 and 10, I found it quite interesting.

Regarding how else companies make money without being granted temporary govt-backed monopolies, Chapter 6 covers both the theoretical and real-life examples.

[1] https://www.bmj.com/content/medical-milestones [2] https://pubsapp.acs.org/cen/coverstory/83/8325/8325list.html