US drug prices are not because of R&D. This title presents a false dichotomy
Drug companies have enough capital at this point that they don't need old drugs to fund new drugs. They can charge a high price for new drugs to recoup their development costs, & then charge closer to the cost of production once that development has been covered
Reformulation does not extend patents, it creates a new patent on the new substance. The substance in the existing patent can be manufactured as a generic after the existing patent expires.
The wrinkle is that the new and existing substances are not equivalent, and thus cannot be substituted for one another. Thus, if a doctor prescribes the new one, that is what needs to be dispensed.
You have just described the patent system. They get a period of patent protection to charge high prices, then anyone can make the drug and competition lowers prices.
There are some places where this falls down, i.e. there are some generic drugs that have high prices due to a lack of competition, but that's not the common case. Have a look at the price of Ibuprofen to see how unpatented generics ought to work.
What really causes the failures is the amount of bureaucratic overhead which deters other companies from entering the generics market. When the market for a drug isn't very large, the return from selling a generic is less than the regulatory cost required to enter the market, so nobody does. Lower the compliance costs and that doesn't happen as much.
Some new drugs are not that critical to have. Others might be. Given that we don't / can't know which drugs will be developed in the future, it's kind of impossible to answer with certainty.
Suggestion: Congress debates if developing slightly fewer medicines is OK if it means lower prices
The suggestion was sadly too long by 6. I’ve gone with “Congress asks if developing slightly fewer medicines is OK if it lowers prices”.
And even if we weren't, it doesn't follow that moving resources from one place to the other is the right choice. When you have two things that both produce benefits exceeding their costs, you're better off to do both of them.
Given the choice between higher prices or not having treatment at all, I suspect those whose medications would be culled would gladly choose higher prices.
I'm not saying that your position is wrong--medical innovation is really important. I'm saying you're being reductionist. There are really hard questions here, and accusing others of privilege does nothing to make this discussion more productive.
I suspect a better set of regulations around generics would solve the problem with ordinary market forces. Probably there are quite a few policies that protect the existing drug companies that don't make any sense for generics.
If there are two drugs available for a condition then not covering one because it's too expensive is more viable. Take one of those companies out of the market and what does that do to your leverage when you're "negotiating" with the other one?
Only instead of determining by a board of doctors whether you are entitled to care, a bureaucratic measure to determine whether a company should investigate cures to what ails you. Better for society, worse for you as an individual.
If the government makes this decision, your backstop becomes "move to a new polity."
This is the core of the argument, that the government should not have this power. Say what you will of the sad state of the US health situation, there are potential solutions not involving this level of "We choose who can have what."
I'm not one with exotic health problems, the kind that involve going to a hospital for a week for a batter of tests and analysis, but I know people for whom this is the case. I suppose those people are the ones this is writing off.
