

India’s Efforts to Aid Poor Worry Drug Makers - vellum
http://www.nytimes.com/2013/12/30/health/indias-efforts-to-aid-poor-worry-drugmakers.html?_r=0&pagewanted=all

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ashray
I personally think that medicine IP should have some sort of limitation where
discoveries in the pharma world cannot be profited from in perpetuity. Even
generic drugs in the western world are VERY expensive. Most of them are simple
compounds and the major justification of price is R&D.

Maybe a better solution would be to have differential pricing for different
regions ? Like, Kindle Books are cheaper in India. Well, of course, there is
the question of the radically poor who live on less than $1 a day. They
wouldn't be able to buy a Kindle Book any more than they can buy a strip of
aspirin.

However, there are so many levels of ethical implications involved in this
kind of situation because we're talking about _people 's lives_.

Maybe another idea could be to have a 5 year IP advantage and then make the
medicines 'public domain' ? IP laws are based on profit incentives but when
dealing with something with such huge humanitarian ramifications we should
definitely take the time to re-evaluate our position on it.

Even people in the western world should have access to cheap medicines. What
needs to be balanced is the innovation/profit incentive with the humanitarian
aspect of it.

~~~
betterunix
I have an even better idea: no pharma patents at all. Instead of relying on
private R&D, rely on public funding -- just like we do in other fields of
science. Let anyone produce the drugs discovered by that research and bring
the focus of research back to drugs that work rather than drugs that are easy
to profit from.

~~~
ashray
I like your idea and also the parallels that you're pointing out. I just can't
see it making it through legislation through the pharma lobbies.

It's always tougher to implement these things _after_ there are big players
out there.

And your last point is something that touches me personally:

 _bring the focus of research back to drugs that work rather than drugs that
are easy to profit from._

This is a massive problem worth discussing. I had a family member die of a
disease which was incurable. One of the big pharma companies had prototypes of
the next drug they wanted to bring to the market but their current drug (which
didn't work..) hadn't 'run its course'. So they delayed the release of the new
one for a few years.

In retrospect, it didn't matter because the new one didn't work either but
this kind of practice is heinous on so many levels and must be stopped.

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girvo
I'm sort of conflicted. I feel that the profits that the pharmaceutical
companies receive from first world developed countries coupled with the strong
IP protection they enjoy here should be good enough, and I'm happy those in
other countries receive the care they need. But then, China, India, they have
a lot of very rich people too, so to pull it off in a way that to a first
approximation makes sense, means some odd regulation and making it harder for
people to get it in general without going through hoops. I don't know... Drugs
are such a weird thing to think about: we're talking about peoples _lives_
here, and as far as I'm concerned human life is the most important thing in
the world, and profiteering from that in the way that pharma companies do
sometimes (ever greening, and the like) is unethical in my opinion, the
research that they conduct creates a lot of value. Truly, I don't know the
correct way of thinking about pharmaceutical companies and business. Hard
topic.

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nazgulnarsil
I don't think it's just to lump pharm behaviors under profiteering. Certainly
some goes on, but that they can charge a high price is the reason some of
these revolutionary medicines were developed in the first place. If R&D
doesn't pay itself back, companies won't do it, and humanity is the poorer for
it. Any sort of two tiered approach encourages people to cheat the system. I
agree it's a tough problem, and we probably haven't found the optimal balance.

~~~
ericd
Perhaps we could step up government funded drug research, and the government
could license it to every drug company? We all benefit from curing these
chronic diseases, and the current model isn't exactly a model of efficiency.

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rational_indian
government = corrupt body = money sink

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ericd
To clarify, I was saying that the US govt. should play a bigger role in drug
R&D, not the Indian govt (though maybe they should too).

US government research money largely goes to research scientists at
universities in the form of research grants, so it's not really the government
performing the research and spending the money. I wouldn't say the university
research departments are money corrupt money sinks.

They could also license the fruits of the research to drug companies in other
countries for a nominal fee (or free) as a form of humanitarian aid.

~~~
rational_indian
I guess you can safely ignore my comment then :)

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ShirsenduK
I am from a small Indian town. And the reality which I have seen first hand
is; the subsidized medicines don't reach the poor and the doctors; who are
bought by the big pharma companies; prescribe some variant which is not
subsidized. The subsidized medicines are never in stock as they are sold in
the black market. Its sad to see politics of corruption hampering research.

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zhaphod
70% of people {think 800 million people} live on less than $2 per day in
India. It would be naive to think that Indian govt will care about IP of
Pharma companies. I understand it takes a billion dollar or more to create
these block buster drugs, but a country like India cannot afford to worry
about the profit these companies make. If these companies say they will either
go out of business or stop producing these kinds of drugs it wouldn't matter
to India. As a bulk of the people who need these drugs are already dying and a
larger portion of the people will die. And India cant do a thing about it.
That is the absurdity of the situation.

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namlem
I'm OK with this. The current system of drug development isn't sustainable
anyway. The rate at which drugs are improving has slowed dramatically. We have
picked all the low hanging fruit. While I believe personal genomics may very
well usher in a golden age of drug development, we need some way of making
testing the drugs easier and cheaper as well to fully reap the benefits.

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fatca
Why would Indian people have to die of cancer, for the profits of the
colluding US pharma oligarchy and their captive regulators?

Both India and China are nuclear powers. Between them, half of the world
population lives there.

If I were India, I would not give in one single inch. Eventually, all respect
is ultimately based on the fear for reprisals. Just as a matter of principle,
I would rather press the nuclear button.

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gaius
India has nukes, aircraft carriers and a space programme. It is _not_ a poor
country. It has poor people tho' because... It has nukes, aircraft carriers
and a space programme. Priorities!

EDIT I assume this is being downvoted because it doesn't kowtow to the "big
pharma is EEEVIL" groupthink, but it doesn't make it any less true.

~~~
ashray
It's not really that straightforward. Believe it or not, developing nukes,
aircraft carriers, and a space programme is actually easier than lifting 600
million people and all their future generations out of poverty.

Take the above into perspective. High tech research, industry, etc. also need
huge investment. What happens if we educate tons of our population and then
they end up without jobs ? (this actually happened in Soviet states not so
long ago..) Reduction of poverty and advances in technology have to happen in
tandem. Besides, most of the amazing strides the US made in technology have
origins in military/space exploration applications.

Reduction of poverty in India is definitely a priority. It's just one of the
priorities. We have a $20 Billion educational plan coming into force soon
(targets higher education as well as lower levels).

Every problem in India is a problem of scale and penetration. I hope people on
HN will appreciate that.

Bill Gates certainly recently understood that when he decided to join the
fight against polio.

~~~
gaius
That is also true, but it is a matter of perspective. I am writing this from
the UK where we don't have aircraft carriers or indigenous launch capability
anymore. There is a time for national prestige but there is also a time to be
pragmatic about what a nation can actually afford.

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anu_gupta
> I am writing this from the UK where we don't have aircraft carriers or
> indigenous launch capability anymore.

What are you talking about? The reason you're being downvoted is that trite,
inaccurate Daily Mail-ish opinions are just dumb.

The UK doesn't have aircraft carriers because it fucked up the decommissioning
/ commissioning cycle. HMS Queen Elizabeth will be operational in 2020 [1].
You seem to be implying that a choice has been made to no longer have aircraft
carriers in order to prioritise welfare.

And what is Trident if it's not "indigenous launch capability"? When did the
UK _ever_ possess land based missile capability?

[1] [http://en.wikipedia.org/wiki/Queen_Elizabeth-
class_aircraft_...](http://en.wikipedia.org/wiki/Queen_Elizabeth-
class_aircraft_carrier)

~~~
gaius
The choice was made to decommission the Invincible class early to save money.
You can wriggle all you like, that is true.

Trident cannot place satellites in orbit, nor launch probes to Mars
([http://www.bbc.co.uk/news/science-
environment-24729073](http://www.bbc.co.uk/news/science-
environment-24729073)).

That's 2 for 2

~~~
anu_gupta
Wriggling?

What is the HMS Queen Elizabeth? When did the UK ever have the sustained
ability to launch into orbit?

Go back to reading the Daily Mail, son, it's a safe place for bigotry.

~~~
gaius
Show me some Daily Mail links then _boy_ , because I haven't read them. In
fact if I were going to guess what paper said "no nukes" I'd say the Grauniad.
India's policy of "guns not butter" cannot be justified given the very real
issues facing their population.

[http://en.wikipedia.org/wiki/Guns_versus_butter_model](http://en.wikipedia.org/wiki/Guns_versus_butter_model)

What is the Queen Elizabeth? I'm glad you asked. It's a carrier that will come
into service at some point in the future and we could not afford to keep a
carrier capability going in the meantime. FACT. It's a class of 2 ships, one
of which will be mothballed as soon as it is built as we cannot afford to
operate it. FACT. The project is ongoing because penalty clauses mean it would
cost too much to cancel it. FACT. The aircraft that will operate from it are
the second choice as we couldn't afford to fit catapults. FACT.

Shall I go on?

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known
Indian regime is spending $1 billion/year on space research when 50% of its
children are malnourished. [http://m.timesofindia.com/india/Every-second-
Indian-child-is...](http://m.timesofindia.com/india/Every-second-Indian-child-
is-malnourished-Report/articleshow/25724848.cms)

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fit2rule
The timing of this article - occurring right in the middle of TPP negotiations
- is highly suspect ..

Is this some sort of agitprop designed to make the disgusting provisions of
the Trans-Pacific Partnership agreement (a truly vile development) somehow
more palatable to the Western world? The TPP, if ratified by the Indian
government, will give American and European Pharmaceutical companies near-
complete control over the pricing of their drugs in the Asian theatre - which
would be a most heinous development if it goes through, because it will
undermine the sovereign rights of these governments to protect their people.

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userbinator
What a word-soup of a title. For some reason I parsed "worry drug" as a single
noun and wondered why their makers are poor...

