Except there is an overabundance of historical evidence of hedge funds giving almost exclusive preference to research which is highly predictable and has negligible impact, as long as it can result in a patent.
See for example below. Aging research is one of the most eclectic areas, because it touches on virtually all biological systems. There are countless promising directions which are grossly underexplored. Yet this massive hedge fund chose to invest in discovering new analogs to older drugs. Why? Because the older drugs are effective, discovering new analogs is easy and the patented products can then be marketed.
So, yes. There is a provable cabal of mustache twirling investors who optimise for profit, at the cost of impact. Why you would defend them, in spite of your self-professed rational interest in the positive externalities of revolutionary healthcare, is beyond me.
Funding in addition to not too the exclusion of. People still fund new restaurants and strip malls not just startups.
Closely related drugs may not cure new diseases but they do help. There’s a lot of drugs like Morphine but the thing is that give doctors options for better treatment. Fast acting and fast metabolizing is beneficial when an EMT is helping someone deal is massive trauma, post surgery recovery and you want a different drug.
Cialis and Viagra may both make your dick hard, but millions of people benefit from the options from having both.
Funding is the essence of scarcity. Funding one thing means those money will not be funding anything else. But you're free to be content with countless minor variations on existing treatments [0]. Curing cancers will require an actual breakthrough.
Total funding for all human activities is scarce, but can go to anything. Money spent on video games could instead be used to fund cancer research.
Thus the percentage of that funding going to medicine isn’t fixed. We essentially spend extra money on this kind of research rather than diverting cancer funding to look for new pain medications. Further, people with sage IV cancer really have benefitted from better pain meds it’s not as useful as a cure but it’s still useful.
Capitalism has freed 90% of humanity to do something other than farm food. We’re in the 3rd stage of human history first almost everyone was hunter gatherer, then nearly everyone was farmers, now people do all kinds of things. How we spend that seemingly boundless surplus of labor may not seem efficient, but it doesn’t need to be to be dramatically better.
Progress is exponential. So looking in the past and saying we should be content with a 90% improvement is misleading, because it is dwarfed by how much more potential there is.
That exponential is based on the increase in number of people not farming. Graph the number of writers/scientists/engineers/etc over time and it’s an exponential, but population isn’t expanded exponentially any more.
I don't defend "them". There is no "them". Conflating price gouging with lack of agency is, a different issue, outside of research. Patents count as output. Regulation hinders progress in the interest of safety and accountability. There are tradeoffs, granted. The idea that funds want to fund partial cures, rather than more comprehensive ones, is partially true. Comprehensive would be better for everyone, if it wasn't so damned difficult in western nations.
PHDs are predicated on thesis papers to prove something novel, which largely have no impact on society. This is a consequence of knowledge availability (and consequently utility), not maliciousness. Medicine is not special, in this regard.
The survival bias applies here. It's hard to know the diseases that are cured or have new treatments, because those cease to be issues at the forefront. Onchocerciasis? Nobody in the 1st world cares that was cured. Peptic ulcer disease? That was handled. What about medical procedures? Even incremental improvements to drugs, allow for more effective treatments or old treatments to have significant efficacy increases.
See for example below. Aging research is one of the most eclectic areas, because it touches on virtually all biological systems. There are countless promising directions which are grossly underexplored. Yet this massive hedge fund chose to invest in discovering new analogs to older drugs. Why? Because the older drugs are effective, discovering new analogs is easy and the patented products can then be marketed.
For general overview of the fund: https://www.technologyreview.com/2022/06/07/1053132/saudi-ar...
Their first major investment was in analogues of a decades old drug called rapamycin: https://www.hevolution.com/en/web/guest/w/hevolution-foundat...
So, yes. There is a provable cabal of mustache twirling investors who optimise for profit, at the cost of impact. Why you would defend them, in spite of your self-professed rational interest in the positive externalities of revolutionary healthcare, is beyond me.