From: Smigrodzki, Rafal (SmigrodzkiR@msx.upmc.edu)
Date: Fri Jun 07 2002 - 11:06:35 MDT
CurtAdams@aol.com [mailto:CurtAdams@aol.com] wrote:
Sent: Thursday, June 06, 2002 10:52 PM
To: extropians@extropy.org
Subject: Re: Bitter Pills
In a message dated 6/6/02 11:26:28, SmigrodzkiR@msx.upmc.edu writes:
>### I could imagine some objective methods of deciding here. For example,
>you could measure the exact impact of new medication on human health (e.g.
>as expressed in QALYs), as a function of the duration and breadth of patent
>protection.
Yes and no. It's precisely measuring that which is so expensive. The FDA
studies give surprisingly little info on this, even at their great expense.
Some of the cost results from government inefficiency, but no matter how
you slice it, following thousands of people for years or decades in a
randomized
clinical trial is insanely expensive. At some point somebody's got to take
risks.
### FDA studies usually do not have survival as a primary endpoint, although
it is sometimes a secondary endpoint and is always tracked. However, you
seem to be referring to the double-blind placebo controlled studies. The
studies needed to evaluate the effects of patent duration would be
different. They would not directly solicit patient participation, instead
they would need to track the following data:
1)Medication input, both patented and generic, for example from pharmacy
registries (it's a pity that not all countries collect such data)
2) Survival data of the general population (collected almost everywhere)
3) Diagnoses (might be available from insurance records)
4) Data on other care resource utilization (nursing homes, hospitalization).
>From these inputs you should be able to assess the correlations between the
use of medications and survival (weighted for QALY with the diagnoses and
resource utilization data). You would observe the differential between the
effects of generics and brand drugs. Once you have such correlations, you
could ask if manipulating the frequency of brand drug introduction would
have any effect on the system. Of course, you would need to do some astute
reasoning to assess the influences of marketing, and prices but this should
be doable.
One of the incidental suggestions I would have is to open medical records of
deceased persons, so the necessary data could be easily collected (no
privacy after death).
Similar reasoning could be applied to gauging the best duration for
copyright protection, differentiating between software, art, and other forms
of intellectual property.
----------
I also know of no work indicating how much research benefit you obtain from
patents. Patents encourage the patented research, but cost in enforcement,
diversion from non-patentable activities, and restriction to related
research.
In the 19th century, 2 countries repealed patents (the Netherlands and
Switzerland);
the Netherlands saw no change in research activity and Switzerland saw an
increase (from thence comes the famed Swiss pharmeceutical and chemical
industries). In principle such work could be done, but I don't think it
has.
### Both countries are very small and they derive most of the research
income by using their large neighbors as markets. Now, you are right that
exactly measuring the general influence of patents on all areas of science
and technology might be very difficult if not impossible. However, I am only
suggesting developing methods for analysis of drug patents, and this should
be somewhat easier.
Rafal
This archive was generated by hypermail 2.1.5 : Sat Nov 02 2002 - 09:14:39 MST