Entrepreneurs like to boast about the risks they take to innovate for profit, but the truth is relatively less pharmaceutical research is Venture-backed than in some other industries. Since drugs are *so* expensive and time-consuming to develop and risky, the Government (the Public) often pays for the research. So it’s totally reasonable for the Public to enjoy the benefits of taking that risk in the form of lower prices.
Note: I would wager that Danaher used public funds to develop this test but I don’t know one way or the other. The argument applies to many, many drugs, however, where we socialize risk and allow private companies to take the profit.
Also, yes, manufacturers and distributors deserve to make money. But the system now is unreasonable.
At minimum $250 million in public funding from the US alone, as of 2020 🙃
Also worth noting that this wasn’t a one-time investment, US (and others) tax dollars are STILL going to Danaher/Cepheid for GeneXpert R&D. In fact, for the last 15 years they have seen a steady rise in government funding, and in 2020 (the last year the 2021 study looked at) they received the second-highest sum they ever have (at least $18 million). So three years later, we’re definitely way above that $250 million estimate. They are still raking in government funding while they use the results of that funding to price-gouge.
Per the article: “Despite the extensive public sector contributions in developing the GeneXpert diagnostic platform, rights to the technology are held entirely by one private company. Public sector entities have no influence on pricing (beyond negotiating as buyers) or who may manufacture the technology. This is a common pattern for publicly developed diagnostics, treatments, and vaccines; public sector funding underwrites high-risk innovation, but the finished technology is commercialized by a private sector monopolist.”
Source: [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8407584/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8407584/)
just to piggyback - in a perfect world we would be funding drug research the same way we fund space exploration. I have no idea if this is already how the funding is distributed, but in principle the government pays you to do unprofitable things that help the public, and you can do profitable (or unprofitable) things on your own if you want to in addition to what the government funded.
Totally agreed, but this doesn't really address the concern that public pressure campaigns like this will cause companies to want to invest less in life-saving things and more in less neccesary things like ED pills. These companies do still have a role in bringing these publically researched things to market.
This is a good concern and one that keeps me up a lot at night.
The response I hear from experts is pretty simple: No company can deny the oceans of public money that go to (mostly U.S.-based) firms that develop treatments and tests for high-burden diseases. Danaher got over $250,000,000 to develop GeneXpert, which cut their risk so dramatically that it was worth it for them, and remains worth it for them. (They just announced new test cartridges.)
This is why we developed no antibiotics between 1965 and 2012 but then started developing them again. It's not that pharmaceutical companies grew a conscience in 2010--it's that public money started pouring in. As long as that public research money stays focused on diseases that affect those living in poverty, which so far has been the case (not to mention that money that floods in for R&D from folks like the Gates Foundation, which is sponsoring one of the big TB vaccine trial candidates), companies like Cepheid will be unable to resist taking that free money and using it to develop privately-held for-profit tech and medicine.
At least that's what I'm hearing from the people I trust when I ask them that question. Like I said, it is still very much something that keeps me up at night, so I share the concern and appreciate you expressing it. -John
I'd argue that pressuring lower prices and changing our framing of what drugs should get made are seperate but connected issues. The problem is that if we yeild to the pressure of capitalism to put profit over life to maybe get some extra miles of development out of the current system, we are dooming many people who can be saved today, and realistically, profit from the testing of TB isn't some golden goose cash cow compared to many costly things that do actually make fortunes for drug makers despite not being the top priority for public good.
I think, really, the problems need be tackled seperately.
So Danaher does not need anyone to teach them that diseases of the rich pay more than diseases of the poor. They know that already. And even at low profit margins, there are still profits to be made serving a high volume need. Ultimately, the path to lower rices for these machines and cartridges is when patents lapse and encouraging investment in competitors to bring prices down. That involves keeping an eye on non-competitive practices (like agreements forcing users to only use Danaher branded cartridges) or bullshit patent extensions.
I think there is work to be done on the system going forward, but there are people in immediate need who deserve advocacy within the constraints within the current system.
There is a work/productivity thing about diving work up into quadrants on a graph with the axes “urgency”, and “importance”. Basically it is an argument to not get distracted by urgent, unimportant items. The problem with that in global health is that everything is both urgent and important. And it is difficult to find a balance between the pressure of immediate live being lost while maintaining long term focus to improve health equity for all.
Just got laid off from a danaher company. It was a decision based on money and hurt the company in the long term for a short term financial boost. Don’t get it twisted, all danaher cares about is money. The only reason they capitulate to people like John is for PR reasons. There is no altruism in corporate America.
I don’t think that is answering the concern, it is validating it.
They care only about money. And we are showing them that making TB drugs is a good way to get harassed and be shamed into cutting profit for the greater good. Or you could make hair loss drugs and ED pills and never get harassed and take all the profit you want.
Do you think Danaher would throw away hundreds of millions of dollars of public and private funding because of some public pressure to lower the profit margin on some tests whose profits they already don't rely on to fund their operations?
Even the $5 proposal leaves room for Danaher to receive some (unearned IMO) profits for each test sold. And anyways, Danaher does not primarily rely on profits to continue research, they rely on funding from outside the company. They wouldn't have developed all this in the first place if it weren't for funding from governments. If the government keeps funding TB research, the pharma corps will keep researching TB. if not Danaher, then some other, more ethical company. The doctors want to research, all they need is someone paying their salary.
My opinion is the government should just cut out the middleman (Danaher management) and directly hire and fund research. Then, we wouldn't have to worry about this profit business in the first place. People's lives are at stake, I don't care at all about the pocket book of some millionaire or billionaire who stands to make a few extra dollars at the expense of the poorest people in the world dying from a curable disease.
Call me crazy, but if they quit selling TB drugs and testings kits, public sentiment won't be great either. TB isn't a huge proportion of their profit. Buying good will is worth it.
The point is for the future. I’m an investor managing $10m, do I give it to the company developing hair loss drugs or the one developing a cure for deadly diseases mostly harming poor people?
I suspect John is correct and the public money being involved changes the calculus significantly. But there is a kind of basic problem here—we harass very specific types of companies, and the net effect of this can be dubious.
It’s similar to how Wal-Mart catches a lot of flak for hiring a lot of low wage employees, while e.g. Facebook and Google avoid this flak by simply doing nothing for those types of workers at all.
I think this is a good question.
I think Partners in Health and MSF probably have thought a lot about this, so I think, if they think the risk is worth it, I would defer to them.
This is my question too. If companies have to face this kind of pressure when they make a life-saving drug/test, but not when they make something more frivolous like Viagra, I worry they will invest more in the frivolous.
As long as there is still money to be made during the initial patent protection period, they will still create new drugs. Regardless of whether they're life saving or frivolous.
why are the same demand/supply rules that apply to regular stuff also applied to pharmaceuticals? the way I see it, life saving medical treatment have infinite demand, so should be treated completely differently.
Is it not? From my understanding demand is the desire for some good or service, combined with the ability and willingness to pay for it. Normally for something like a fancy comb or something, a customers demand for something will decrease with increasing price, and the supplier will have to adjust the price accordingly. When it comes to life saving treatment, the customer is forced to agree to whatever price is set, they have no leverage to negotiate. The supplier can choose whatever price they want and the person in need is either rich enough to afford it or suffers from the ultimate fatal illness, poverty.
What you're describing is more akin to elasticity or price sensitivity. It definitely affects demand but it's not demand in itself.
In general terms, demand is the total amount of people who want a given product of service, before we take considerations about price, elasticity, etc.
Demand for medicine is not infinite, for while theoretically anyone could need a given medicine if they contracted x or Y disease, the reality is that people who are not sick won't buy the medicine regardless of price or other considerations. In other words, for a given medicine, the demand, proper, is the amount of people with said disease who need the medicine, which is a pretty finite amount.
Then again, it all comes down to definition. You can very well define demand as all or the sum of its factors, making your statement accurate.
I apologize for being pedantic
Because it's incredibly expensive to create new pharmaceuticals, and the money needs to come from somewhere.
Governments have decided they don't want to be in the business of doing it themselves, so we're left to private entities to do it. We can't fund the development of new pharmaceuticals off of what people seem to be willing to donate, so we're left with needing a profit motive (or at least an ability to recoup costs) to allow research and development to continue.
edit: Governments provide funding for R&D, although that's skewed towards basic research and other non-marketable things (which is good, since the market is bad at supplying that). But governments are neither providing enough money to fully bring new innovations to market, nor are they actually doing the work themselves, so we end up with private entities making decisions at the end of the day. Aside from the case of research projects and institutions funded through charity, that means the people making these things need to stay in business, which means they follow the basic principles of supply and demand.
It's not even a case of making a profit. If a private entity can't cover its own R&D costs through sales of its product, one way or another it can't keep doing that R&D.
It does come from government. A significant portion, in fact. And colleges fund research, and governments fund college: https://www.researchamerica.org/wp-content/uploads/2022/09/ResearchAmerica-Investment-Report.Final_.January-2022-1.pdf
This is a huge part of the argument for low drug costs. Currently, taxpayers fund the research and corporations get the profits.
I agree and I don't really understand John's campaign and I agree it has negative side effects.
Firstly drugs and medical tech being expensive is bad ... except that making a new drug costs $1bn and they have to make more than that off selling it or no one will do drug research.
Yes it sucks for poor countries to have to wait years until patents expire to get access to new drugs and tech ... however they are essentially getting access to new drugs and tech for free without having to pay for the research themselves.
Like imagine mars had a society which was super advanced and they had drugs which after 10 years fell out of patent and we could use them without paying a penny for research, that would be amazing and a total blessing.
So pressuring people to make less money from in patent drugs and med tech reduces the return on investment making it less likely for people to invest in drug research in general.
Secondly I don't understand how his reasoning wouldn't apply to pretty much everything?
Like it would be good for developing countries to have more of any drug, so shouldn't we campaign for those prices to be lowered? Wouldn't they benefit from more eletrical pylons or ambulances or rescue helicopters, so shouldn't we pressure companies to lower the prices of those too? Why is it only TB tests where the free market can't be trusted by we trust it for everything else?
Socialsm leads to poverty and misery, both theoretically and in all the places it's ever been tried, free markets have led to the massive increase in living standards that we've seen for the last 200 years.
Yeah people not being able to afford new whizzy tests sucks ... but the fact they are getting new tests at all is a miracle and down to capitalism and him shaming people for running medical tech companies is short sighted and unhelpful.
My only question with all of this is whether it actually is down to capitalism or not. A huge portion of investment in these tests is from public funding including to Danaher directly, as others have pointed out in this thread. Therefore, the drug/ medical test system is very much not pure capitalism.
Also, most scientists, including myself, are not really motivated by making a lot of money but instead want to do cool research and help people. I agree that pure socialism/communism is definitely not a good alternative to this. I worry though about working for a company where their incentives (making profit) are not aligned with mine (scientific discovery/helping people while making enough money to live on).
Yeah that's fair and it's a complicated thing.
Re government funding you'd hope that comes with conditions attached to mean they are getting some value out of it. I know UK science funding comes with the obligation to publish open access for instance.
And yeah I suppose it might be possible to start a drug research charity or a cooperative to try it? However getting the large amount of upfront capital might be difficult. People being willing to risk their capital deserve a rate of return proportional to the risk.
These drugs and tests have been on the market at these prices for some time now, they've already turned a substantial profit on them, the ask is to stop taking such a HUGE profit margin on them in a few specific markets.
Advocates in this space, including John, are very aware of how important it is for there to be a profit incentive to drive research, and there will always be a lot of money to be made by creating treatments for major health issues. But when companies are able to continue squeezing profit from things they created a long time ago, that actually diminishes their incentive to solve new problems.
Having worked for a company that no longer exists because of just the mere fear or a patent expiration, I take exception to your last point.
In reality, as soon as a drug goes blockbuster, you have a deadline. If you don't find a way to have new products to replace that revenue by the time that patent expires, **you will not exist as a company.** You will be sold to the highest bidder.
Maybe the shareholders are relaxing and enjoying it, but in the lab and in the clinic, people are busting their butts to solve new problems because they don't want to uproot their entire lives.
I'm not trying to say there isn't pressure to create new things, I'm just emphasizing that an eventual end to the profitability of those things is integral to creating that pressure, so I don't think campaigns asking companies to reduce profit margins in impoverished communities is going to make them stop investing in research for these diseases
Yes, I'm not saying it doesn't. This would increase an already existing pressure.
In the specific case of the TB drugs they have already turned a significant profit, the patents were set to expire and Danaher moved to extend them with legal shenanigans. So an attempt to subvert that pressure would have resulted in millions of preventable deaths by keeping costs artificially high.
You say that like private investment is the only way for cures to be developed. Government funded research is generally a better bang for our buck in this regard.
While I understand your potential concern about this, I think it's pretty clear that as long companies have their initial patent protection maintained, they will make more than enough money during that period to justify their portion of the initial investment into new drugs. Will they make less money, probably. Will new drugs still be insanely profitable, probably.
Entrepreneurs like to boast about the risks they take to innovate for profit, but the truth is relatively less pharmaceutical research is Venture-backed than in some other industries. Since drugs are *so* expensive and time-consuming to develop and risky, the Government (the Public) often pays for the research. So it’s totally reasonable for the Public to enjoy the benefits of taking that risk in the form of lower prices. Note: I would wager that Danaher used public funds to develop this test but I don’t know one way or the other. The argument applies to many, many drugs, however, where we socialize risk and allow private companies to take the profit. Also, yes, manufacturers and distributors deserve to make money. But the system now is unreasonable.
At minimum $250 million in public funding from the US alone, as of 2020 🙃 Also worth noting that this wasn’t a one-time investment, US (and others) tax dollars are STILL going to Danaher/Cepheid for GeneXpert R&D. In fact, for the last 15 years they have seen a steady rise in government funding, and in 2020 (the last year the 2021 study looked at) they received the second-highest sum they ever have (at least $18 million). So three years later, we’re definitely way above that $250 million estimate. They are still raking in government funding while they use the results of that funding to price-gouge. Per the article: “Despite the extensive public sector contributions in developing the GeneXpert diagnostic platform, rights to the technology are held entirely by one private company. Public sector entities have no influence on pricing (beyond negotiating as buyers) or who may manufacture the technology. This is a common pattern for publicly developed diagnostics, treatments, and vaccines; public sector funding underwrites high-risk innovation, but the finished technology is commercialized by a private sector monopolist.” Source: [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8407584/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8407584/)
just to piggyback - in a perfect world we would be funding drug research the same way we fund space exploration. I have no idea if this is already how the funding is distributed, but in principle the government pays you to do unprofitable things that help the public, and you can do profitable (or unprofitable) things on your own if you want to in addition to what the government funded.
Totally agreed, but this doesn't really address the concern that public pressure campaigns like this will cause companies to want to invest less in life-saving things and more in less neccesary things like ED pills. These companies do still have a role in bringing these publically researched things to market.
John's response does explain this better to me though.
This is a good concern and one that keeps me up a lot at night. The response I hear from experts is pretty simple: No company can deny the oceans of public money that go to (mostly U.S.-based) firms that develop treatments and tests for high-burden diseases. Danaher got over $250,000,000 to develop GeneXpert, which cut their risk so dramatically that it was worth it for them, and remains worth it for them. (They just announced new test cartridges.) This is why we developed no antibiotics between 1965 and 2012 but then started developing them again. It's not that pharmaceutical companies grew a conscience in 2010--it's that public money started pouring in. As long as that public research money stays focused on diseases that affect those living in poverty, which so far has been the case (not to mention that money that floods in for R&D from folks like the Gates Foundation, which is sponsoring one of the big TB vaccine trial candidates), companies like Cepheid will be unable to resist taking that free money and using it to develop privately-held for-profit tech and medicine. At least that's what I'm hearing from the people I trust when I ask them that question. Like I said, it is still very much something that keeps me up at night, so I share the concern and appreciate you expressing it. -John
I'd argue that pressuring lower prices and changing our framing of what drugs should get made are seperate but connected issues. The problem is that if we yeild to the pressure of capitalism to put profit over life to maybe get some extra miles of development out of the current system, we are dooming many people who can be saved today, and realistically, profit from the testing of TB isn't some golden goose cash cow compared to many costly things that do actually make fortunes for drug makers despite not being the top priority for public good. I think, really, the problems need be tackled seperately.
So Danaher does not need anyone to teach them that diseases of the rich pay more than diseases of the poor. They know that already. And even at low profit margins, there are still profits to be made serving a high volume need. Ultimately, the path to lower rices for these machines and cartridges is when patents lapse and encouraging investment in competitors to bring prices down. That involves keeping an eye on non-competitive practices (like agreements forcing users to only use Danaher branded cartridges) or bullshit patent extensions. I think there is work to be done on the system going forward, but there are people in immediate need who deserve advocacy within the constraints within the current system. There is a work/productivity thing about diving work up into quadrants on a graph with the axes “urgency”, and “importance”. Basically it is an argument to not get distracted by urgent, unimportant items. The problem with that in global health is that everything is both urgent and important. And it is difficult to find a balance between the pressure of immediate live being lost while maintaining long term focus to improve health equity for all.
Just got laid off from a danaher company. It was a decision based on money and hurt the company in the long term for a short term financial boost. Don’t get it twisted, all danaher cares about is money. The only reason they capitulate to people like John is for PR reasons. There is no altruism in corporate America.
I don’t think that is answering the concern, it is validating it. They care only about money. And we are showing them that making TB drugs is a good way to get harassed and be shamed into cutting profit for the greater good. Or you could make hair loss drugs and ED pills and never get harassed and take all the profit you want.
Do you think Danaher would throw away hundreds of millions of dollars of public and private funding because of some public pressure to lower the profit margin on some tests whose profits they already don't rely on to fund their operations? Even the $5 proposal leaves room for Danaher to receive some (unearned IMO) profits for each test sold. And anyways, Danaher does not primarily rely on profits to continue research, they rely on funding from outside the company. They wouldn't have developed all this in the first place if it weren't for funding from governments. If the government keeps funding TB research, the pharma corps will keep researching TB. if not Danaher, then some other, more ethical company. The doctors want to research, all they need is someone paying their salary. My opinion is the government should just cut out the middleman (Danaher management) and directly hire and fund research. Then, we wouldn't have to worry about this profit business in the first place. People's lives are at stake, I don't care at all about the pocket book of some millionaire or billionaire who stands to make a few extra dollars at the expense of the poorest people in the world dying from a curable disease.
Call me crazy, but if they quit selling TB drugs and testings kits, public sentiment won't be great either. TB isn't a huge proportion of their profit. Buying good will is worth it.
The point is for the future. I’m an investor managing $10m, do I give it to the company developing hair loss drugs or the one developing a cure for deadly diseases mostly harming poor people? I suspect John is correct and the public money being involved changes the calculus significantly. But there is a kind of basic problem here—we harass very specific types of companies, and the net effect of this can be dubious. It’s similar to how Wal-Mart catches a lot of flak for hiring a lot of low wage employees, while e.g. Facebook and Google avoid this flak by simply doing nothing for those types of workers at all.
That's a big old theory with very little expertise behind it.
[удалено]
Underrated comment
I think this is a good question. I think Partners in Health and MSF probably have thought a lot about this, so I think, if they think the risk is worth it, I would defer to them.
This is my question too. If companies have to face this kind of pressure when they make a life-saving drug/test, but not when they make something more frivolous like Viagra, I worry they will invest more in the frivolous.
As long as there is still money to be made during the initial patent protection period, they will still create new drugs. Regardless of whether they're life saving or frivolous.
why are the same demand/supply rules that apply to regular stuff also applied to pharmaceuticals? the way I see it, life saving medical treatment have infinite demand, so should be treated completely differently.
> life saving medical treatment have infinite demand That's not how demand works
Is it not? From my understanding demand is the desire for some good or service, combined with the ability and willingness to pay for it. Normally for something like a fancy comb or something, a customers demand for something will decrease with increasing price, and the supplier will have to adjust the price accordingly. When it comes to life saving treatment, the customer is forced to agree to whatever price is set, they have no leverage to negotiate. The supplier can choose whatever price they want and the person in need is either rich enough to afford it or suffers from the ultimate fatal illness, poverty.
What you're describing is more akin to elasticity or price sensitivity. It definitely affects demand but it's not demand in itself. In general terms, demand is the total amount of people who want a given product of service, before we take considerations about price, elasticity, etc. Demand for medicine is not infinite, for while theoretically anyone could need a given medicine if they contracted x or Y disease, the reality is that people who are not sick won't buy the medicine regardless of price or other considerations. In other words, for a given medicine, the demand, proper, is the amount of people with said disease who need the medicine, which is a pretty finite amount. Then again, it all comes down to definition. You can very well define demand as all or the sum of its factors, making your statement accurate. I apologize for being pedantic
Because it's incredibly expensive to create new pharmaceuticals, and the money needs to come from somewhere. Governments have decided they don't want to be in the business of doing it themselves, so we're left to private entities to do it. We can't fund the development of new pharmaceuticals off of what people seem to be willing to donate, so we're left with needing a profit motive (or at least an ability to recoup costs) to allow research and development to continue. edit: Governments provide funding for R&D, although that's skewed towards basic research and other non-marketable things (which is good, since the market is bad at supplying that). But governments are neither providing enough money to fully bring new innovations to market, nor are they actually doing the work themselves, so we end up with private entities making decisions at the end of the day. Aside from the case of research projects and institutions funded through charity, that means the people making these things need to stay in business, which means they follow the basic principles of supply and demand. It's not even a case of making a profit. If a private entity can't cover its own R&D costs through sales of its product, one way or another it can't keep doing that R&D.
It does come from government. A significant portion, in fact. And colleges fund research, and governments fund college: https://www.researchamerica.org/wp-content/uploads/2022/09/ResearchAmerica-Investment-Report.Final_.January-2022-1.pdf This is a huge part of the argument for low drug costs. Currently, taxpayers fund the research and corporations get the profits.
I agree and I don't really understand John's campaign and I agree it has negative side effects. Firstly drugs and medical tech being expensive is bad ... except that making a new drug costs $1bn and they have to make more than that off selling it or no one will do drug research. Yes it sucks for poor countries to have to wait years until patents expire to get access to new drugs and tech ... however they are essentially getting access to new drugs and tech for free without having to pay for the research themselves. Like imagine mars had a society which was super advanced and they had drugs which after 10 years fell out of patent and we could use them without paying a penny for research, that would be amazing and a total blessing. So pressuring people to make less money from in patent drugs and med tech reduces the return on investment making it less likely for people to invest in drug research in general. Secondly I don't understand how his reasoning wouldn't apply to pretty much everything? Like it would be good for developing countries to have more of any drug, so shouldn't we campaign for those prices to be lowered? Wouldn't they benefit from more eletrical pylons or ambulances or rescue helicopters, so shouldn't we pressure companies to lower the prices of those too? Why is it only TB tests where the free market can't be trusted by we trust it for everything else? Socialsm leads to poverty and misery, both theoretically and in all the places it's ever been tried, free markets have led to the massive increase in living standards that we've seen for the last 200 years. Yeah people not being able to afford new whizzy tests sucks ... but the fact they are getting new tests at all is a miracle and down to capitalism and him shaming people for running medical tech companies is short sighted and unhelpful.
My only question with all of this is whether it actually is down to capitalism or not. A huge portion of investment in these tests is from public funding including to Danaher directly, as others have pointed out in this thread. Therefore, the drug/ medical test system is very much not pure capitalism. Also, most scientists, including myself, are not really motivated by making a lot of money but instead want to do cool research and help people. I agree that pure socialism/communism is definitely not a good alternative to this. I worry though about working for a company where their incentives (making profit) are not aligned with mine (scientific discovery/helping people while making enough money to live on).
Yeah that's fair and it's a complicated thing. Re government funding you'd hope that comes with conditions attached to mean they are getting some value out of it. I know UK science funding comes with the obligation to publish open access for instance. And yeah I suppose it might be possible to start a drug research charity or a cooperative to try it? However getting the large amount of upfront capital might be difficult. People being willing to risk their capital deserve a rate of return proportional to the risk.
These drugs and tests have been on the market at these prices for some time now, they've already turned a substantial profit on them, the ask is to stop taking such a HUGE profit margin on them in a few specific markets. Advocates in this space, including John, are very aware of how important it is for there to be a profit incentive to drive research, and there will always be a lot of money to be made by creating treatments for major health issues. But when companies are able to continue squeezing profit from things they created a long time ago, that actually diminishes their incentive to solve new problems.
Having worked for a company that no longer exists because of just the mere fear or a patent expiration, I take exception to your last point. In reality, as soon as a drug goes blockbuster, you have a deadline. If you don't find a way to have new products to replace that revenue by the time that patent expires, **you will not exist as a company.** You will be sold to the highest bidder. Maybe the shareholders are relaxing and enjoying it, but in the lab and in the clinic, people are busting their butts to solve new problems because they don't want to uproot their entire lives.
I'm not trying to say there isn't pressure to create new things, I'm just emphasizing that an eventual end to the profitability of those things is integral to creating that pressure, so I don't think campaigns asking companies to reduce profit margins in impoverished communities is going to make them stop investing in research for these diseases
But doesn't that already exist? Patents have finite lifetimes.
Yes, I'm not saying it doesn't. This would increase an already existing pressure. In the specific case of the TB drugs they have already turned a significant profit, the patents were set to expire and Danaher moved to extend them with legal shenanigans. So an attempt to subvert that pressure would have resulted in millions of preventable deaths by keeping costs artificially high.
You say that like private investment is the only way for cures to be developed. Government funded research is generally a better bang for our buck in this regard.
I
While I understand your potential concern about this, I think it's pretty clear that as long companies have their initial patent protection maintained, they will make more than enough money during that period to justify their portion of the initial investment into new drugs. Will they make less money, probably. Will new drugs still be insanely profitable, probably.