It is the 17th Century. Thomas Wharton, bent over a human cadaver, gingerely cuts a small, whitish lump of flush from around the body’s larynxhad discovered the thyroid gland, for which we can all be grateful. We can also be grateful that he did not hold the lump of flesh aloft and proclaim a patent monopoly over any procedures involving it. Yet the molecular anatomy of the human body is now subject to such monopolies. There are genes in your body which, in effect, belong to other people.
Patent monopolies allow drug companies to charge profit margins of more than 1000% percent, except in places like India where, happily, they are often ignored. Right or not, they are the driving force behind the modern biotech industry.
The patent monopoly is, in effect, a relic of the middle ages. Craftsmen could publish a patent guaranteeing them a monopoly, and so prevent valuable knowledge being hidden away in trade secrets. Yet there is little chance of trade secrets being kept in most modern applications – nobody would take a drug whose composition was a secret, and such a drug could easily be uncloaked by a chemist. Nobody sat down and worked out the patent system, thinking “this is how we ought to fund bio medical research”, and yet it is often taken as an inevitability, or the only alternative to radical socialism.
That the development of new drugs should be rewarded is obvious, but our current system is a market distortion of the worse kind. As much as half of the money gained goes towards marketing and lobbying. Demand is created by sophisticated advertisement campaigns, producing a slow shift towards theories of illness which facilitate the prescription of medications.
This is a result of the massive information gap between drug companies and their customers. Doctors, inevitably, lack the complex scientific and statistical knowledge to deal with pharmaceutical industries’ sophisticated marketing and manipulation of evidence. Patients of course are even more helpless. Decisions about what drugs to use and their costs are made by sick people and their doctors: people who are desperate for a cure and often not particularly fussy about spending their money, no matter how long the odds of success are.
Most damningly, the patent system is failing to promote good research. The constant pressure of stock market economics means that drug companies will only pursue short term profit. Basic research must be funded by public bodies, who then sell their research to private companies for a pittance. With safety trials taking so long, the profit motive is misdirected, prejudicing research towards duplicating existing drugs, or producing drugs that are of little benefit, such as the “next generation” of anti-psychotics. Research is chasing profit instead of driving innovation.
Even where useful drugs are developed there is a bias towards those that treat chronic illnesses – witness the almost total lack of research into antibiotics, and compare it to the research into erectile dysfunction. Useful research that does not lead to a profit – for instance on the effects of vitamin supplements or polluted water – is neglected.
The most subtle – but in my opinion most serious – side effect of patent monopoly in the modern world has been to discredit western medicine. The “seratonin theory” of depression, it has been said, resembles concluding that lack of aspirin in the head causes headaches. It’s persistence for decades, supported by the flimsiest of evidence, can only be attributed to a medical establishment obsessed with pharmaceuticals. With so much modern medicine being geared towards selling pharmaceutical products that are often ineffective or even detrimental in their effects, patients inevitably become disillusioned. Well meaning intelligent doctors are seen, with some justification, as tools of an feeling, capitalist machine. Little wonder that patients turn towards homeopathy or raki healing – at least there they can save money and support small business. As a consequence, the vast edifice of modern medicine in all it’s incredible efficacy is dismissed as propaganda. Vaccinations are refused, and in our superstition disease becomes a judgement, visited on us by nature for our failure to eat only raw foods or align our souls with the universe.
Reform will be difficult. There is more than a little irony that the USA, once famous for flaunting foreign patent laws, is now the epicenter of modern patent law. The international nature of the system will necessitate co-operation between governments. However the USA itself now has a vested interested in co-operating – if it cannot control the absurd cost of medical treatment it will go bankrupt. Multiple solutions are possible, governments could declare for instance, that all medical patents must be publicly owned. It would then buy those which are worth purchasing from the industry and sell them at market price. Purchase decisions would consider expected benefit to patients, rather than expected profit, and by people with sufficient background knowledge make informed decisions. The pharmaceutical industry is already “too big to fail”, and almost too influential to challenge. We look on in horror as across the atlantic, children younger than 10 are declared “bi-polar” and have their personalities medicated away.
These are visions of the future. Our grasp of the truth is being erroded by greed.