A new proposal, urging “a public option for pharmaceutical R&D,” argues that a federal pharmaceutical research and development laboratory––the National Pharmaceutical Institute––could implement a “tried-and-true approach to meeting public health needs” that would result in social, economic and political benefits. The NPI would help erode Big Pharma’s regulatory capture, break its monopoly on the medicine supply, implement further transparency and accountability, and increase public power.
Public biomedical R&D labs have precedent both in states like Massachusetts, Michigan, New York, and California, as well as abroad in Brazil, Canada, Australia, Brazil, Cuba, and Thailand. These labs have worked on a wide variety of medicines, including but not limited to vaccines for diphtheria-tetanus and yellow fever; treatments for infant botulism; insulin; Chagas disease; lung cancer; HIV; hepatitis C; leprosy; schistosomiasis; and Covid-19.
DANA BROWN; [email protected]
Brown is a Senior Fellow at the Vanderbilt Policy Accelerator for Political Economy and Regulation. Previously, she was the Director of Health and Economy at the Democracy Collaborative.
Brown told the Institute for Public Accuracy: “Worldwide, public biomedical R&D was fairly widely accepted as necessary and good before neoliberalism. There were large public R&D labs in Canada, across Europe and the ex-Soviet space, South America, Australia, and various smaller places in the U.S. Most were privatized, but this is a tried-and-true strategy that needs adaptation to the current environment. There is proof of concept.
“The state of Massachusetts owns MassBiologics. Both Massachusetts and Michigan were producing their own tetanus-diptheria vaccines in the mid-1980s. When there was a nationwide vaccine shortage, those states did not suffer from it. Small states don’t last here. If the federal government has the capacity to make something, it means we aren’t bidding against the rest of the world. That is a piece of political power that often gets forgotten… At the moment, we rely on Big Pharma for all of our medicines, so the government is forced to play ball with them. We have to ask to negotiate drug prices. But when the government is the one making fancy medicines, then the public and the people that represent us have more negotiating power and can negotiate more transparency in contracts.
“Media coverage tends to focus on drug prices, period. I understand that, because obscene drug prices affect everyone, and not just people with prescriptions for high-cost medicines. But that narrative misses the larger story, which is that high prices are a symptom of a larger problem and are the natural outcomes of relying solely on a for-profit model of medicine. We are already putting billions into R&D each year, but there are plenty of areas in medicine––neurological and cardiovascular and rare diseases––where we can imagine putting more into development… and speeding up science.
“I’m not blind to the political realities of Washington. This [solution is] not likely to get implemented overnight. But a growing group––public officials, patient advocates, public health folks, people who work inside international organizations working on access to medicines––believe that some form of public pharmaceutical R&D at scale is not only necessary, but at some point inevitable… given the massive amounts of capital that flow to private interests and the unsustainability of that over time.
“The groundwork has been laid. We have seen various bills at various levels of government, more education of policymakers on these ideas, and a big push in the E.U. over the last few years to create an amendment that would put tens of millions of euros toward a public R&D enterprise. It ultimately didn’t get through last year’s reconciliation there, but that legislation will be reintroduced. If something like that happened, and [drug production] was done in an open-science way and was moving faster [in Europe], then there would be pressure on the U.S. to do something similar. The general global trends of climate change, an increasing number of natural disasters and related disease outbreaks, will also put pressure on public health in the next decade. New antibiotics and vaccines will be desperately needed, but they aren’t great market goods. Policymakers can throw more money at Big Pharma in the form of subsidies and tax breaks to coax them to produce those products, but the fiscally conservative thing to do is to create a public option.”