[T]here are very good reasons - well known to all economists -- for preferring that drugs be sold in a competitive market with the price approximating the marginal cost of production. The gap between price and marginal costs under the current system of patent supported research leads to large and rapidly growing distortions. This includes denying drugs to patients who could afford them if they were sold at their marginal cost, the distortions also include the tens of billions of dollars spent each year on promoting drugs.All very real problems, these, and one can note that this sort of protectionism matters much, much more than the various trade barriers people get agitated about. Now obviously we can't just junk the patent system; companies need some incentive to invest in research. But sure we can think of alternatives that work better. Baker lists a couple, including Dennis Kucinich's proposal to get rid of drug patents and steer about $25 billion in taxpayer money—about what Big Pharma claims to spend on research—to government-backed research organizations, similar to the current NIH or the research universities of yore, and socialize drug research. (He lists some other, less drastic, and very clever alternatives too.) More on that in a bit, but the point here is that any financing alternative will have to achieve four main things:
Even more serious is the incentive that monopoly pricing provides firms to conceal or misrepresent research findings. Finally, a large gap between price and marginal cost will inevitably lead to the production of unauthorized versions of patent protected drugs. While these unauthorized versions make drugs available at a lower costs to patients, their quality cannot be ensured since illegal markets are unregulated.
1) provide incentives for pursuing "useful" researchObviously it's tricky to decide what is and isn't "useful" research—who decides? the "market"? the government? the dying children lobby?—but the current patent system certainly does badly on the last three counts. Drug companies presently have greater financial incentives to cater their research towards balding, impotent, overweight suburban males rather than look into, say, innovative malaria treatments for the Third World. The patent system also gives drug companies incentives to pursue "me-too" drugs and reap the monetary rewards—see Marcia Angell on this—as well as to suppress any inconvenient research findings.
2) minimize the possibility that market distortions will create incentives to pursue less useful lines of research
3) minimize the risk that political interference will direct research spending to less useful ends
4) minimize the incentive to suppress research findings