I. The United States
The United States expends a substantially higher portion of GDP than other developed countries on research and development for, and on the purchase of, pharmaceutical products, without a discernible difference in health outcomes compared with those other countries. The US pharmaceutical innovation pipeline has been weak. The preponderance of drugs newly placed on the market is minor variations on existing treatments. US industrial competitiveness is burdened by high health-care costs, including pharmaceutical costs. Despite these well-known characteristics of the US market, the United States is seeking to require other countries, including developing countries, to adopt its regulatory model.
The United States leads the world in funding HIV-AIDS treatment programs in Africa and elsewhere.
- Identifying basic distortions
- Is the patent-marketing exclusivity system broken?
- Are competition laws properly applied?
- Does direct to consumer advertising distort the allocation of resources?
- Is the FDA functioning properly?
- Is the ban on government negotiation of Medicare pharmaceutical prices economically justified?
- Are there political-economy distortions arising from political contributions and lobbying?
- Will negotiating with other countries to eliminate price controls and spend more on pharmaceuticals fix the problems affecting the US market?
- Does the Bayh-Dole Act properly return public investment to patient-consumers?
- How can the basic distortions be addressed?
- Exporting problems or solutions
- Should the US Trade Representative be exporting the US model to the rest of the world? With what impact on consumers, foreign and domestic?
- Can domestic US pharmaceutical producers compete with Indian and Chinese producers on quality and price? If so, should we encourage exports of low-cost generic versions of domestically patented products under the WTO waiver and amendment?