An
interesting research
article at the Health Affairs
blog asserts there is no relationship between high U.S. prescription drug
prices and drug companies’ research and development budgets. The point of the
article is to debunk the argument that research-based drug companies must earn
high profits if they are going to reinvest in R&D. While the data are
correct, the article misunderstands the nature of capital markets.
The
authors point out that U.S. prices for patented prescription drugs are
significantly higher, in real dollars, than prices in other developed
countries. (Most observers claim this is because foreign governments impose
price controls. I think it is more attributable to price
differentiation due to variation in national income per capita.)
The
analysis estimates the amount of revenues attributed to the 15 companies which
sell the top 20 drugs (by worldwide sales) which are attributable to U.S.
“premium” pricing. It finds those revenues exceed the R&D budgets of the
firms which earn them - $166 billion versus $66 billion, in 2015. It also lists
the amounts by company. For example, Merck earns about $11 billion from U.S.
“premium” pricing, which is 159 percent of its R&D budget.
These
“premium” prices derive from patents, which prevent other drug-makers from
copying medicines invented by innovators, for a limited time. In a static
sense, that means an innovator earns high profits if doctors prescribe its medicines.
However,
that innovator does not get to keep its profits, and the capital market does
not expect it to. Instead, investors decide every day whether they trust that
management to invent more new drugs. If other management teams promise better
opportunities, the firms in this analysis must distribute capital back to their
investors via dividends or share buybacks.
Indeed,
there is a lot of fretting among the large research-based drug-makers that they
are too large and bureaucratic to be innovative. The purpose of patents is not
to keep profits recycling through the same 15 largest drug-makers. It is to
give investors confidence that when the profits are returned to them they can
reinvest them in the next generation of lifesaving medicines, wherever their
inventors can be found.
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