Socialism seems to create a lot of markets for the Capitalist private sector.
This should be changed to
“Then the US government fails to fund the billions of dollars required for medicinal trials needed to get FDA approval”
No one is stopping the US government from doing all the necessary work to verify the medicines work and put them in the public domain.
Academia produces tens of thousands of papers per year; many of these are garbage, p-hacking or low value - the rest are often contradictory, misleading, hard to interpret or just report a giant body of raw-ish data. It is a very valuable process - despite all the waste - but the result of this is too raw to be actionable.
This body of raw 'science' is the necessary substrate for biotechnology and drug development - it needs to be understood, processed, and conceptualised into a hypothesis (which most likely fail) strong enough to invest billions of dollars into.
Pharmaceutical industry is the market-based approach to prioritising investment into drug development (what is it, 100B$ p/y?) - and even a leftist who might want to debate in favour of a different economic model would have to agree that this job is hard, important, and needs to be done.
Transitioning from “nice idea” to “consumer product” is a vast chasm. Most people that do not actually have experience taking things from research to production grossly under-estimate the amount of effort involved. From a purely economic perspective, the “research” part of the total bill is dwarfed by the activity required to turn it into a salable product.
Some of the most productive areas of US government biomedical research have not come from NIH but from DoD. Most people do not realize that virtually all modern trauma medicine was invented by US military research as a very active ongoing program. If you get in a bad automobile accident, most things that happen will be the product of US military research. But interestingly, these programs have very sparse research budgets, literally just single millions of dollars in many cases. But that is trauma medicine, not drug development.
Drug trials in particular are extremely expensive. People like to pretend these don’t exist. A few million in research costs doesn’t write off billions of dollars in development costs. There is no mathematical way to argue otherwise.
You are right. NSF backs this (https://ncses.nsf.gov/pubs/nsf23320). Businesses now fund ~80% of R&D, USG funds ~20%.
According to CBO pharma spends ~$90B on R&D (https://www.cbo.gov/publication/57126) so $30B I would not call trivial or a rounding area, but your points still stands that it is the minor share.
> A few million in research costs doesn’t write off billions of dollars in development costs. There is no mathematical way to argue otherwise.
There could be an important distinction between infra R&D and last mile R&D. The cost of developing a drug in our current system might be $3B today on average, but if you also had to replace all the infra R&D USG invested in over decades (GenBank, PubMed, and all the other databases from NCBI and the like) that these efforts depend on, it might be much higher. So I could still see an argument that the government pays for the research needed by all the drugs, then private sectors builds on that and pay for the last mile for each one.
However, I think you've put forward strong points against the argument "the research is done using public funds, and then privatized and commercialized later".
> Drug trials in particular are extremely expensive. People like to pretend these don’t exist.
I think in general people are frustrated because for all the money going into pharma people have not been getting healthier in the USA, in fact, in the median case, the opposite. So some big things are going wrong. I think you've shown that the problem is not that government is paying for high drug development costs and industry is coasting.