The profits aren't limitless. Pharma is an industry in decline, because drug r&d is so hard

As it currently stands, 60%+ of the new drugs that are developed in the world these days are for cancer or rare disease. Because for most other diseases, drug r&d is not profitable. Neuro is too risky because the biology is complex. Cardiovascular and metabolic disease is too costly because of regulatory and reimbursement hurdles. Infectious disease is a field where generics dominate, and the regulatory system is failing to support efforts to fight drug resistant strains

For-profit companies fund 3x what governments fund. We don't have the federal budgets to support a public drug industry. And we don't have the political will at least in the US to empower federal funding increases of that magnitude

It certainly isn't ideal that profit driven companies control which drugs get approved. But if profit driven companies didn't fund new drug development, no one else would

The general idea might be economically sound, but the exclusivity period would also need to account for the risk that research costs would never be recuperated, e.g. if the result of the research turns out to be ineffective or unsafe.

Between failure, placebo effect, and the possibility of being less effective than other treatments... that isn't guaranteed. Studying these drugs may just prove they aren't worth using.

If it's so straight forward to prove, the government should just fund the studies itself. There's no reason to grant any private company anything in that case.

The NIH currently spends $33B a year on research. Not all of that is drug related

The top ~15 pharma companies spend over $70B a year on r&d, and VC funds $15B in the US alone

Even assuming government operates as efficiently as private industry, we are talking almost triple the NIH budget to accomplish that

> Even assuming government operates as efficiently as private industry, we are talking almost triple the NIH budget to accomplish that

So increase the budget? If we assume the government would operate as efficiently as private industry, then it would be cheaper overall. The other option is for private industry to recoup the costs plus profits from society at large.

Obviously increasing the budget is politically difficult, but let's not pretend the current method makes any real economic sense.

The NIH budget has declined 20% in the last 15 years. Not only is there a strong downward trend, but the movements in funding levels are gradual. I'd say that tripling the NIH budget is not just politically difficult, but politically impossible

Then just leave the drugs grandfathered. If we view something as a problem (i.e. the lack of formal drug approval processes on old drugs), but we are not willing to solve the problem right (i.e. providing funding to government agencies to do the research), then we shouldn't do anything at all. Continuing the status quo is also a reasonable action.

That would be the best thing to do IMO, but the problem is politics. Congress loves wasting money on toys that kill people, but when it comes to things that saves lives and advance science, all of a sudden budgets are tight or we need a new round of tax cuts.