"US Pharmaceutical Innovation in an International Context," the American Journal of Public Health. "We explored whether the United States is responsible for the development of a disproportionate share of the New Molecular Entities (NMEs) produced worldwide. [...] The United States was responsible for the development of 43.7% of the NMEs. The United Kingdom, Switzerland, and a few other countries innovated proportionally more than their contribution to GDP or prescription drug spending, whereas Japan, South Korea, and a few other countries innovated less. Conclusion: Higher prescription drug spending in the United States does not disproportionately privilege domestic innovation, and many countries with drug price regulation were significant contributors to pharmaceutical innovation."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/
"Global Drug Discovery: Europe is Ahead," Health Affairs Vol. 28 Supplement 1. "It is widely believed that the United States has eclipsed Europe in pharmaceutical research productivity. Some leading analysts claim that although fewer drugs have been discovered worldwide over the past decade, most are therapeutically important. Yet a comprehensive data set of all new chemical entities approved between 1982 and 2003 shows that the United States never overtook Europe in research productivity, and that Europe in fact is pulling ahead of U.S. productivity. Other large studies show that most new drugs add few if any clinical benefits over previously discovered drugs."
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.28.5....
The argument that the US "subsidizes" the rest of the world's health care is something that US pharmaceutical companies would very much like us to believe, but the evidence for it appears to be pretty shaky.
If it's by revenue to the much maligned Big Pharma, then I think not. R&D is a big cost, but not nearly as big in percentage as shown by the pharma companies, so were they all to contract due to sudden existence failure of the USA, they'd still make big profits if they kept the costs the same. The smaller companies would evaporate.
I'm basing this on comparing Teva USA vs Teva Global R&D spending data. That is 10% everywhere, 15% in the US (dropping faster) and falling regardless of the USA or not, which is pumping in more money into this company every day.
I picked Teva because they're representative and one of global market leaders.
https://www.statista.com/statistics/272544/expenditure-on-re...
Solid: https://articles2.marketrealist.com/2018/01/whats-teva-pharm...
(Yes, you can also read their quarterlies for USA branch and other ones. I checked a few.)
Decent write-up, if a bit old: https://www.healthaffairs.org/do/10.1377/hblog20170307.05903...
I'm curious why they chose that time period. It was published in 2010. This omits 6 years between publication date of the article and the end of the range they chose and omitted all data prior to 1992. How would the data differ if you didn't choose this 12 year period?
> although fewer drugs have been discovered worldwide over the past decade, most are therapeutically important.
> Other large studies show that most new drugs add few if any clinical benefits over previously discovered drugs.
These two statements contradict one another and the second one sounds awfully like moving the goal posts because the data doesn't support the conclusions.
The abstract I quoted reads: "Some leading analysts claim that although fewer drugs have been discovered worldwide over the past decade, most are therapeutically important. Yet a comprehensive data set of all new chemical entities approved between 1982 and 2003 shows that the United States never overtook Europe in research productivity, and that Europe in fact is pulling ahead of U.S. productivity. Other large studies show that most new drugs add few if any clinical benefits over previously discovered drugs."
The first snippet you pulled out is prefaced by Some leading analysts claim. This study's meta-analysis concludes that those analysts are incorrect.
> All major health care innovations were invented here
To quote Rage Against the Machine: whoever told you that is your enemy
Sorry, what?
My country doesn't have any "free access" to drug innovation, it pays mucho dinero to buy drugs, and American companies hold and enforce all kinds of patents on them.
It's also not some "one way" innovation street. Tons of medical/drug innovation, especially all the major "low hanging fruits" (which make up for most of modern health benefits) up to the mid-20th century came from outside the USA.
And that's not counting all the major European etc drug companies GlaxoSmithKline (British), La Roche (Swiss), Novartis (Swiss), Sanofi-Aventis (French), Bayer (German), Boehringer Ingelheim (German), etc.
Of the top 5 grossing drug companies, only 1 is American (#1 Pfizer). And the revenues of #1 are close to the revenues of #2 and #3, (45 vs 40 and 38 billion) so it's not like some great disparity where Pfizer takes all.
Not to mention that a lot of "USA innovations" were created by immigrants, whose country of origin paid for their raising, education, etc, even up to their undergraduate degree, and then they went to the USA and innovated as researchers...
Slow down with the chauvinism...
If you didn't develop a drug or pay for its development, but get access to it one day at only the cost of manufacture, then you're getting the R&D for free.
All of the drug companies you mentioned, while not founded in America, do most of their R&D in America.
You're right about many immigrants developing those drugs, but they came to America to do so. You should ask yourself "why?"
For the record, I'm an immigrant to the US.
Everybody gets the free access (including other American companies). Like you get free access to European drugs, once the patents expire. But all this is played into the cost of the drug while the patent holds. Nobody sells drugs at a cost, so there's that...
>All of the drug companies you mentioned, while not founded in America, do most of their R&D in America.
That's just wrong.
>You're right about many immigrants developing those drugs, but they came to America to do so. You should ask yourself "why?"
More cushioned life, compared to a place like China (at least of yore), and opportunities to make it big in business.
Also, by that thinking, all the suckers and losers in the market subsidize others.
Citation needed.
I never went through the whole list because it took a super long time, but when I tried sampling where most of these ~300 drugs were developed, it was like 80% developed in the US. I got through like 50-60 of them before I gave up. 50-60 should be good enough to be representative of the 300 or so. Feel free to go through them yourself if you don't believe me.
I didn't so I did.
I checked the first thirty listed in the Wikipedia article. Of those, only 8 have been developed in the USA including one developed by the American branch of a Swiss company.
That's merely 26%. Not insignificant but quite far from 80%. After a quick sampling of the rest I would be surprised if the exact proportion is above a third.
Halothane - England (1956)
Isoflurane - United States (1979)
Nitrous Oxide - England (1772)
Oxygen - N/A
Ketamine - United States (1966)
Propofol - United States (1989)
Bupivacaine - Sweden (1957)
Lidocaine - Sweden (1885)
Ephedrine - China (?, introduced to western medicine by an American traveling to China)
Atropine - Germany (1833)
Midazolam - United States (1976)
Morphine - Germany (1803)
Aspirin - France (1853)
Ibuprofen England (1953)
Paracetamol - United States (1877)
Codeine - France (1832)
Fentanyl - United States (1960)
Methadone - Germany (1937)
Amitriptyline - United States (1960)
Cyclizine - United States (1947)
Dexamethasone - United States (1957)
Diazepam - United States (1959)
Docusate - ???
Fluoxetine - United States (1972)
It's ridiculous how hard it is to figure out where most of these were developed.
When I first went through the WHO list, I did so in reverse by year of discovery:
https://en.wikipedia.org/wiki/List_of_drugs_by_year_of_disco...
I stopped checking again at this point. As a reminder your first claim was 80% of the list. I think your reliability has clearly been established at this point.
https://en.wikipedia.org/wiki/List_of_drugs_by_year_of_disco...
Except for Alectinib, which was developed in Japan, 13 of the 14 drugs developed in the 21st century for example have been developed in the United States:
That's 93%. Again what has the rest of the World been doing?
So 9 by the 24th in the list not 30, so your reliability has also been established.