要奖励,不要专利

现代医学的成功部分是建立在新药之上的,制药公司投入几十亿美元来研发新药。这些公司可以通过专利来收回它们的开支,专利赋予它们一段时间的垄断权,从而使它们给药品开出远高出其生产成本的价格。我们不指望谁会不计回报地去进行创新。但是由专利体系所提供的激励是否恰当呢?所有的钱都使用和贡献在最紧要的疾病的治疗上了吗?可悲的是,答案是一个响亮的“不”。

专利体系最根本的问题很简单,那就是它是建立在限制知识的使用上的。因为增加一个人享受任何一部分知识的利益并不会带来额外的成本,所以限制知识是没有效率的。但是专利体系不但限制知识的使用,它还授予(暂时性的)垄断权从而使没有保险的人经常无力购买药品。在第三世界,对于那些无力购买新的名牌药物但是可能有钱购买非专利药物的人来说这是事关生死的问题。比如说,用于第一线爱滋病防御的非专利药物单单从2000年以来就把治疗的费用降低了大约99%,从1万美元降到了130美元。

但是,尽管支出了高昂的价格,发展中国家所得到的回报却非常小。制药公司把远高于它们花在研究上的钱花在了广告和产品推销上,它们花在研究迎合消费者生活方式上的药物(比如治疗阳萎和脱发的药物)钱要远高于花在研究挽救生命的药物上的钱,而它们几乎没有花钱去研究治疗像疟疾这种折磨着数以千万计的穷人的药物。这是一个简单的经济学的问题。公司会把它们的研究放在有钱的地方,而不会去管它对社会的相对价值。穷人买不起药,所以对他们的疾病的研究就很少,不管其总体的成本是多少。

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