I'm astounded by the stupidity of this proposal. First, you cannot simply say "I'm going to the lab today and finding a cure for malaria because the government has a blue ribbon in store." The biology of the disease (ANY DISEASE) offers multiple pathways (ie challenges)toward understanding how it forms and replicates in the body. If the pathway toward understanding how the disease works is thoroughly understood then sure, it's no problem to go into the lab, develop the appropriate compound, and scale it up for trials (which obviously don't always work). That simply isn't the case, ummm, which is why the government, foundations, universities, and yes private companies spend tens of billions of dollars each year in simply trying to better understand the basic science behind disease. Nobody complains about the fact NIH hasn't "discovered" a single known drug, yet we continue to funnel billions into its coffers because it's broadly understood that without its work (and grants) there would be far less innovation (and hence medicine and jobs for PhDs and MDs in the US) than currently takes place.

So it doesn't matter if there's a $5 billion pot, $50 billion pot or a $500 billion pot, a company simply can't bank its future on being the first to find a cure for any given illness because it might never happen despite the best efforts of its scientists. Moreover there isn't a single investor IN THE WORLD who'd loan money to an enterprise premised on winning the powerball, which actually holds better odds of success for than inventing a vaccine to prevent HIV/AIDS.

Then there's the matter of a 'global tax' on Rx sales to fund the prize. Just who is supposed to collect it? As hard as it is to believe the world is not spelled 'USA' and not every drug company is an American entity. So basically this is a call to tax US companies, all of which is easily avoidable by transferring operations to Shanghai or Hyderbad. And should the sales of generic companies be taxed too? After all they do ABSOLUTELY NO scientific research, yet rake in billions in profits each year.

Then there's the matter of turning over the manufacture of the product to these harmless generic companies who could sell the product 'at cost' to various governments around the world. Give me a break. India is already home to the biggest generics industry in the world yet the overwhelming majority of its citizens have never taken any medicine other than an aspirin. Since we're in fantasy land why not just simply pass a law requiring its industry to meet the health needs of its 600 million desperately poor people by selling its drugs 'at cost' to the government in Delhi? Sound absurd? Absolutely, so why not just simply pass a law requiring US companies to supply their products -- whether they are cars, laptops, jets, software, drugs, etc -- to foreign governments at cost? After all there's an inherent public good in doing so.

Really, I'm absolutely astounded by the stupidity of this post as it shows a total ignorance of science, international relations, and global health policy. While I'm no fan of Senator Brownback or his politics, the fact of the matter is the innovative drug industry represents our best chance of 'discovering' a compound or biologic to cure diseases of every stripe. Rather than flog it for trying to invent statins (which do actually improve public health) to ensure it has a revenue stream to conduct research in areas of infectious disease and cancer.

Bobby,

You misconstrue how a prize system could work. It doesn't upset the patent system. It simply decouples the reward for innovation from making individual patients with a particular disease pay through high prices for innovation in that field. By taxing the health care system and establishing prizes in areas of greatest medical need, the prize system will channel innovators into areas of the great medical need. They can continue to pursue mass market, me-too drugs, of course. But the prizes would be less and the incentives to market heavily reduced. It could turn drug companies from marketing machines into true research-oriented organizations.

You make one error: NIH has invented plenty of drugs. 50 of the first 59 cancer chemotherapy drugs came out of NCI from the late 1940s through the 1980s. Ceredase, a drug for the rare Gaucher's disease, was entirely developed by NIH. Most of the early HIV/AIDS drugs were entirely developed by NIH and then licensed to the private sector. All this is documented in my book.

And don't forget the Walter Reed Army Institute of Research (WRAIR), whom some call the best little drug company in the government. It has developed more drugs for malaria than any other organization in the world over the years, including chloroquine, which, sadly, has now become largely ineffective due to resistance.

I doubt that GSK has spent $600 million developing this vaccine. One of the main tasks of companies' public relations is to maximize the costs spent on R&D and buying or building manufacturing capacity, because it is the chief rationale for high prices and/or special dispensations.

For an analysis of how Congress has been misled on the costs of R&D and good, external evidence that net corporate costs are much lower, see the new review of the CBO report on the subject at http://bioethics.upenn.edu/people/?last=Light&first=Donald

Don

First, thank you for responding, know you have better things to do than argue with me.

Regarding the prize system, I'm not misconstruing anything. Why hasn't it worked for BioShield? Hasn't the government set aside billions of dollars to channel R&D into areas of unmet medical need? It's the scientific equivalent of Iraq -- billions down the drain and our national security is worse off than it was before (since we're no closer to having vaccines for anthrax and other nasty germs than we are to putting a man or woman on Mars). So why do you think setting aside billions more (I don't care if it comes through taxing the Rx industry) will spur innovation where it isn't currently occuring?

Then there's the matter of focusing on my view of NIH. I am sorry that I erred. So to summarize we've given it a trillion dollars and forty years to discover a malaria drug that doesn't work any more, an orphan drug useful only to a sliver of humanity, and a slew of cytoxins that will hopefully one day be viewed as instruments of torture when new therapeutics in development actually neutralize, or God willing, prevent cell mutation. I am obviously being cynical because your defense of the institution as one which can be trusted to take products from the lab to patient backs up my original point. If NIH catches lightning in a bottel then great, let it commercialize its discoveries. But in the overwhelming majority of instances we need it to continue funding basic scientific research regardless of the paucity of clear-cut therapeutic advances because it's essential to not just understanding human biology, but lubricating our university labs and churning out PhDs who are willing to try and isolate a gene for 18 hours a day for years on end. Those people are not just the lifeblood of America's economy but represent our best hope to put wheelchairs in the Smithsonian.

Then there's the final matter of you not addressing the role of the generics industry. I love that my generic Ambien is a fraction of the innovators former cost, same with the antibiotics for my daughter's ear infection. But the fact of the matter is these are for-profit businesses, and the reasons they're product is so cheap is they don't do an ounce of R&D, save for 20 patient bioequivalency studies. Yet I'd be stunned if Senator Sanders thinks they should play a greater role in addressing the crisis of access in places like India and sub-Saharan Africa (namely by selling their product 'at cost' to any government that needs it). No, far to easy to cheer on Thailand's military junta (thirty-some members of Congress did just this) when it declares that AIDS drugs cost too much and will allow for compulsory licensing. Let's set side aside the fact the junta not only toppled a democratic government, continues to receive military aid, and gets preferential market access to the US BUT has done ZILCH to crack down on a tourist industry which relies on scumbags from around the world to visit Thailand, tour the beaches, and then rape children and young women in the jillions of brothels lining the streets of its cities (in turn leading to the spread of AIDS and TB).

Again, thanks for responding -- an no, I'm not a right wing nut and get like you am sick of seeing ED ads on the nightly news. But I think there's more than enough blame to go around on why it is we don't have research into diseases areas that are prevalent in the West and figure out a better way to foster innovation into those channels. I think Brownback's amendment represents a realistic hope of getting there, and I don't care if GSKs shareholders benefit from getting drug review for a cold medicine if it means kids in Africa get a chance to live past their second birthday.

I am disappointed in your assertion that "There's no quarreling with the assertion that this Glaxo effort to develop a much-needed malaria vaccine -- an effort, by the way, that has bedeviled scientists for decades because of the complexity of the parasite -- ought to receive a multi-billion-dollar reward if it succeeds." You seem to think that Glaxo has pulled this out of the thin air after poor bedeviled scientists had failed miserably. Actually work by us bedeviled scientists has been going on for more than 40 years with the support of taxpayer money from the NIH, USAID and Dept. of Defense. The first immunization study was " Nussenzweig, R., J. P. Vanderberg, H. Most and C. Orton. 1967. Protective immunity produced by the injection of X-irradiated sporozoites of Plasmodium berghei. Nature 216: 160-162". I later discovered the antibody (CSP antibody) that led to the identification of the CS protein, which is the very basis of the Glaxo vaccine (Vanderberg, J. P., R. Nussenzweig and H. Most. 1969. Protective immunity produced by the injection of X-irradiated sporozoites of Plasmodium berghei. V. In vitro effects of immune serum on sporozoites. Mil. Med. (Suppl.) 134: 1183-1190.) And I later led the efforts that used malaria sporozoites for the first successful vaccination of a human against malaria (Clyde, D., H. Most, V. McCarthy and J. P. Vanderberg. 1973. Immunization of man against sporozoite-induced falciparum malaria. Am. J. Med. Sci. 266: 169-177.). I am glad that Glaxo is now coming to the aid of us poor bedeviled scientists. There are things in basic research that scientists are able to do and there are vaccine production things that can be done only by a large corporation such as Glaxo. But please give a break to the poor bedeviled scientists (me and many others) who spent their entire professional lives doing the groundwork for a vaccine and then find that you are crediting Glaxo and insulting us. By the way, I believe that it is immoral for scientists who have had their work supported by taxpayers profit personally from a vaccine that they helped to develop but I believe that I am in a minority on this subject.