Why are drug prices so high? Investigating the outdated US patent system | Priti Krishtel

Translator: Reviewer: Daban Q. Jaff

For my husband, it was love at first sight.

(Laughter)

Here's what happened.

Years ago, Rudy,

who I had strictly put in the friend zone at the time,

came over to my house and met my dad,

a pharmaceutical scientist who had just retired

after bringing a drug to market.

My dad said,

"Ah, you probably wouldn't have heard of it.

It's for IPF,

idiopathic pulmonary fibrosis."

Rudy paused for a long time, and then he said,

"That's the disease that took my father's life 15 years ago."

Rudy says that this is the moment he fell in love.

(Laughter)

With my father.

(Laughter)

Even though it was too late for my dad to save his,

he felt that destiny had delivered us this full-circle moment.

In my family, we have a special love for my father's inventions.

And in particular, we have a reverence for his patents.

We have framed patents on the wall in our house.

And there's a recognition in our family that everything I've been able to do --

college, law school, health justice work --

all of it is because America enabled my father

to fulfill his potential as an inventor.

(Applause)

Last year, I met the director of the US Patent Office

for the first time,

and I sent my family a selfie from that office in Virginia.

(Laughter)

I got so many emojis back,

you would have thought I had met Beyoncé.

(Laughter)

But truth be told,

I was actually there to talk about a problem --

how our outdated patent system is fueling the high cost of medicines

and costing lives.

Today, over two billion people live without access to medicines.

And against this global crisis,

drug prices are skyrocketing,

including in wealthier countries.

Thirty-four million Americans have lost a family member or a friend

in the last five years,

not because the treatment didn't exist,

but because they couldn't afford it.

Rising drug costs are pushing families into homelessness,

seniors into bankruptcy

and parents to crowdfunding treatment for their critically ill children.

There are many reasons for this crisis,

but one is the outdated patent system

that America tries to export to the rest of the world.

The original intention behind the patent system

was to motivate people to invent

by rewarding them with a time-limited monopoly.

But today, that intention has been distorted beyond recognition.

Corporations have teams of lawyers and lobbyists

whose sole job is to extend patent protection as long as possible.

And they've kept the patent office busy.

It took 155 years for the US Patent Office

to issue its first five million patents.

It took just 27 years for it to issue the next five million.

We haven't gotten drastically more inventive.

Corporations have gotten drastically better at gaming the system.

Drug patents have exploded --

between 2006 and 2016, they doubled.

But consider this:

The vast majority of medicines associated with new drug patents

are not new.

Nearly eight out of 10 are for existing ones,

like insulin or aspirin.

My organization, a team of lawyers and scientists,

recently conducted an investigation into the 12 best-selling drugs in America.

We found that, on average,

there are 125 patents filed on each medicine.

Often for things we've known how to do for decades,

like putting two pills into one.

The higher a patent wall a company builds,

the longer they hold on to their monopoly.

And with no one to compete with,

they can set prices at whim.

And because these are medicines

and not designer watches,

we have no choice but to pay.

The patent wall is a strategy to block competition.

Not for the 14 years maximum

that America's founders originally envisioned,

or the 20 years allowed by law today,

but for 40 years or more.

Meanwhile, prices on these drugs have continued to increase --

68 percent since 2012.

That's seven times the rate of inflation.

And people are struggling or even dying,

because they can't afford the meds.

Now I want to be really clear about something.

This isn't about making the pharmaceutical industry the bad guy.

What I'm talking about today

is whether the system we created to promote progress

is actually working as intended.

Sure, the pharmaceutical companies are gaming the system,

but they're gaming it because they can.

Because we have failed to adapt this system

to meet today's realities.

The government is handing out

one of the most prized rewards in business --

the opportunity to create a product that is protected from competition --

and asking for less and less in return on our behalf.

Imagine awarding 100 Pulitzer Prizes to one author for the same book.

(Murmurs)

It doesn't have to be this way.

We can create a modern patent system

to meet the needs of a 21st-century society.

And to do that,

we need to reimagine the patent system to serve the public,

not just corporations.

So how do we do it?

Five reforms.

First, we need to stop handing out so many patents.

Back under the Kennedy administration,

in an effort to curb rising drug costs,

a congressman from Tennessee proposed an idea.

He said,

"If you want to tweak a drug,

and you want to get another patent on it,

the modified version has to be significantly better, therapeutically,

for patients."

Because of intense lobbying,

this idea never saw the light of day.

But a reimagined patent system

would resurrect and evolve this simple, yet elegant proposition.

That to get a patent,

you have to invent something substantially better

than what's already out there.

This shouldn't be controversial.

As a society,

we reserve the big rewards for the big ideas.

We don't give Michelin stars to chefs who just tweak a recipe --

we give them to chefs who change how we think about food.

And yet, we hand out patents worth billions of dollars

for minor changes.

It's time to raise the bar.

Second,

we need to change the financial incentives of the Patent Office.

Right now, the revenue of the Patent Office

is directly linked to the number of patents that it grants.

That's like private prisons getting paid more to hold more people --

it naturally leads to more incarceration,

not less.

The same is true for patents.

Third, we need more public participation.

Right now, the patent system is like a black box.

It's a two-way conversation between the patent office and industry.

You and I aren't invited to that party.

But imagine if instead,

the Patent Office became a dynamic center for citizen learning and ingenuity,

staffed not just by technical experts and bureaucrats,

but also by great public-health storytellers

with a passion for science.

Regular citizens could get accessible information

about complex technologies

like artificial intelligence or gene editing,

enabling us to participate in the policy conversations

that directly impact our health and lives.

Fourth,

we need to get the right to go to court.

Right now in America, after a patent is granted,

the public has no legal standing.

Only those with a commercial interest, usually other drug companies,

have that right.

But I've witnessed firsthand how lives can be saved

when everyday citizens have the right to go to court.

Back in 2006 in India,

my organization worked with patient advocates

to challenge, legally, unjust HIV drug patents,

at a time when so many people were dying,

because medicines were priced out of reach.

We were able to bring down the prices of medicines

by up to 87 percent.

(Applause)

On just three drugs,

we were able to save health systems half a billion dollars.

Now, cases like these can save millions of lives

and billions of dollars.

Imagine if Americans had the right to go to court, too.

And lastly, we need stronger oversight.

We need an independent unit that can serve as a public advocate,

regularly monitoring the activities of the Patent Office

and reporting to Congress.

If a unit like this had existed,

it would have caught, for example, the Silicon Valley company Theranos

before it got so many patents for blood testing

and landed an evaluation of nine billion dollars,

when in reality,

there was no invention there at all.

This kind of accountability is going to become increasingly urgent.

In the age of 23andMe,

important questions are being asked

about whether companies can patent and sell

our genetic information and our patient data.

We need to be part of those conversations

before it's too late.

Our information is being used to create the new therapies.

And when that moment of diagnosis comes for me and my family,

or for you and yours,

are we going to have to crowdfund to save the lives of those we love?

That's not the world I want to live in.

It's not the world I want for my two-year-old son.

My dad is growing older now,

and he is still as quietly brilliant and morally directed as ever.

Sometimes people ask us whether things get heated between us:

the patent-holding scientist

and his patent-reforming lawyer daughter.

It's such a profound misunderstanding of what's at stake,

because this is not about scientists versus activists,

or invention versus protection.

This is about people,

our quest to invent and our right to live.

My dad and I understand that our ingenuity and our dignity

go hand in hand.

We are on the same side.

It is time to reimagine a patent system

that reflects that knowing.

Thank you.

(Applause)