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 Investigating the outdated US patent system | Priti Krishtel

Prevodilac: Tijana Maslać Lektor: Ivana Korom

For my husband, it was love at first sight.

Za mog muža je to bila ljubav na prvi pogled.

(Laughter)

(Smeh)

Here's what happened.

Evo šta se dogodilo.

Years ago, Rudy,

Godinama unazad, Rudi,

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

kojeg sam striktno držala u zoni prijatelja,

came over to my house and met my dad,

je svratio kod mene kući i upoznao mog tatu,

a pharmaceutical scientist who had just retired

farmaceutskog naučnika koji se tek penzionisao,

after bringing a drug to market.

nakon lansiranja leka na tržište.

My dad said,

Moj tata je rekao:

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

''Ah, verovatno nisi čuo za njega.

It's for IPF,

Za IPF je,

idiopathic pulmonary fibrosis."

idiopatsku plućnu fibrozu.''

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

Rudi je ćutao dugo vremena, a zatim je rekao:

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

''To je bolest koja je oduzela život mom ocu pre 15 godina.''

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

Rudi kaže da je ovo momenat kada se zaljubio.

(Laughter)

(Smeh)

With my father.

U mog tatu.

(Laughter)

(Smeh)

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

Iako je bilo prekasno da moj tata spasi njegovog,

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

osetio je da nam je sudbina dostavila ovaj momenat punog kruga.

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

U mojoj porodici gajimo posebnu ljubav za izume mog oca.

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

I naročito imamo poštovanje prema njegovim patentima.

We have framed patents on the wall in our house.

Uramili smo patente na zidovima naše kuće.

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

I postoji priznanje u našoj porodici da sve što sam uspela da uradim -

college, law school, health justice work --

koledž, studije prava, rad na zdravstvenom pravu -

all of it is because America enabled my father

sve to je zato što je Amerika omogućila mom ocu

to fulfill his potential as an inventor.

da ispuni svoj potencijal kao pronalazač.

(Applause)

(Aplauz)

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

Prošle godine sam upoznala direktora Zavoda za američke patente

for the first time,

po prvi put,

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

i poslala sam mojoj porodici selfi iz te kancelarije u Virdžiniji.

(Laughter)

(Smeh)

I got so many emojis back,

Primila sam toliko emotikona,

you would have thought I had met Beyoncé.

da biste pomislili da sam upoznala Bijonse.

(Laughter)

(Smeh)

But truth be told,

Ali istinu govoreći,

I was actually there to talk about a problem --

bila sam tamo da bih razgovarala o problemu -

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

kako naš zastareli patentni sistem podstiče visoke cene lekova

and costing lives.

i košta živote.

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

Danas preko dve milijarde ljudi živi bez pristupa lekovima.

And against this global crisis,

I uprkos ovoj globalnoj krizi,

drug prices are skyrocketing,

cene lekova rastu,

including in wealthier countries.

uključujući i bogatije zemlje.

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

Trideset četiri miliona Amerikanaca je izgubilo člana porodice ili prijatelja

in the last five years,

u poslednjih pet godina,

not because the treatment didn't exist,

ne zato što lečenje ne postoji,

but because they couldn't afford it.

već zato što ne mogu da ga priušte.

Rising drug costs are pushing families into homelessness,

Rastuće cene lekova guraju porodice u beskućništvo,

seniors into bankruptcy

starije u bankrot

and parents to crowdfunding treatment for their critically ill children.

i roditelje u humanitarnu pomoć za lečenje njihove kritično obolele dece.

There are many reasons for this crisis,

Postoji dosta razloga za ovu krizu,

but one is the outdated patent system

ali jedan je zastareli patentni sistem

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

koji Amerika pokušava da izveze u ostatak sveta.

The original intention behind the patent system

Inicijalna namera iza patentnog sistema

was to motivate people to invent

je bila da motivišu ljude da pronalaze

by rewarding them with a time-limited monopoly.

nagrađujući ih sa vremenski ograničenim monopolom.

But today, that intention has been distorted beyond recognition.

Ali danas je ta namera iskrivljena do neprepoznatljivosti.

Corporations have teams of lawyers and lobbyists

Korporacije imaju timove advokata i lobista

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

kojima je jedini posao da produže zaštitu patenta što je duže moguće.

And they've kept the patent office busy.

I oduzeli smo kancelariji za patente vremena.

It took 155 years for the US Patent Office

Trebalo je 155 godina američkom zavodu za patente

to issue its first five million patents.

da izda prvih pet miliona patenata.

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

Trebalo je samo 27 godina da se izda narednih pet miliona.

We haven't gotten drastically more inventive.

Nismo postali drastično inventivniji.

Corporations have gotten drastically better at gaming the system.

Korporacije su postale drastično bolje u poigravanju sa sistemom.

Drug patents have exploded --

Patenti lekova su eksplodirali -

between 2006 and 2016, they doubled.

između 2006. i 2016. su se udvostručili.

But consider this:

Ali uzmite u obzir ovo:

The vast majority of medicines associated with new drug patents

velika većina lekova povezanih sa novim patentima za lekove

are not new.

nisu novi.

Nearly eight out of 10 are for existing ones,

Skoro osam od deset su za već postojeće,

like insulin or aspirin.

poput insulina ili aspirina.

My organization, a team of lawyers and scientists,

Moja organizacija, tim advokata i naučnika

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

su nedavno sproveli istragu o 12 najprodavanijih lekova u Americi.

We found that, on average,

Saznali smo da, u proseku,

there are 125 patents filed on each medicine.

ima 125 patenata podnesenih za svaki lek.

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

Često za stvari koje znamo da radimo već decenijama,

like putting two pills into one.

poput spajanja dve pilule u jednu.

The higher a patent wall a company builds,

Što viši patentski zid kompanija gradi,

the longer they hold on to their monopoly.

to duže zadržava svoj monopol.

And with no one to compete with,

I nemajući sa kim da se takmiče,

they can set prices at whim.

mogu da postavljaju cene kako hoće.

And because these are medicines

I pošto su ovo lekovi,

and not designer watches,

a ne dizajnerski satovi,

we have no choice but to pay.

mi nemamo izbora sem da platimo.

The patent wall is a strategy to block competition.

Patentski zid je strategija da se blokira konkurencija.

Not for the 14 years maximum

Ne za maksimalnih 14 godina,

that America's founders originally envisioned,

kako su prvobitno predvideli osnivači Amerike,

or the 20 years allowed by law today,

niti 20 godina koliko je danas zakonski dozvoljeno,

but for 40 years or more.

već za 40 ili više godina.

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

U međuvremenu su cene lekova nastavile da rastu -

68 percent since 2012.

68 posto od 2012.

That's seven times the rate of inflation.

To je sedam puta više od stope inflacije.

And people are struggling or even dying,

I ljudi se muče ili umiru,

because they can't afford the meds.

jer ne mogu da priušte lekove.

Now I want to be really clear about something.

Sada želim da budem jasna o nečemu.

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

Ovde se ne radi o predstavljanju farmaceutske industrije kao negativca.

What I'm talking about today

Ono o čemu danas pričam je

is whether the system we created to promote progress

da li sistem koji smo stvorili kako bismo promovisali napredak

is actually working as intended.

zapravo radi onako kako je zamišljeno.

Sure, the pharmaceutical companies are gaming the system,

Naravno da se farmaceutske kompanije poigravaju sa sistemom,

but they're gaming it because they can.

ali se poigravaju zato što mogu.

Because we have failed to adapt this system

Jer nismo uspeli da adaptiramo ovaj sistem

to meet today's realities.

današnjoj realnosti.

The government is handing out

Vlada izdaje

one of the most prized rewards in business --

jednu od najcenjenijih nagrada u biznisu -

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

mogućnost kreiranja proizvoda koji je zaštićen od konkurencije -

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

i traži sve manje i manje zauzvrat u našu korist.

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

Zamislite da nagradite jednog autora za istu knjigu sa 100 Pulicerovih nagrada.

(Murmurs)

(Mrmljanje)

It doesn't have to be this way.

Ne mora da bude ovako.

We can create a modern patent system

Možemo da stvorimo moderni patentni sistem,

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

koji bi odgovarao potrebama društva 21. veka.

And to do that,

A da bismo to uradili,

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

treba da osmislimo patentni sistem koji služi javnosti,

not just corporations.

a ne samo korporacijama.

So how do we do it?

Pa kako to da uradimo?

Five reforms.

Pet reformi.

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

Prvo, treba da prestanemo da izdajemo toliko patenata.

Back under the Kennedy administration,

Pod Kenedijevom administracijom,

in an effort to curb rising drug costs,

u pokušaju da se suzbije rastuća cena lekova,

a congressman from Tennessee proposed an idea.

član Kongresa iz Tenesija je predložio ideju.

He said,

Rekao je,

"If you want to tweak a drug,

''Ako želite da poboljšate lek,

and you want to get another patent on it,

i želite da dobijete još jedan patent za isti,

the modified version has to be significantly better, therapeutically,

modifikovana verzija treba da bude znatno bolja, terapeutski,

for patients."

za pacijente.''

Because of intense lobbying,

Zbog intenzivnog lobiranja,

this idea never saw the light of day.

ova ideja nikada nije ugledala svetlost dana.

But a reimagined patent system

Ali poboljšan patentni sistem

would resurrect and evolve this simple, yet elegant proposition.

bi osigurao i evoluirao ovaj jednostavan, a pametan predlog.

That to get a patent,

Za dobijanja patenta,

you have to invent something substantially better

treba da izmislite nešto suštinski bolje

than what's already out there.

od već postojećeg.

This shouldn't be controversial.

Ovo ne bi trebalo da bude kontroverzno.

As a society,

Kao društvo,

we reserve the big rewards for the big ideas.

ostavljamo velike nagrade za velike ideje.

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

Ne dajemo Mišelinove zvezdice za šefove kuhinja koji su samo poboljšali recept,

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

dajemo ih onima koji su promenili način na koji razmišljamo o hrani.

And yet, we hand out patents worth billions of dollars

A ipak, izdajemo patente vredne milijarde dolara,

for minor changes.

zbog malih promena.

It's time to raise the bar.

Vreme je da podignemo standard.

Second,

Drugo,

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

treba da promenimo finansijske podsticaje Zavoda za patente.

Right now, the revenue of the Patent Office

Upravo sada je prihod Zavoda za patente

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

direktno povezan sa brojem patenata koje odobrava.

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

To je kao da privatni zatvori zarađuju više ukoliko zatvore više ljudi -

it naturally leads to more incarceration,

prirodno je da dolazi do više zatvaranja,

not less.

ne manje.

The same is true for patents.

Isto je istinito i za patente.

Third, we need more public participation.

Treće, treba nam više javnog učešća.

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

Sada je patentni sistem poput crne kutije.

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

To je dvosmerni razgovor između patentnog sistema i industrije.

You and I aren't invited to that party.

Vi i ja nismo pozvani na tu žurku.

But imagine if instead,

Ali zamislite da je umesto toga

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

Zavod za patente postao dinamični centar za građansku obuku i domišljatost,

staffed not just by technical experts and bureaucrats,

čiji su članovi ne samo tehnički eksperti i birokrate,

but also by great public-health storytellers

već i sjajni pripovedači javnog zdravstva

with a passion for science.

sa strašću prema nauci.

Regular citizens could get accessible information

Obični građani bi imali dostupne informacije

about complex technologies

o kompleksnim tehnologijama

like artificial intelligence or gene editing,

poput veštačke inteligencije ili modifikovanja gena,

enabling us to participate in the policy conversations

omogućavajući nam da učestvujemo u političkim razgovorima,

that directly impact our health and lives.

koji direktno utiču na naše zdravlje i živote.

Fourth,

Četvrto,

we need to get the right to go to court.

treba da steknemo pravo odlaska na sud.

Right now in America, after a patent is granted,

Sada u Americi, nakon što se patent odobri,

the public has no legal standing.

javnost nema legalnu poziciju.

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

Samo oni sa komercijalnim interesom, često druge farmaceutske kompanije,

have that right.

imaju to pravo.

But I've witnessed firsthand how lives can be saved

Ali svedočila sam iz prve ruke kako se životi mogu spasiti

when everyday citizens have the right to go to court.

kada obični građani imaju pravo odlaska na sud.

Back in 2006 in India,

U Indiji 2006,

my organization worked with patient advocates

moja organizacija je radila sa zaštitnicima pacijenata,

to challenge, legally, unjust HIV drug patents,

kako bismo legalno izazvali nepravedne patente lekova za HIV,

at a time when so many people were dying,

u doba kada je dosta ljudi umiralo,

because medicines were priced out of reach.

jer su cene lekova bile nedostižne.

We were able to bring down the prices of medicines

Uspeli smo da spustimo cene lekova

by up to 87 percent.

za 87 posto.

(Applause)

(Aplauz)

On just three drugs,

Za samo tri leka

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

smo uspeli da uštedimo pola milijarde dolara zdravstvenim sistemima.

Now, cases like these can save millions of lives

Sada, slučajevi poput ovih mogu da sačuvaju milione života

and billions of dollars.

i milijarde dolara.

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

Zamislite kada bi i Amerikanci imali pravo odlaska na sud.

And lastly, we need stronger oversight.

I naposletku, treba nam dobar nadzor.

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

Treba nam nezavisna jedinica koja bi služila poput javnog zagovornika,

regularly monitoring the activities of the Patent Office

redovno nadgledajući aktivnosti Zavoda za patente

and reporting to Congress.

i izveštavajući Kongres.

If a unit like this had existed,

Da je jedinica poput ove postojala,

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

opazili bi na primer, kompaniju Teranos, iz Silicijumske doline,

before it got so many patents for blood testing

pre nego što su dobili toliko patenata za testiranje krvi

and landed an evaluation of nine billion dollars,

i stekli procenu na devet milijardi dolara

when in reality,

dok u stvarnosti,

there was no invention there at all.

uopšte nije postojao izum.

This kind of accountability is going to become increasingly urgent.

Ova vrsta odgovornosti će postati izuzetno hitna.

In the age of 23andMe,

U doba ''23andMe",

important questions are being asked

postavljaju se važna pitanja

about whether companies can patent and sell

o tome da li kompanije mogu da patentiraju i prodaju

our genetic information and our patient data.

naše genetske informacije i naše podatke o pacijentima.

We need to be part of those conversations

Treba da postanemo deo tih razgovora

before it's too late.

pre nego što bude prekasno.

Our information is being used to create the new therapies.

Naše informacije se koriste za stvaranje novih terapija.

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

I kada dođe trenutak dijagnoze za mene i moju porodicu,

or for you and yours,

ili za vas i vašu,

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

da li ćemo se okrenuti humanitarnoj pomoći kako bismo spasili živote onih koje volimo

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

To nije svet u kojem želim da živim.

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

To nije svet koji želim za mog dvogodišnjeg sina.

My dad is growing older now,

Moj tata sada stari,

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

i i dalje je prilično brilijantan i moralan kao i uvek.

Sometimes people ask us whether things get heated between us:

Ponekad nas ljudi pitaju da li su se stvari između nas zahuktale:

the patent-holding scientist

patentski naučnik

and his patent-reforming lawyer daughter.

i njegova ćerka, advokat za reformu patenata.

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

To je takvo temeljno nerazumevanje o tome šta je u pitanju,

because this is not about scientists versus activists,

jer nije o naučnicima nasuprot aktivista,

or invention versus protection.

ili o izumima nasuprot zaštite.

This is about people,

Ovo je o ljudima,

our quest to invent and our right to live.

našoj potrazi za stvaranjem i našem pravu da živimo.

My dad and I understand that our ingenuity and our dignity

Moj tata i ja razumemo da naša domišljatost i naše dostojanstvo

go hand in hand.

idu ruku pod ruku.

We are on the same side.

Na istoj smo strani.

It is time to reimagine a patent system

Vreme je da osmislimo patentni sistem

that reflects that knowing.

koji oslikava to saznanje.

Thank you.

Hvala.

(Applause)

(Aplauz)