Chapter 8: Positive regulation: The complementary role of supports and sanctions
We begin this chapter by presenting the case for an integrated approach to countering all the forms of misconduct discussed in Part II. This will involve creating a hierarchy of strategies for building on the strengths of the pharmaceutical industry, while adopting in parallel with this a mix of strategies for enforcement. Within the hierarchy of strategies for building strengths we find that patents dominate thinking far more than evidence as to their effectiveness warrants. It may well be that patent terms need to be reduced, options for compulsory licences on patented drugs extended and complementary reward systems for innovation strengthened if patents are to contribute to a reversal of the steep decline in pharmaceutical innovation that has been seen over the past 25 years. Patents are simultaneously a strength and a weakness of the innovation system, encouraging innovation by some but preventing innovation by others. Open-source biotechnology to reinvigorate pharmaceutical innovation, complementing the patent model of innovation, is one option. Society has failed to adopt an evidence-based approach to determine how one might craft patent law so that it does less harm and more good than is currently the case. If we over-use overly long patents, their benefits in terms of innovation will be outweighed by the cost to society resulting from prolonged maintenance of monopolies. We are troubled that the pharmaceutical industry has allowed investment in real research and development to fall.
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