Why not let rich people fund drug development directly?


That is, why not let ill rich people fund directly the research into a treatment that might cure them? That's the premise of this fascinating plutocratic proposal. That piece is very long, very detailed and walks you through almost all aspects of what is being offered. The essential idea is that, especially with cancers, there's a lot of weird ones that affect very few people. But there's quite a lot of rich people about and there's enough of them that, statistically, at least a few, a handful, of such rich people will get each and every one of those weird cancers.

This helps us to solve a certain problem that we've got with funding research into disease cures. We should, obviously, as a society be working on the low hanging fruit. A cure for something that kills 20,000 out of 100,000 people is worth a very great deal more in terms of human utility than a cure for something that kills 5 out of 100,000 people is. Tax funding of such research should therefore, again obviously, be concentrated on trying to find the cures for those widely suffered from diseases, not the weird and rare ones.

However, when we move from societal benefit to private benefit the numbers rather change. Someone suffering from one of those weird cancers is very interested indeed in a cure for that weird cancer. And some of those very interested people will be rich enough to fund the next step in the research. The step being talked about here is the movement of a likely looking treatment out of the lab and into Phase I clinical trials.

Those Phase I trials are where the first 10 or 50 people get given the treatment to see what it actually does to human beings. And there's a number of problems at this point. Neither tax money nor standard pharma investment cash is going to be very interested. One on the grounds that societal benefit will be greater with efforts made elsewhere, the other on the grounds that the final market simply isn't large enough to make it worthwhile. But of course rich people dying of the weird cancer face a different calculus.

The proposal is, at its simplest, just to allow said rich and ill people to pay for the Phase I trials (or some portion of them) in return for a guaranteed place on that very trial. They get this treatment that may cure them, 9 to 49 people get that same treatment without having had to pay anything and we all get the benefit of the advance in human knowledge.

Predictably this will cause howls of outrage in certain quarters. But we think that it's a fascinating idea: at the very least it's something that should be widely discussed and also in detail. No one is claiming that this is a perfect and final plan. Only that it's a very interesting one.

If we can harness the desire of rich people not to die to our goal of treating non-rich people dying of the same diseases then why the heck not?