I know the one you mean Amanda, and can I honestly say it was put up simply as a piece of childish humour, hopefully to raise a smile as much as to annoy you. I apologise if it did cross a line, as there was no intention to cause any real offence, certainly no more than what is usual on Sin Bin.

It didn't specifically annoy me – heat, kitchens etc – but it did cross a line for the reason I outlined earlierall try to use the new year as a chance to keep a tad calmer than on occasions.

Big Pharma is a massive showing of the failings of capitalism. It shows that money trumps progress and the benefits of R&D done through the state and academia. Capitalism makes things cheaper, there is clearly and obviously a place for it. It brings this to the masses and market efficiencies do work in some areas. However market efficiencies also fail in a lot of areas. It drives what is profitable not what is the best option, it drives what makes the most money, not what helps the most people. There is a need for the Eli Lilly company to mass produce cheaply and efficiently vaccines. But the fact is that it took government money and academic research, and the genius of an academic in Jonas Salk to create the vaccine.

In other areas too, for example Monsanto make a fortune and are hugely controversial, It needed the Mexican State, Charity, and Norman Borlaug to reject Du Ponts money to save billions of lives. Redirecting the money from the Monsanto’s and Eli Lillys to the Jonas Salk and Norman Borlaugs to research for the greater sum of human knowledge will not only push forward human progress and make all our lives better, give us better access to the unfettered truth rather than the lies and lies of omission companies often rely on to protect their market position (is there any Big Pharma company which hasn’t introduced a fairly damaging drug, then hidden behind biased research before being found out?) but also give the capitalists more doodahs and whatsits to make cheaply and sell on. A virtuous cycle if any ever existed.

Smokey - that's a tad OTT about big pharma.

The argument for big pharma has always been about their ability to fund speculative development. This is hugely expensive, especially when you consider we're not just talking about a few drugs, or just coming up with an idea but going through complex and expensive development and testing through to human trials and large-scale production for many drugs at the same time.

The current model is based on the funding of the above being in turn protected by the ability to earn abnormal profits from developed products for a period via patent protection.

I'm not arguing that the current model isn't flawed - it is. Genuine groundbreaking research nearly always comes from outside of big corporates, partly because they focus a lot of effort on developing new versions of existing drugs, or new drugs to treat the same disease. Corporates will also focus on diseases where the potential payoffs from a cure promise to be significant - i.e. they'll focus far more time on common ailments than uncommon ones.

But like many things, you can't "fix" the system that exists by tampering with just part of it - e.g. remove patent protection entirely and there's zero incentive for anyone to commercially develop any new drug. The problem then becomes who funds the research and how (and a lot of academics in R&D are directly or indirectly supported in part by big pharma).

My own experience of big Pharma centres around Astrazeneca. They have a huge R&D centre near Macclesfield - a site so big and developed it's almost a town in itself. Approx 2,000 R&D staff iirc - a huge expense to the company. Most of it is relocating to Cambridge in a few years, but that's another story.

They have several dozen key staff travelling internationally mainly to other AZ locations every week, and up until around 2010 they all travelled Business Class, no questions asked. They were buying so many seats most of the airlines they used offered corporate preferred deals to capture the maximum number of travellers possible and retain the business. This had been the status quo for many, many years, the reasoning being they wanted their staff fresh and ready to work when they arrived - many, many companies cite this reason for buying premium seats, and fair enough.

Then, around 2010, a (cancer?) drug they had spend many hundreds of millions and many years developing was denied certification in the States. All that money down the drain. Tens of thousands of salaried R&D hours wasted, leading directly and indirectly to several thousand AZ jobs being lost globally over the past few years.

Another consequence was that their international travel dipped drastically. Many staff stopped travelling, others travelled Economy Class. This may seem trivial but I know for a fact when the move to Cambridge happens and AZ stop flying out of Manchester, the revenue loss means at least one airline will almost certainly cut a route, which can mean the loss of jobs across a number of companies such as ground handlers, caterers, security, airline staff, etc.

Pharma drug pipelines are often years long and can cost hundreds of millions in R&D, testing, trials, etc, a huge investment and a huge risk. Despite the myths, they're not simply milking state and academia, they're making enormous investment and bearing enormous cost themselves. They do so because their competitors are racing them to get these drugs developed and to market where the profits need to cover that investment and then some.

On the other hand at least some of that research and design and construction is done purely with profit in mind - how can we build more, more quickly, at lower cost ?

The Rolls Royce issue is a case in point, we would not have the jet engines that we have now were it not for Government decrees that they should be quieter (not least decrees from the USA) and less poluting, accompanied by a different requirement to make them run more efficiently (cheaper).

Compare any new aircraft and the noise it makes upon take-off ( I live 1 mile away from an airport ) with any old video of a Boeing 707 taking off, when you sat inside one of those you knew that something dramatic and noisy was happening outside because it was dramatic and noisy INSIDE - also check out the exhaust output from one of those and you'll see how poluting they were - then bare in mind that the first solution to make those aircraft bigger was simply to add more of the same engines to them.

Many of which are conducted by the countries finest universities.

id agree with most of that. I wouldn’t simply remove patent protection but there needs to be a fundamental restructure of the relationship between the state, the public, academia and Big Pharma for numerous reasons, some which you mention, other such as the lies, lies of omission, and general bending of the truth which has become commonplace in medicine because there can be quite a big discrepancy between what is good for the patient and what is good for the drug company. Not to mention the uncomfortable relationship we should all see between doctors and Big Pharma and marketing and Big Pharma. Im also not keen on the duplication of research being done by competing big pharma companies. That seems 'inefficient' when it could be done more collaboratively in an academic setting.

As I said earlier, there is a place for drug companies, but for me the relationship should always be the Jonas Salk creating the thing, where it can be done through academia, where it can be peer reviewed, where all information is made public, where the aim is the truth and the answer, not the money, and the Eli Lilly manufacturing the thing.

The other problem with big pharma is they are less inclined to find cures for illnesses or conditions, preferring instead to find treatments. There's no real money in cures

If bigpharma1 invents a treatment that doesn't cure, and bigpharma2 invents a treatment that provides a permanent cure, who gets the business?

Whoever pays the biggest kickback to the state/doctor?

You can never trust the state. The one business with the most scope to create and abuse a monopoly.

Never trust big business. It exists solely and purely and unequivocally to take your money.

I have to ask who would you trust more to prescribe the best drug for you, to you. Your NHS GP, or your friendly local Glaxosmithkline sales rep?

Unlike the state, big business (why do you differentiate from small business here?) can't force you to hand over your money.

AFAIK, Glaxosmithkline produce drugs, rather than prescribe them.