Pharmaceutical Patents

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    Public Grants, Private Tollbooth: Who Pays Twice for Xtandi?

    ByPhil McCracken

    At my invoice desk, the Xtandi money trail arrives wearing a lab coat and leaves in a limousine. The complaint is straightforward: public funding helped support UCLA-linked research, while commercialization and patent control became associated with Astellas and Pfizer. Then patients encountered annual U.S. price claims reaching roughly $160,000 to $180,000. That is a remarkable billing arrangement—taxpayers help finance the road, private interests control the toll gate, and the patient gets charged for driving on it.

    Not every stage of Xtandi’s development can be reduced to one public grant or one private decision, and a list price is not the same as every patient’s bill. But the public-return question remains as stubborn as a bad line item: when public science helps move an essential medicine forward, what does the public receive besides another invoice? Innovation may begin as public service, yet somehow ends as private property with a collections department. Follow the invoice long enough and it reaches the same destination: the patient, standing at the pharmacy counter with the receipt and no lobbyist’s expense account.

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    Medicare’s Taxpayer-Funded Layaway Plan

    ByHarlan Quill

    At the courthouse-basement level of policy math, the arrangement is hard to defend: taxpayers help absorb the early risk of medical discovery, then a private patent can put the finished medicine behind a padlock while Medicare and patients meet the checkout price.

    That is a taxpayer-funded layaway plan. We help finance the scientific groundwork, a company controls the bottle, and the public returns to retrieve its medicine with a bill wearing a shareholder-return hat. If public support helps make a breakthrough possible, public policy should at least ask what public value comes back. Otherwise, we did not merely buy the breakthrough; we rented it back from the company that put a padlock on the bottle.

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