[Plura-list] We paid to develop Merck's covid pill

[Cory Doctorow]

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The paperback for Attack Surface - a standalone Little Brother book for adults - is out!

https://us.macmillan.com/books/9781250757517/attacksurface

Signed copies:

https://www.darkdel.com/store/p1840/Cory_Doctorow_-__Attack_Surface_HB_%26_TPB.html#/

One-month only audiobook sale with Little Brother and Homeland:

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Read today's issue online at: https://pluralistic.net/2021/10/06/merck-cenary/

Today's links

* We paid to develop Merck's covid pill: And now they're charging us a 4,000% markup on it.

* This day in history: 2016, 2020.

* Colophon: Recent publications, upcoming/recent appearances, current writing projects, current reading

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🗾 We paid to develop Merck's covid pill

Comparing the government to a household or a business isn't merely inapt (a government is a currency creator, while a household is a currency user - their budgeting constraints are totally unrelated) - it's also profoundly dishonest.

Like, if you really are worried about government "living beyond its means," then you should freak out every time Congress writes a $715B no-strings-attached check to the Pentagon, or sends $258B to the ultra-rich as part of the CARES Act.

https://www.propublica.org/article/the-cares-act-sent-you-a-1-200-check-but-gave-millionaires-and-billionaires-far-more

If the government is like a household that can "charge too much to its credit card," then it shouldn't matter whether the spending is going for universal pre-K and Medicare for All or junk bonds and a $1T fighter jet that can't even fly.

https://www.nytimes.com/2019/08/21/magazine/f35-joint-strike-fighter-program.html

The household analogy only arises for our ability to house, feed, clothe, educate and care for each other - when it comes to corporate subsidies and blank checks for Beltway Bandits, the whole establishment converts to (transient, highly selective, ardent) adherence to Modern Monetary Theory.

The same is true when we talk about running government like a business, another thing the government is nothing like, and another analogy that is only raised to justify shredding the social safety net, and jettisoned when it comes to handing billions to giant corporations.

Take Merck's blockbuster covid therapeutic drug Molnupiravir, whimsically named for Thor's hammer, which made headlines after a trial in which it was 100% successful in preventing death in covid patients.

https://scholar.harvard.edu/files/melissabarber/files/estimated_cost-based_generic_prices_for_molnupiravir_for_the_treatment_of_covid-19_infection.pdf

A five-day course of Molnupiravir costs $17.74 to produce. Americans - and Medicare, and US insurers - will pay $712 to receive a five-day course of the drug, representing a tidy 4,000% profit for Merck.

But of course, the cost of Molnupiravir isn't merely the cost of production - the major cost is the high-risk capital that was used to fund the initial development and testing. In the world of business, the investor who bears that risk should reap the reward.

Right?

Here's the thing: that investor was the US government. Molnupiravir was developed at public expense at Emory University, which received $10M from the DoD between 2013-15 and another $19M from the NIH. That's a $29M public subsidy into early-stage, high-risk research.

If the US government should be run like a business, then we are the angel investors. Sure other investors came in afterwards - after our investment had vastly reduced the risk - like Ridgeback, who bought the rights from Emory in 2020 and flipped them to Merck.

Like all follow-on investors, Ridgeback and Merck should expect to pay more money for a smaller share. The angel investors' share will be diluted, of course, but only a little. We angel investors took all the risk, and the majority of the reward is rightfully ours.

But that's not what people who say "we should run the government like a business" mean. The business in question isn't a startup with shrewd investors.

Rather, it's more like a schlock Hollywood film, the kind that's funded by star-struck midwestern dentists who are stupid enough to agree to a share of the "net profits" and get nothing, not even a free ticket to the premiere.

If the US government is a business, then American public are the suckers at the table, the marks who get hustled into paying for everything in exchange for nothing, not even the bragging rights. Our contribution is treated as both beneath mention and literally unmentionable.

That's why the pronouncements about Molnupiravir are all misleading statements from Ridgeback and Merck about how they self-funded, and why the only reason we discovered the public origins of the drug was because of crack research from Knowledge Ecology International.

https://www.keionline.org/36648

Merck and Ridgeback stand to make $7 billion from Molnupiravir this *year*, and the majority of that money will come from Americans paying $712 to take a $17 drug that they already shelled out $29m to develop.

https://qz.com/2068247/merck-could-make-up-to-7-billion-from-its-covid-19-drugs-in-2021/

Most of those profits *won't* come from abroad - because, as Micah Lee points out for The Intercept, people in other countries will enjoy a full course for a mere $12, courtesy of a giant Indian generics factory.

https://theintercept.com/2021/10/05/covid-pill-drug-pricing-merck-ridgeback/

America isn't a business. The US government funded the basic research into this because if we left things up to business, we would be royally fucked. Businesses are risk averse and cowardly and do not fund the science that uplifts us.

As Mariana Mazzucato documents in her landmark 2013 book "The Entrepreneurial State," every successful American company owes its existence to a vast public subsidy - a subsidy that is routinely erased. 

https://marianamazzucato.com/books/the-entrepreneurial-state

We *must* erase it. If we acknowledge it, we'd know the *last* thing we want is for the government to run itself like a business - we want the government to run itself like a *government*. We want it to invest in research, and then make that research available on equitable terms.

We could make publicly funded work public domain - or we could condition access to publicly funded work on a maximum profit margin, say, 10% (which would price a course of Molnupiravir at $20). That is to say, we could make public research a force for public benefit.

Because government is not a business nor a household. It is neither a profit-maximizer nor a currency user. It is a benefit-maximizer and  a currency creator - or it could be. 

The alternative isn't a government that budgets like a household or runs like a business. It's a government that budgets like a drunken sailor (or a drunken admiral out for drinks with a military contractor's sales rep) and bargains like a star-struck midwestern dentist.

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🗾 This day in history

#5yrsago Would-be Ukip leader hospitalised following “altercation” (“punched by a colleague”) https://www.telegraph.co.uk/news/2016/10/06/ukip-leadership-favourite-steven-woolfe--in-serious-condition-af/

#5yrsago Merciless reporting on the Chicago Police Department’s extortion racket, & the senior officials who covered it up https://theintercept.com/2016/10/06/in-the-chicago-police-department-if-the-bosses-say-it-didnt-happen-it-didnt-happen/

#1yrago America's wild hog "pig bomb" https://pluralistic.net/2020/10/06/hybrid-vigor/#porcs

#1yrago Maine's drunken, thieving, bumbling, child-porning public defenders https://pluralistic.net/2020/10/06/hybrid-vigor/#gideon-v-wainwright

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🗾 Colophon

Currently writing: 

* Spill, a Little Brother short story about pipeline protests. Yesterday's progress: 308 words (22657 words total)

* Picks and Shovels, a Martin Hench noir thriller about the heroic era of the PC. Yesterday's progress: 1033 words (10609 words total). 

* A Little Brother short story about remote invigilation.  PLANNING

* A nonfiction book about excessive buyer-power in the arts, co-written with Rebecca Giblin, "The Shakedown."  FINAL EDITS

* A post-GND utopian novel, "The Lost Cause."  FINISHED

* A cyberpunk noir thriller novel, "Red Team Blues."  FINISHED

Currently reading: Analogia by George Dyson.

Latest podcast: Breaking In https://craphound.com/news/2021/09/26/breaking-in-fixed/

Upcoming appearances:  

* Reconciling Social Media & Democracy, Tech Policy Press, Oct 7
https://zoom.us/webinar/register/WN_O2qI4RJ8S7K2x6cpsQhnuQ

* From Wayback to Way Forward: The Internet Archive turns 25, Oct 21
https://www.eventbrite.com/e/from-wayback-to-way-forward-the-internet-archive-turns-25-virtual-tickets-163615196457

* Keynote for SeaGL 2021, Nov 5-6
https://seagl.org/news/2021/06/08/format-2021

Recent appearances:

* Community & Technology
https://www.youtube.com/watch?v=rjupiYDDwZM

* Infosec Apocaylpse (We're In podcast)
https://were-in.simplecast.com/episodes/cory-doctorow-and-the-infosec-apocalypse-SeDf3qB_

* Walled Culture
https://www.youtube.com/watch?v=_AnGd4PaG6U

Latest book:

* "Attack Surface": The third Little Brother novel, a standalone technothriller for adults. The *Washington Post* called it "a political cyberthriller, vigorous, bold and savvy about the limits of revolution and resistance." Order signed, personalized copies from Dark Delicacies https://www.darkdel.com/store/p1840/Available_Now%3A_Attack_Surface.html

* "How to Destroy Surveillance Capitalism": an anti-monopoly pamphlet analyzing the true harms of surveillance capitalism and proposing a solution. https://onezero.medium.com/how-to-destroy-surveillance-capitalism-8135e6744d59 (print edition: https://bookshop.org/books/how-to-destroy-surveillance-capitalism/9781736205907) (signed copies: https://www.darkdel.com/store/p2024/Available_Now%3A__How_to_Destroy_Surveillance_Capitalism.html)

* "Little Brother/Homeland": A reissue omnibus edition with a new introduction by Edward Snowden: https://us.macmillan.com/books/9781250774583; personalized/signed copies here: https://www.darkdel.com/store/p1750/July%3A__Little_Brother_%26_Homeland.html

* "Poesy the Monster Slayer" a picture book about monsters, bedtime, gender, and kicking ass. Order here: https://us.macmillan.com/books/9781626723627. Get a personalized, signed copy here: https://www.darkdel.com/store/p1562/_Poesy_the_Monster_Slayer.html.

Upcoming books:

* The Shakedown, with Rebecca Giblin, nonfiction/business/politics, Beacon Press 2022

This work licensed under a Creative Commons Attribution 4.0 license. That means you can use it any way you like, including commercially, provided that you attribute it to me, Cory Doctorow, and include a link to pluralistic.net.

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