Why are drug prices so high? Investigating the outdated US patent system | Priti Krishtel

Summary

In this TED talk, Priti Krishtel explores the outdated U.S. patent system and its role in driving high drug prices. She shares personal stories and professional insights to highlight how the current patent laws, designed to inspire innovation, are being manipulated by pharmaceutical companies to maintain monopolies. This results in exorbitant drug costs, making essential medicines unaffordable for many. Krishtel proposes a comprehensive reform to make the system more equitable and aligned with the public interest, thus ensuring that innovation benefits all.

Highlights

• Priti Krishtel shares a personal connection to the pharmaceutical world through her father, a retired drug inventor. 👨‍🔬
• The outdated patent system is a key contributor to high drug costs and inequitable access to medications. 💊
• Krishtel discusses the urgent need for patents to encourage genuine innovation rather than minor drug modifications. 🔍
• She explains how drug patents often extend beyond their intended time, blocking competition and keeping prices high. 🚫💲
• Krishtel proposes five reforms to overhaul the patent system, focusing on public interest and transparency. ✨

Key Takeaways

• Current U.S. patent laws are being manipulated, leading to high drug prices. 💸
• Pharmaceutical companies extend patent protections to maintain monopolies. 🏢
• Most 'new' drug patents aren't for new drugs, but tweaks on existing ones. 🏷️
• Rising drug costs push families into financial hardship. 💔
• Reforms are required to ensure patents serve public interest, not just corporations. 🔄

Overview

Priti Krishtel begins her TED talk by sharing a touching personal story involving her father, a pharmaceutical scientist, and Rudy, a man whose father died from a disease her father helped to treat. This connection nicely frames her argument about the importance and impact of drug patents. She explains that her family values patents for the opportunities they provided, but she also highlights the problems within the system that need addressing.

The heart of Krishtel’s talk is an exploration of the U.S. patent system, which she argues is outdated and easily manipulated by corporations. This manipulation allows companies to extend patent protections and keep drug prices artificially high. Krishtel identifies a trend of filing numerous patents for minor modifications to drugs, which doesn't align with the original intention of patents to reward true innovation.

Krishtel’s solution lies in comprehensive reform. She advocates for fewer patents, public involvement in the patent process, legal rights for citizens to challenge unfair patents, and stronger oversight of the Patent Office. By implementing these changes, she believes the system can prioritize public health and access over corporate profits, ensuring that the benefits of patents are shared more equitably.

Chapters

• 00:00 - 01:30: Introduction and Personal Story The chapter 'Introduction and Personal Story' begins with the speaker sharing a personal anecdote about her husband, Rudy, who experienced 'love at first sight.' At the time, Rudy was just a friend to the speaker and had been placed firmly in the 'friend zone.' The story unfolds with Rudy visiting the speaker's house, leading to an encounter with her father, a retired pharmaceutical scientist. This introduction sets the stage for a narrative likely to explore themes of love, relationships, and personal history.
• 01:30 - 04:00: Outdated Patent System and High Drug Prices The chapter discusses the issue of high drug prices linked to the outdated patent system. It includes a personal anecdote where the speaker's father mentions a drug for idiopathic pulmonary fibrosis (IPF), which prompts a poignant connection with someone whose father passed away from the same disease. This encounter illustrates personal and emotional stakes in the broader issue of drug pricing.
• 04:00 - 06:30: Exploitative Practices and Impact This chapter explores the theme of generational impact and appreciation for familial achievements. The narrator reflects on how their family's admiration and respect for their father's inventions and patents have significantly shaped their lives. Despite coming too late to save the father's own prospects, these innovations embodied a full-circle moment symbolizing opportunity and legacy for the next generation. The chapter underscores how the patents not only adorn their home but also stand as a testament to the opportunities provided by America, enabling pursuits in education and health justice.
• 06:30 - 11:30: Needed Reforms The chapter 'Needed Reforms' discusses the narrator meeting the director of the US Patent Office. The narrator humorously describes sending a selfie to their family, equating the director's significance to meeting a celebrity due to the overwhelming emoji responses. The narrator hints at the meeting's purpose being to address a problem, rather than mere pleasantries.
• 11:30 - 12:30: Conclusion and Personal Reflection The chapter discusses the impact of the outdated patent system on global healthcare, highlighting how it contributes to the high cost of medicines and limits access, particularly affecting over two billion people worldwide. It emphasizes the dire consequences, noting that even in wealthier countries like the United States, the exorbitant cost of drugs leads to unnecessary loss of life despite the availability of treatments.

Why are drug prices so high? Investigating the outdated US patent system | Priti Krishtel Transcription

• 00:00 - 00:30 For my husband, it was love at first sight. (Laughter) Here's what happened. Years ago, Rudy, who I had strictly put in the friend zone at the time, came over to my house and met my dad, a pharmaceutical scientist who had just retired
• 00:30 - 01:00 after bringing a drug to market. My dad said, "Ah, you probably wouldn't have heard of it. It's for IPF, idiopathic pulmonary fibrosis." Rudy paused for a long time, and then he said, "That's the disease that took my father's life 15 years ago." Rudy says that this is the moment he fell in love. (Laughter) With my father. (Laughter)
• 01:00 - 01:30 Even though it was too late for my dad to save his, he felt that destiny had delivered us this full-circle moment. In my family, we have a special love for my father's inventions. And in particular, we have a reverence for his patents. We have framed patents on the wall in our house. And there's a recognition in our family that everything I've been able to do -- college, law school, health justice work -- all of it is because America enabled my father
• 01:30 - 02:00 to fulfill his potential as an inventor. (Applause) Last year, I met the director of the US Patent Office for the first time, and I sent my family a selfie from that office in Virginia. (Laughter) I got so many emojis back, you would have thought I had met Beyoncé. (Laughter) But truth be told, I was actually there to talk about a problem --
• 02:00 - 02:30 how our outdated patent system is fueling the high cost of medicines and costing lives. Today, over two billion people live without access to medicines. And against this global crisis, drug prices are skyrocketing, including in wealthier countries. Thirty-four million Americans have lost a family member or a friend in the last five years, not because the treatment didn't exist, but because they couldn't afford it.
• 02:30 - 03:00 Rising drug costs are pushing families into homelessness, seniors into bankruptcy and parents to crowdfunding treatment for their critically ill children. There are many reasons for this crisis, but one is the outdated patent system that America tries to export to the rest of the world. The original intention behind the patent system was to motivate people to invent
• 03:00 - 03:30 by rewarding them with a time-limited monopoly. But today, that intention has been distorted beyond recognition. Corporations have teams of lawyers and lobbyists whose sole job is to extend patent protection as long as possible. And they've kept the patent office busy. It took 155 years for the US Patent Office to issue its first five million patents. It took just 27 years for it to issue the next five million.
• 03:30 - 04:00 We haven't gotten drastically more inventive. Corporations have gotten drastically better at gaming the system. Drug patents have exploded -- between 2006 and 2016, they doubled. But consider this: The vast majority of medicines associated with new drug patents are not new. Nearly eight out of 10 are for existing ones,
• 04:00 - 04:30 like insulin or aspirin. My organization, a team of lawyers and scientists, recently conducted an investigation into the 12 best-selling drugs in America. We found that, on average, there are 125 patents filed on each medicine. Often for things we've known how to do for decades, like putting two pills into one. The higher a patent wall a company builds,
• 04:30 - 05:00 the longer they hold on to their monopoly. And with no one to compete with, they can set prices at whim. And because these are medicines and not designer watches, we have no choice but to pay. The patent wall is a strategy to block competition. Not for the 14 years maximum that America's founders originally envisioned, or the 20 years allowed by law today,
• 05:00 - 05:30 but for 40 years or more. Meanwhile, prices on these drugs have continued to increase -- 68 percent since 2012. That's seven times the rate of inflation. And people are struggling or even dying, because they can't afford the meds. Now I want to be really clear about something. This isn't about making the pharmaceutical industry the bad guy. What I'm talking about today
• 05:30 - 06:00 is whether the system we created to promote progress is actually working as intended. Sure, the pharmaceutical companies are gaming the system, but they're gaming it because they can. Because we have failed to adapt this system to meet today's realities. The government is handing out one of the most prized rewards in business -- the opportunity to create a product that is protected from competition --
• 06:00 - 06:30 and asking for less and less in return on our behalf. Imagine awarding 100 Pulitzer Prizes to one author for the same book. (Murmurs) It doesn't have to be this way. We can create a modern patent system to meet the needs of a 21st-century society. And to do that, we need to reimagine the patent system to serve the public, not just corporations.
• 06:30 - 07:00 So how do we do it? Five reforms. First, we need to stop handing out so many patents. Back under the Kennedy administration, in an effort to curb rising drug costs, a congressman from Tennessee proposed an idea. He said, "If you want to tweak a drug, and you want to get another patent on it, the modified version has to be significantly better, therapeutically, for patients." Because of intense lobbying,
• 07:00 - 07:30 this idea never saw the light of day. But a reimagined patent system would resurrect and evolve this simple, yet elegant proposition. That to get a patent, you have to invent something substantially better than what's already out there. This shouldn't be controversial. As a society, we reserve the big rewards for the big ideas. We don't give Michelin stars to chefs who just tweak a recipe --
• 07:30 - 08:00 we give them to chefs who change how we think about food. And yet, we hand out patents worth billions of dollars for minor changes. It's time to raise the bar. Second, we need to change the financial incentives of the Patent Office. Right now, the revenue of the Patent Office is directly linked to the number of patents that it grants. That's like private prisons getting paid more to hold more people --
• 08:00 - 08:30 it naturally leads to more incarceration, not less. The same is true for patents. Third, we need more public participation. Right now, the patent system is like a black box. It's a two-way conversation between the patent office and industry. You and I aren't invited to that party. But imagine if instead,
• 08:30 - 09:00 the Patent Office became a dynamic center for citizen learning and ingenuity, staffed not just by technical experts and bureaucrats, but also by great public-health storytellers with a passion for science. Regular citizens could get accessible information about complex technologies like artificial intelligence or gene editing, enabling us to participate in the policy conversations
• 09:00 - 09:30 that directly impact our health and lives. Fourth, we need to get the right to go to court. Right now in America, after a patent is granted, the public has no legal standing. Only those with a commercial interest, usually other drug companies, have that right. But I've witnessed firsthand how lives can be saved when everyday citizens have the right to go to court.
• 09:30 - 10:00 Back in 2006 in India, my organization worked with patient advocates to challenge, legally, unjust HIV drug patents, at a time when so many people were dying, because medicines were priced out of reach. We were able to bring down the prices of medicines by up to 87 percent. (Applause) On just three drugs, we were able to save health systems half a billion dollars.
• 10:00 - 10:30 Now, cases like these can save millions of lives and billions of dollars. Imagine if Americans had the right to go to court, too. And lastly, we need stronger oversight. We need an independent unit that can serve as a public advocate, regularly monitoring the activities of the Patent Office
• 10:30 - 11:00 and reporting to Congress. If a unit like this had existed, it would have caught, for example, the Silicon Valley company Theranos before it got so many patents for blood testing and landed an evaluation of nine billion dollars, when in reality, there was no invention there at all. This kind of accountability is going to become increasingly urgent. In the age of 23andMe, important questions are being asked
• 11:00 - 11:30 about whether companies can patent and sell our genetic information and our patient data. We need to be part of those conversations before it's too late. Our information is being used to create the new therapies. And when that moment of diagnosis comes for me and my family, or for you and yours, are we going to have to crowdfund to save the lives of those we love? That's not the world I want to live in.
• 11:30 - 12:00 It's not the world I want for my two-year-old son. My dad is growing older now, and he is still as quietly brilliant and morally directed as ever. Sometimes people ask us whether things get heated between us: the patent-holding scientist and his patent-reforming lawyer daughter. It's such a profound misunderstanding of what's at stake,
• 12:00 - 12:30 because this is not about scientists versus activists, or invention versus protection. This is about people, our quest to invent and our right to live. My dad and I understand that our ingenuity and our dignity go hand in hand. We are on the same side. It is time to reimagine a patent system that reflects that knowing. Thank you. (Applause)