The US pays the most for healthcare for worse outcomes. Free market not doing so great. An expensive new drug is not necessarily an effective drug, nor is a free market required to innovate. The US imports a very effective lung cancer immunotherapy vaccine from Cuba, for example (CIMAvax EGF).
> How many new drugs is Japan developing? From what I can tell, a fraction of what we do. The free market is pretty damn good at that.
Japan actually has a bunch of fairly major pharma companies that develop a lot of new drugs. You just don't hear their names in the US because the drugs get licensed to other companies when they're sold in the US and you only hear the name of the company that licensed them, but there are plenty of drugs that are commonly described in the US that were developed by Japanese pharma companies.
Local drug price regulations actually don't necessarily affect drug companies in a given country that much for this reason (they don't just develop drugs for the domestic market, and licensing to other countries to sell internationally is pretty much the norm).
However, in the case of the US it seems like the US pays a disproportionate amount of the total costs so it's possible that US drug price controls would affect pharma companies worldwide more than other countries' drug price controls. I'm not sure whether or not this can really be described as the free market doing a good job or not since the location where drugs are developed doesn't really affect their availability in other countries.
The important metric here ahould be average health of the population, not total number of new drugs developed.
I dont have those stats handy, but given how unhealtht the American population is as a whole I dont expect that we'd end up on the better end of that comparison.
If it's so good at it, why does it always need government funding?
(As testified before a congressional committee by an FDA official, his response to the question of "how many drugs receive government research funding?" was "all of them.")
Where is the "always" coming from? Check actual clinical trials registries and you will see that most clinical trials are not funded by the government.
That's a very biased way of looking at things, because you don't seem to understand how the research is organized in the first place.
The industry works all the time with academics. Academics do the fundamental science labor, which means identifying new targets, new pathways, new proteins and so on. This kind of research is indeed usually funded by a combination of public and private grants. Most of that research leads to nothing in the end, by the way - not everything they produce is picked up by the pharma industry, because most of what they produce fails to give results - that's the inherent property of doing fundamental research.
Then the industry purchases/licenses (and patents) what is considered to have the largest commercial potential - then pre-clinical, phase 1 up to phase 3 are mostly funded by the pharma industry. This is also where the bulk of the cost is. A clinical trial in phase 3 can costs in the dozens of millions of dollars, and there's always a solid chance that it fails to meet its endpoints so the risk is far from nil.
Based on the NIH numbers, the funding for research (i.e. grants) is about 45 billions annually. At the same time, the pharma industry spends 87 billions per year on R&D, which is about twice more.
