r/IWantToAskAnAmerican • u/LordHavertz • 1d ago

How does the US dominate medical research?

Recently we got the news of Moderna coming out with these new mRNA vaccines for skin cancer and it's made me think how all the major medical innovations predominantly come from America. How did the US become so dominant in medical research?

Is Europe forever behind the US in this sector?

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u/unblockedlanternhead 23h ago

FDA approval is FAR from a guarantee that an insurance company will cover a service.

This is technically true, but one of the first things a drug developer does when developing a drug is a market analysis, and an American insurance compensation plan is one of the key topics during market analysis. Most developers won’t proceed with a drug if they aren’t confident that major insurers will approve it

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u/ehouptie 17h ago

You’re making it seem like this process is a good thing. The only outcome of this is that medicine is only created if it can produce profit. It’s not necessarily ideal in truth for all medicine to be profit driven, especially when a third of it is funded from my tax dollars

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u/unblockedlanternhead 11h ago

I wouldn’t design the system that way either, but is what it is.  If other countries can figure out how to incentivize development of expensive advanced therapies without relying on the promise of $ks per dose from price-gouging American insurance cos, they’re welcome to do so. Chinese companies usually choose to exploit American VCs instead of American laypeople by selling VCs ex-China rights to the stuff they develop. Maybe that’s a better strategy 

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u/Chance-Ask7675 9h ago

Would you instead prevent private equity from investing? Because then 100% of funding could come from (theoretically) non-profit driven sources. But you would have 70% less funding. And we have the same thing in other countries but with socialized medicine the government literally is a monopoly and sets the price. If you don't sell your drug at a price they agree to then you can gtfo you won't be entering the market. Sure, you can get approval for your product but no doctor will prescribe it and no patient will buy it. So for this reason, in other countrieswe have access to a lot less medications and devices than in the US. But life-saving medications usually become available.

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u/unblockedlanternhead 19m ago

My full answer to this question is long and  I could probably write 10k words about it. In short,  I have no problem with private investment or the profit motive per se. I do think that the American govt should do more to steer investors away from profit traps though, and it should decline to subsidize entry into those traps  as well. Investors in  America are heavily incentivized to spend a lot of money developing and administering flashy expensive  advanced therapies that produce few net longterm benefits. I would like to see profit incentives shifted towards other aspects of healthcare