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Light, D.W. and Lexchin, J.R. “The costs of coronavirus vaccines and their pricing.” Journal of the Royal Society of Medicine 2021 Vol 114 (11): 502-504.

The net cost for researching, testing and manufacuturing Western vaccines, after subtracting all public subsidies, is much smaller that what the US and Europe are agreeing to pay for them. This makes them unaffordable to many middle and lower income countries and impedes treating the global pandemic. 

Darrow, Jonathan and Donald Light, “Beyond The High Prices Of Prescription Drugs: A Framework To Assess Costs, Resource Allocation, And Public Funding,” Health Affairs 2021, vol. 40, No. 2:281-88.

Corporate R&D costs for new drugs in the U.S. are reduced by a large number of taxpayer-paid subsidies. They are further reduced by "pull" subsidies built into patents and insurance. This article pulls these subsidies into a comprehensive framework for tracking and accounting for public subsidies for pharmaceutical corporate R&D. 

Light, D.W. and Lexchin, J.R. 2021 “Pharmaceuticals as a market for ‘lemons’: theory and practice.” Social Science and Medicine 268 113368

This overview first considers and revises the economic theory of 'lemons', that is products like cars and drugs in which sellers know about hidden flaws and risks of harm but do not disclose them to buyers. The authors then describe how incentives and institutional practices reward companies for producing more 'lemons'. The market for more drugs with hidden risks and flaws is likely to flourish.

Institutional Corruption and the Myth of Safe, Effective Drugs

Explains how the FDA has become institutionally corrupt so that 90 percent of new approvals provide few or no advantages, and drugs are the 4th leading cause of death.

BMJ "Pharmaceutical R&D: What do we get for all that money?"

High prices and little added value characterize most new drugs. The industry turns out articles on the so-called innovation crisis but we prove there is none. Rather, a hidden business model leads to scores of minor variations.

GOOD PHARMA: the Public Health Model of the Mario Negri Institute

Describes how a large institute (51 labs), devoted to developing better medicines for patients, provides a public health model works without patenting any of its discoveries or new uses in an open-science, collaborative, self-critical style at much lower costs with data transparency than commercialized research.

A Trio of Short Critiques of the FDA

1. "The FDA's new clothes (for safer drugs): tattered, missing sleeve, torn pocket...
2. "Why do cancer drugs get such an easy ride? Many trials allowed that lack basic features for clear evidence of benefits or harms.
3. "Serious risks for few new benefits from FDA-approved drugs" That's what the FDA gives us.

Serious Risks and Few Benefits from FDA-Approved Drugs

Health Affairs Blog on how most drugs approved by FDA provide few advantages for patients but expose them to substantial risks.

The Risk Proliferation Syndrome behind Prescription Drugs

Pulls together the syndrome of practices, laws, and rules that are maximizing harmful side effects from new drugs that usually provide few or no off-setting benefits.

Presents evidence of an epidemic of adverse reactions that have made prescription drugs the 4th leading cause of death, tied with stroke. A major cause of hospitalizations, falls, and accidents.

The more drugs are marketed, the more diluted become their benefits but the more widespread become their harmful side effects.

Data Exclusivity with no benefits

A detailed account of extending data exclusivity without credible evidence it increases innovation. A costly protection from free-market competition

"Why do cancer drugs get such an easy ride?"

Rushed approvals result in a poor deal for both patients and cancer research. While regulators claim they approve major advances, independent evidence documents flawed, biased, and incomplete evidence so that no one can know if most help cancer patients. Accelerated reviews and easy-ride quasi-evidence reward more research for more drugs with little evidence of benefit.

Epidemic of Adverse Side-effects

Although prescription drugs are a major health hazard and leading cause of death, sociologists and epidemiologists fail to mention or study them. Lying at the intersection of medicine and health as an ironic perverse effect makes them particularly interesting

Review of Deadly Medicines And Organised Crime: How Big Pharma Has Corrupted Healthcare By Peter C. Gøtzsche

Describes this readable, deeply researched book by one of Europe's authorities on evidence about the effectiveness and risks of new drugs. Companies are organized and they commit crimes repeatedly; so aren't they like organized crime? Contrasts these practices with a model of ethical, open research, where no patents are pursued.


Senior oncologist, Hagop Kantarjian, and I show that very high prices for cancer & specialty drugs are not due to high costs of research, nor to added clinical value. Companies are simply spiraling up prices already 2-3 times what other capitalist countries allow, because we allow them to. High co-pays hurt patients and impede good clinical care.

Health Affairs review of PHARMAGEDDON

Insights in to how drug companies have been transforming illness, diagnosis, the role of doctors, and treatment, away from clinical pathology to risks by numbers.


"The Inverse Benefit Law"

The more widely a drug is marketed, the more diluted become its benefits but not its risk of harm. Types and examples given. Forthcoming in the American Journal of Public Health

"Foreign Free Riders drive up US drug Prices" - myth

Drug companies have been campaigning for years to persuade lawmakers and leaders that Europe and Canada are "free riders" that make Americans pay high prices to pay for research costs abroad. This article assembled evidence this is not true and that the free-rider argument itself makes little sense on products sold internationally.

Harvard Professors Violate Ethical Standards

Three Harvard professors violated nearly every standard when we questioned the Tufts-DiMasi high estimate of R&D costs.

Commercial influence on Medical Journal Editors

While medical journal editors work hard to minimize commercial bias in research articles that can threaten their reputation and trustworthiness, editors need to consider commercial influences on themselves, like revenues from reprints of positive results and advertising. These could be significantly reduced.

Global Drug Discovery: Europe is Ahead,” Health Affairs – web exclusive

This article takes industry data used by supported economists to "show" American dominance in R&D and shows that dollar for dollar the opposite is the case.

The quality of the data, however, is terrible; so who knows what the real story is? Yet major policies are decided on this terrible data and bias analysis.


Estimated Costs of R&D for Rotavirus Vaccines

Based on detailed construction of R&D costs, prices can be much lower than claimed


The political construction of a mythic tool for getting vaccines to the world's poor. How the G8 leaders were misled, based on grand claims. Ends by calling for designing advanced commitments to suit the situation and needs of key stakeholders, rather than staying wedded to a failed design.