Pharmaceutical innovations
Pharmaceutical innovations today are guided by patents, which give inventors exclusive rights for a set time. This system rewards patentable ideas and profits, but it doesn’t reliably drive faster or broader access to medicines for those who need them most.
R&D is very expensive. In 2014, about $140 billion was spent on pharmaceutical research and development, producing roughly 25–35 new drugs each year. Advances in technology speed up data analysis, but the process of testing and approving drugs remains long and costly.
Differences in health care can come from how quickly and widely new medicines are adopted. The industry often defines “innovative” mainly by whether a product is patentable, but real innovation should meet an unmet or inadequately met health need and improve outcomes that weren’t possible before.
Productivity in drug research has slowed, a trend sometimes called Eroom’s Law. There are efforts to speed things up: the FDA’s Breakthrough Therapy Designation aims to bring truly important new medicines to market faster.
Concerns about patents include that some “innovation” patents have a low bar for inventiveness. The Medicines Patent Pool (MPP) is a UN-backed program that helps improve access to affordable HIV medicines in developing countries by pooling patents so generic versions can be made and used in combination therapies.
Experts also look at how we measure innovation. Some propose separating novel, breakthrough ideas from incremental improvements. The Internal Rate of Return (IRR) is often used to gauge profitability, and some analyses have shown IRR slipping in recent years. Regulatory uncertainty can also slow down development.
The Health Impact Fund (HIF) is a proposed system that would pay for medicines based on the real health impact they achieve, incentivizing research and distribution where a drug would substantially reduce disease burden. It was proposed by researchers including Thomas Pogge and Aidan Hollis and is supported by Incentives for Global Health (IGH).
A consequence of a patent-heavy system is that money tends to flow toward patentable research and away from unpatentable ideas. In 2019, pharma invested billions in R&D, a gain for patented products but a potential miss for non-patented work.
Clinical trials add to the cost and risk of bringing a drug to market, which makes it hard to fund projects that aren’t patentable or highly profitable. Biologics and plant-based therapies also raise questions about what is patentable, and different countries have different rules.
A common pattern in drug development is: discover an interesting natural trait, verify it with experiments, isolate the active substance, modify it to create something new, patent the new substance, and then test it in trials. A well-known example is HAMLET, a complex derived from human breast milk that showed cancer-killing properties in the lab and led to patents and later trials; however, because breast milk itself isn’t patentable, funding for large-scale trials has been limited.
There are many natural compounds with potential medical value, like Aloe vera. While some studies suggest topical uses for burns, acne, psoriasis, and other conditions, not enough money goes into rigorous trials because the outcomes aren’t easily patentable or highly profitable.
In short, the current system shapes what kind of research gets funded. We can measure money spent and trial costs, but we can’t know exactly what amount would have been spent on unpatentable or less profitable work. The big question remains: could more unpatentable or non-profit-driven research unlock important health advances that patents alone don’t capture?
This page was last edited on 3 February 2026, at 00:25 (CET).