David Leonhardt had a column discussing overuse of expensive medical care in the NYT today. Remarkably, this discussion did not mention the effect of patents in complicated decisions on treatment and raising costs.
Patents are essential to this discussion for two reasons. First, drugs and medical tests that are very expensive are generally expensive because of government granted patent monopolies, not their inherent cost. For example, a new generation of cancer drugs that can cost tens of thousands per year would be relatively cheap in the absence of patent protection. These drugs were expensive to develop, but once they have been developed, the production is cheap. By forcing patients to pay the high patent protected price, an otherwise simple decision (use the cheap drug) can instead be made very complicated.
The other reason why patents play such an important role in this discussion is that they give a party (the patent holder) a huge stake in misrepresenting the issues. Because drug companies or makes of medical equipment stand to make patent rents on the use of their product, they have an enormous incentive to promote its use even in cases where it may not be appropriate. This can lead to overuse and misuse, especially since the patent holder has the most information on their product. They may conceal evidence that it is less beneficial than claimed or even that it is harmful.
This column is the sort of place where it would be expected that readers would find a serious discussion of the role of patents in complicating decisions on appropriate care. It is disappointing that this issue is not addressed.