Interesting piece, but it contains a complete misunderstanding of advance market commitments (AMCs). Taxpayers *don't pay* if the drug isn't successful. That's literally the point. They pay if the drug passes predetermined criteria, e.g. safety & efficacy, and proportional to the volume produced. - ThreadSky

scientificdiscovery.dev • 74 days ago

Interesting piece, but it contains a complete misunderstanding of advance market commitments (AMCs).

Taxpayers *don't pay* if the drug isn't successful. That's literally the point.

They pay if the drug passes predetermined criteria, e.g. safety & efficacy, and proportional to the volume produced.

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beckya.bsky.social•72 days ago

A good rule of thumb is to totally ignore Ezra Klein these days

graemeedgeler.bsky.social•73 days ago

I think I saw Abundance as suggesting a governing strategy, rather than an electoral one.
Democrats govern a bunch of places, and will win election sometime. When they do, they should try to make government work and should be angry if it doesn't.

roguehci.bsky.social•74 days ago

Taxpayers do pay though. Unsuccessful development attempts are usually factored into approved drug pricing. Whoever pays this (taxpayers in insurance dominated systems or individuals out of their own pocket) may differ, but in the end, you need to be net positive as a company.

scientificdiscovery.dev•74 days ago

But that doesn't differ from the regular process of drug development, where the R&D costs are funded by the pharmaceutical company or academic research group etc. The issue is how AMCs as a funding model differ from that.

roguehci.bsky.social•74 days ago

Oh yes, no doubt. I just don't think there's ever a world where taxpayers don't pay. Be it directly or indirectly, somebody has to pay for unsuccessful rounds.

scientificdiscovery.dev•74 days ago

Yes, but the other issue is that AMCs involve an advance commitment to a low unit price after a drug passes the criteria

scientificdiscovery.dev•74 days ago

"Conservatives decry the usage of industrial policy to “pick winners and losers,” but this is literally the federal government taking a gamble on a new innovation to buy the product."

No, it's literally the opposite.

Rather than hoping to pick winners, funding is allocated only after success.

scientificdiscovery.dev•74 days ago

If you want to read about what advance market commitments actually are, and what problems they can help solve, I highly recommend this piece by Nan Ransohoff for Works in Progress:

scientificdiscovery.dev•74 days ago

I hope @iaristotleg.bsky.social will correct this.

iaristotleg.bsky.social•73 days ago

will fix, thx for letting me know! (should note that they envision AMCs beyond just drug discovery, for uses like making cement that’s better for the environment)

scientificdiscovery.dev•73 days ago

Great, thank you! Ah, useful to know. I don't know as much about how they're used in those settings, but my understanding is that it's only the commitment that's made in advance.

scientificdiscovery.dev•74 days ago

Perhaps the misunderstanding comes from the word "advance".

But this doesn't involve funding in advance, it involves committing in advance to funding in the future *if* the drug or product meets certain criteria.

scientificdiscovery.dev•74 days ago

AMCs differ from "pull funding", where governments, pharma companies, etc. fund research groups at the outset, not knowing which will succeed, and using high prices to recoup R&D costs.

Instead, AMCs are a fund for the drugs that succeed, and involve a commitment to a low price per-dose.

nmk.wtf•73 days ago

Aren't AMCs examples of "pull funding"? I thought funding R&D is "push funding". But I might be getting this wrong.

scientificdiscovery.dev•73 days ago

Kudos to @iaristotleg.bsky.social for making a correction on this

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