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You’re right, I’m sorry for giving the impression that they would make 1,000 times as much money. It’s probably more like 10 times.

if we accept your reasoning, i.e, that Big Pharma prefers to treat rather than cure, then we wouldn’t have any cures at all, would we?

Not at all. They prefer to make money, and typically, but not always, a treatment is the better way to make money. But in the case of a virus, it’s usually practical to develop a vaccine. If they attempt only to find a mere treatment and no cure, they face the risk that a competitor will find a cure and win the market, since consumers obviously prefer cures over treatments. So I would expect a money-minded Big Pharma exec might, in that case, pursue both avenues, treatment and cure. If they find only one approach that works (whether it be treatment or cure), that’s what they will try to sell. If they find a treatment and a cure, then they’ll want to strategize: how likely is it that a competitor will find and sell a cure rather than a treatment? In the end, if their cost-benefit analysis shows the treatment route is likely to make more money, they’ll tend to ignore the cure and sell the treatment (perhaps in the U.S. they could get away with selling a cure at such a large markup that it costs as much as the treatment would have, but don’t most countries have some cost limits in place that would make treatments better in terms of overall revenue?) Edit: it occurs to me that for vaccines for dangerous but obscure diseases like Ebola, a vaccine is easily more profitable than a treatment because (1) you sell vaccines to people who don’t have the disease, which far outnumber victims, and (2) a treatment for a virus is only purchased as long as the body hasn’t cured the disease by itself. This doesn’t apply to something like HIV, of course, where the body will never cure the disease by itself.

On the other hand, if, as with cancer, if there’s an implicit understanding among all the companies that treatments are better than cures, we would expect them to work harder to find the former. Eventually cures may be found and sold, but more by accident than by design.

At least, that’s my mental model of Big Pharma. To show that this is not how it works, you’d have to show me that the chief executives care more about patients than about shareholders and their bottom line. Can you do that?

Edit: also, it’s not just about whether they spend more to search for treatments versus cures, but also about which diseases they attempt to cure. For instance, for Big Pharma, it is much better to treat erectile dysfunction than to treat or cure malaria, because victims of the latter tend to have dramatically less money. I’m not saying they would spend nothing at all on malaria research, just that they would spend less, because a smart businessman knows that small teams with a tight budget are sometimes very successful.

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